The Medical Billing Specialist training series offers a detailed and comprehensive journey into the world of medical billing and ICD coding. Designed for both beginners and experienced professionals, this series covers essential topics such as ICD-9, ICD-10, and ICD-11 coding systems, medical terminology, anatomy, HIPAA compliance, and fraud prevention. Through a mix of theoretical knowledge and practical application, learners are equipped with the skills needed to navigate the complex healthcare billing landscape
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Certificate of Completion
A Medical Billing Specialist’s role, you will be working with ICD coding and the position encompasses a range of responsibilities integral to healthcare administration. Here are some of the responsibilities they may be expected to handle:
ICD Coding and Classification: Accurately classify and code medical diagnoses and procedures using the ICD-9, ICD-10, and ICD-11 coding systems, ensuring compliance with healthcare regulations and enabling effective billing processes.
Billing and Reimbursement: Prepare and submit billing claims to insurance companies, ensuring that each claim is accurate, compliant, and submitted in a timely manner. Follow up on unpaid claims and handle billing disputes.
Medical Records Management: Maintain and manage patients’ medical records, ensuring that they are complete, accurate, and compliant with HIPAA and other privacy laws. This includes updating records with the latest diagnoses and procedures.
Compliance and Ethics: Adhere to HIPAA regulations and stay vigilant against fraud and abuse in medical billing. Implement and monitor compliance with ethical standards and legal requirements in the billing process.
Insurance and Claims Processing: Liaise with insurance companies to verify patient coverage and understand insurance contract specifics. Work on claims denials, providing necessary documentation to ensure maximum reimbursement for services rendered.
Patient Communication: Communicate with patients regarding their bills, explaining charges, and answering questions about insurance claims and payments. Provide information on payment plans and financial assistance programs if necessary.
Data Entry and Accuracy: Enter data into billing software accurately and efficiently. Ensure that all numerical and coded data in the healthcare billing system is correct to prevent errors in billing and insurance claims.
Reporting and Documentation: Generate financial and billing reports, documenting claims status, payments, denials, and outstanding balances. Use these reports to identify trends and areas for improvement in the billing process.
Continuous Education: Keep up-to-date with the latest changes in billing codes, insurance policies, and healthcare regulations. Attend training sessions and seminars related to medical billing and coding.
Team Collaboration: Work closely with healthcare providers, coding specialists, and other administrative staff to ensure a streamlined and effective billing process. Collaborate on complex cases to determine appropriate billing and coding strategies.
A Medical Billing Specialist is expected to possess a thorough understanding of medical terminology, coding systems, and billing practices, serving as a crucial link between healthcare providers, patients, and insurance companies.
Lesson 3 - Medical Terminology
Medical Terminology
Lesson 2 - Anatomy Physiology
Anatomy
Anatomic Organ Systems
Lesson 4 - Introduction to ICD-9-cm
Introduction To ICD-9-Part 1
Introduction To ICD-9-Part 2
Introduction To ICD-9-Part 3
Introduction To ICD-9-Part 4
Introduction To ICD-9-Part 5
Introduction To ICD-9-Part 6
Introduction To ICD-9-Part 7
Diagnostic Procedures
Coding And Reporting Guidelines-Part 1
Coding And Reporting Guidelines-Part 2
Coding And Reporting Guidelines-Part 3
Lesson 5 - Application of ICD-9-cm (Ch 1-9)
Application Of ICD-9-CM
Caution
Neoplasms
Other Metabolic And Immunity Disorders Section
Hypertensive Heart And Chronic Kidney Disease
Lesson 7 - Introduction to ICD-10-CM
Overview Of ICD-10-CM
Lesson 1 - Introduction to CPT and HCPCS
Introduction To CPT And Level II National Codes-HCPCS
CMS-1500 Form
Categorized By
Category I Codes
Format
Lesson 2 - Evaluation and Management (E/M)
Evaluation And Management-Part 1
Evaluation And Management-Part 2
Nature Of Evaluation And Management Services
Example Of HPI
Review Of Systems
E And M Documentation Guidelines
E And M Exam-Part 1
E And M Exam-Part 2
Exam
Medical Decision Making
Number Of Diagnoses Or Treatment Options
Amount And Or Complexity Of Data Reviewed
Nature Of Presenting Problem
E And M Documentation-Level Based On TIme
Hospital E And M Codes
Subsequent Visits
InitialInpatient Services
ProlongedServices
Modifiers
Lesson 3 - Surgery, Integumentary system, Anesthesia & Modifiers
Anesthesia
Physical Status Modifiers
Medicare Policy
Surgical Guidelines
58 Staged Or Related Procedure
Modifier 52-Reduced Services
Ancillary Modifiers
Integumentary System
Morphology
Integumentary-Nails
