Classes :: class description :

Medical Billing

Course Objectives

Upon completion of this curriculum, the student will obtain the necessary knowledge and skill to perform the daily tasks of a medical biller in the healthcare industry.  This includes becoming proficient in the MediSoft software to submit claims, enter charges, record payments, and generate reports and statements, including diagnosis and procedural code reports.

Outline

Module 1: Introduction to computers in Medical Office

•  Flow of information

                        Dealing with providers and their staff
                        Gathering and Recording Patient Information

•   Role of computers in Medical Office

                        Scheduling Appointment
                        Canceling Appointment
                        Appointments, Tracking, Patient Follow up
                        Scheduling Applications

Module 2: Introduction to MediSoft

•     Introduction to MediSoft Patient Account Software

                        Entering patient information
                        Working with cases

•      Patient Transaction

                        Billing patients and filing insurance claims
                        Entering charge transaction
                        Entering payments and adjustments
                        Credit Cards, Bank payments

Module 3: Types of Insurance Companies

•        Types of insurance companies

                    HMO Medicare, Medicaid, Bluecross/Blueshield, Commercial Insurance,
                     Tricare, CHAMPVA and Worker’s Compensation.

•         Insurance Claim Processing

                        Managed Care contracts and private payers.
                        Medicare and Medicaid Claim Processing
                        Bluecross/Blueshield Claim Processing
                        Tricare and CHAMPVA Claim Processing
                        Worker’s compensation Claim Processing

Module 4: Medical Coding (1)

•         ICD-9-CM or Diagnosis Coding

                        Medical Terminology
                        What is ICD-9-CM Coding system
                        What are E & V codes

•           Diagnosis Reporting

How diagnosis codes affect reimbursement codes– how to report them the
            right way
            How to report "old" conditions and elective services
            Code complaints and symptoms, Identify carrier mandated ICD-9 codes

Module 5: Medical Coding (2)

•    CPT or Procedural Coding

                        Topic Discussion Medical Coding Procedures
                        Locate and select the correct code

•      Guidelines to Procedural Coding

Learn fragmentation and unbundling guidelines
            How to bill for services outside the surgical package
            How to properly report professional and technical components