Integumentary-Introduction
Clinical Scenario
Mohs Micrographic Surgury
Lesson 4 - Musculoskeletal
Musculoskeletal System
Rheumatism
Endoscopy And Arthroscopy
Lesson 5 - Respiratory and Cardio
Respiratory System
Endoscopy
Mediastinum And Diaphragm
Circulatory Systems
Associated Diagnosis
Pacemaker Or Pacing Cardioverter-Defibrillator
CABG
Bypass Grafts
Selective Catheterization
Endovascular Revascularization
Coronary Therapeutic Services And Procedures
Intracardiac Electrophysiological Procedures And Studies
Lesson 6 - Female Genital System, Maternity Care and General Surgery
Hemic And Lymphatic Systems
Female Genitourinary And Maternity Care
Ultrasound
Male Genitourinary
Bladder
Eyes
Ears
Digestive System Terms
Digestive Procedures
Endocrine And Nervous System
Nervous System-Part 1
Nervous System-Part 2
Nervous System-Part 3
Lesson 9 - Medicine
Medicine
Chemotherapy
Category III Codes
Conclusion
Lesson 1 - Introduction to Reimbursement
Intro
Medicare-PartB
Fraud And Abuse
Lesson 7 - Radiology
Radiology
Modifiers
Diagnostic Ultrasound
Radiation Treatment Management
Lesson 8 - Pathology
Regulatory Terms
Urinalysis
Lesson 6 - Application of ICD-9-cm (Ch 10-19)
Diseases Of The Genitourinary System
Diabetes Mellitus In Pregnancy
Diseases Of Musculoskeletal SystemAnd Connective Tissue
Burns
Adverse Effects Poisoning And Toxic Effects
Module 1: Certain Infectious and Parasitic Diseases
Intro
Certain Infectious And Parasitic Diseases
Module 2: Neoplasm
Neoplasm
Module 3: Diseases of the Blood and Blood Forming Organs
Diseases Of The Blood And Blood Forming Organs
Module 4: Endocrine, Nutritional and Metabolic Diseases
Endocrine Nutritional And Metabolic Diseases
Module 5: Mental Disorders
Mental Disorders
Module 6: Diseases of the Nervous System
Disesases Of The Nervous System
Module 7: Diseases of the Eye and Adnexa
Diseases Of The Eye And Adnexa
Module 8: Diseases of the Ear and Mastoid Process
Diseases Of The Ear And Mastoid
Module 9: Diseases of the Circulatory System
Diseases Of The Circulatory System
Module 10: Diseases of the Respiratory System
Diseases Of The Respiratory System
Module 11: Diseases of the Digestive System
Diseases Of The Digestive System
Specific Coding Exercises
Module 12: Diseases of the Skin and Subcutaneous Tissue
Diseases Of The Skin And Subcutaneous Tissue
Module 13: Diseases of the Musculoskeletal System and Connective Tissue
Diseases Of The Musculoskeletal System And Connective Tissue
Module 14: Diseases of the Genitourinary System
Diseases Of The Genitourinary System
Module 15: Pregnancy, Childbirth, and the Puerperium
Pregnancy Childbirth And The Puerperium
Module 16: Newborn (Perinatal) Guidelines
Newborn Perinatal Guidelines
Module 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
Congenital Malformations Deformations And Chromosomal Abnormalities
Module 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings
Symptoms Signs And Abnormal Clinical And Laboratory Findings
Module 19: Injury, Poisoning and Certain Other Consequences of the External Causes
Injury Poisoning And Certain Other Consequences Of The External Causes
Specific Coding Questions
Module 20: External Causes of Morbidity
External Causes Of Morbidity
Module 21: Factors Influencing Health Status
Factors Influencing Health Status
Case Study 1 And 2
Outro
Module 1: Anatomy
Module 1 Workbook
1.1 Introduction
1.2 Human Body
1.3 Skin
1.4 Bones, Muscles and Joints
1.5 Heart and Blood Vessels
1.6 Lungs
1.7 Stomach, Intestines and Colon
1.8 Kidney, Bladder, Prostate and More
1.9 Uterus, Ovaries and Female Parts
1.10 Eye
1.11 Glands
1.12 Ear, Nose and Throat
1.13 Blood
1.14 Immune
1.15 Brain and Spinal Cord
Module 2: Diagnosis Coding
Module 2 Workbook
2.1 Overview of ICD
2.2 Outpatient Guidelines
2.3 Infectious and Parasitic
2.4 Neoplasms
2.5 Diseases of the Blood and Blood Organs
2.6 Endocrine, Nutritional and Metabolic Diseases
2.7 Mental and Behaviroal Health
2.8 Pregnancy, Childbirth and the Puerperium
2.9 Conditions Originating in Perinatal Period
2.10 Symptoms, Signs and Abnormal Clinical and Laboratory Findings
2.11 Injury, Poisoning and Certain Other External Causes
2.12 Diseases of the Skin and Subcutaneous Tissue
2.13 External Causes of Morbidity
2.14 Factors Influencing Health
2.15 Circulatory System
2.16 Eye
2.17 Respiratory
2.18 Digestive
Module 3: Procedure Coding
Module 3 Workbook
3.1 Evaluation and Management part 1
3.1 Evaluation and Management part 2
3.1 Evaluation and Management part 3
3.1 Evaluation and Management part 4
3.2 Anesthesia
3.3 Modifiers
3.4 Surgery part 1
3.4 Surgery part 2
3.4 Surgery part 3
3.5 Radiology
3.6 Pathology
3.7 OB/GYN
3.8 Physical Medicine part 1
3.8 Physical Medicine part 2
3.9 HCPCS
3.10 Diving Into Coding part 1
3.10 Diving Into Coding part 2
3.10 Diving Into Coding part 3
3.11 NCCI, MUE and GME
3.12 CAT Codes
Module 4: Billing Guidelines and Practices
Module 4 Workbook
4.1 HIPAA, Compliance and Reimbursement part 1
4.1 HIPAA, Compliance and Reimbursement part 2
4.1 HIPAA, Compliance and Reimbursement part 3
4.1 HIPAA, Compliance and Reimbursement part 4
4.2 The Next Steps
Module 1: HIPAA and Privacy
HIPAA and Privacy
Security, Safeguards, and Controls
Examples and Cases
Module 2: Fraud, Waste, and Abuse
Fraud, Waste, and Abuse
Case Examples and Law
Module 3: Compliance and Prevention
Compliance and Prevention
The Medical Billing Specialist training series is a comprehensive educational program designed to equip learners with the essential skills and knowledge required in the field of medical billing and coding. This series encompasses a range of courses, each focusing on different yet interconnected aspects of medical billing, ensuring a well-rounded and thorough understanding of the profession. Starting with the foundational principles of medical terminology and anatomy in the “Medical Coding and Billing ICD-9” course, students gain a solid grounding in the language and structure of the human body, which is crucial for accurate coding and billing.
As the series progresses, learners are introduced to the intricacies of the ICD-10 coding system in the “Medical Coding and Billing ICD 10” course. This segment delves deeper into the complexities of coding medical diagnoses and procedures, providing students with the tools to navigate the nuanced world of healthcare coding standards. The course is meticulously structured to ensure learners are well-versed in the latest coding practices, preparing them for real-world challenges in medical billing.
The training further advances with the “ICD 10 & 11 Medical Coding and Billing” course, which brings students up-to-date with the newest developments in the field, including the transition to ICD-11. This course is particularly valuable for those looking to stay ahead in the rapidly evolving landscape of medical billing and coding. It not only reinforces previous learning but also introduces forward-thinking concepts and practices that are becoming increasingly relevant in the healthcare industry.
In addition to the technical aspects of coding and billing, the series places a strong emphasis on legal and ethical considerations in the “HIPAA, Fraud, and Abuse” course. This crucial component of the training educates students on the importance of compliance with healthcare laws and regulations, particularly HIPAA, and the detection and prevention of fraud and abuse in medical billing. The course aims to instill a strong ethical framework in students, ensuring they are not only skilled in the technicalities of the job but also in upholding the highest standards of professional integrity.
Overall, the Medical Billing Specialist training series offers a detailed, practical, and ethically grounded educational experience, setting up aspiring medical billing professionals for a successful and fulfilling career in this vital sector of healthcare administration.
The Medical Billing Specialist training series is designed to cater to a diverse group of individuals who are either looking to enter or enhance their skills in the field of medical billing and coding. Here are some of the people who might benefit from this training:
The versatility of this training series makes it suitable for a wide range of professionals and individuals interested in the field of medical billing and coding, offering them the opportunity to develop or enhance skills that are highly valued in the healthcare industry.
Medical coding and billing involves translating healthcare services, procedures, diagnoses, and equipment into universal medical alphanumeric codes. A Medical Coding and Billing Specialist is responsible for accurately coding medical records and processing insurance claims, ensuring healthcare providers are reimbursed for their services.
To become a Medical Coding and Billing Specialist, individuals typically need to complete a specialized training program or a certification course. These programs often cover medical terminology, anatomy, and various coding systems like ICD-9, ICD-10, and CPT. Some roles may require an associate degree or a professional certification.
While not always mandatory, certification can enhance job prospects and credibility in the field. Certifications like the Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) are obtained through accredited organizations, such as the AAPC or AHIMA, often after passing a comprehensive exam.
Yes, many Medical Coding and Billing Specialists have the option to work remotely, thanks to digital health records and online coding systems. Remote work arrangements depend on the employer’s policy and the nature of the specific role within the organization.
Experienced specialists can advance to supervisory or managerial roles, become auditors, consultants, or educators in the field. Continuous education and additional certifications, such as specializing in a particular area of coding, can further enhance career prospects.
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Smooth delivery and easy access to LMS. Good to see that the LMS offers progress tracking. Would be great if badges were offered on completion of courses to share via Credly to future employers.