MyCAA-APPROVED HEALTHCARE COURSE

MEDICAL BILLING & CODING

Physician practices, hospitals, pharmacies, long-term care facilities, chiropractic practices, physical therapy practices, and other healthcare providers all depend on medical billing and coding for insurance carrier reimbursement.

CERTIFICATION: NHA-CBCS

PROGRAM COSTS: Varies

COURSE CONTACT HOURS: 375

PROGRAM DURATION: 4 Months

EXTERNSHIP AVAILABLE: Yes

The Medical Billing & Coding Profession

Medical billing and coding is one of the fastest-growing careers in the healthcare industry today! The need for professionals who understand how to code healthcare services and procedures for third-party insurance reimbursement is growing substantially. Physician practices, hospitals, pharmacies, long-term care facilities, chiropractic practices, physical therapy practices, and other healthcare providers all depend on medical billing and coding for insurance carrier reimbursement. The medical industry will have almost 50% more jobs available by 2018; therefore, a surplus of medical facilities will continue to hire candidates who specialize in medical billing and coding.

The Medical Billing & Coding Program

This billing and coding course offers the skills needed to perform complex coding and billing procedures. The course covers: CPT (Introduction, Guidelines, Evaluation and Management), specialty fields (such as surgery, radiology and laboratory), ICD-9 (Introduction and Guidelines) and basic claims processes for insurance reimbursements.

This billing and coding program delivers the skills students need to solve insurance billing and coding problems. It details proper assignment of codes and the process to file claims for reimbursement. This course covers the following key areas and topics:

  • An overview of healthcare and the insurance industry
  • The organization and use of the ICD-9-CM, CPT, and HCPCS manuals to identify correct codes
  • Detailed review and practice using the alphabetic index and tabular list of the ICD-9-CM
  • Detailed review and practice coding examples from all sections within the CPT
  • Basic claims processes for medical insurance and third-party reimbursements
  • Completing common insurance forms, tracing delinquent claims, and appealing denied claims

Detailed Course Information

  • Introduction to International Classification of Diseases, Clinical Modifications and Coding Guidelines
  • Introduction to the organization and use of the ICD-9-CM and CPT manuals
  • Basics of diagnostic and procedural coding
  • The Health Insurance Claim Form (CMS 1500)
  • HIPAA and Electronic Data Interchange (EDI)
  • Review and practice coding Evaluation and Management (E&M) services
  • Review and practice coding from anesthesia, surgery, radiology, medicine, and the pathology/laboratory sections of the CPT
  • CPT Modifiers, E and V Codes, and Late Effects
  • Coding surgical procedures of the integumentary system
  • Coding surgical and medical procedures of the cardiovascular system
  • Coding procedures related to the female genital system and maternity care and delivery
  • Coding for general surgery, radiology, pathology and laboratory services
  • Coding for diagnostic and therapeutic services and the Level II National Codes
  • Tracing delinquent claims and insurance problem solving
  • Third-party reimbursement issues

Education and Certifications

  • Students should have or be pursuing a high school diploma or GED.
  • Numerous national certification exams are available for students who complete this course including American Academy of Professional Coders (AAPC), American Health Information Association (AHIMA) and others.
  • Certain national certification organizations suggest 6 months to 2 years of practical work experience prior to pursuing certain national certification exams.

Technical Requirements

WINDOWS USERS

  • Windows 7, XP or Vista
  • 56K modem or higher
  • Soundcard & Speakers
  • Firefox, Chrome or Microsoft Internet Explorer

MAC OS USERS

  • Mac OS X or higher (in classic mode)
  • 56K modem or higher
  • Soundcard & Speakers
  • Apple Safari

SUPPORTED BROWSERS

System will support the two latest releases of each browser. When using older versions of a browser, users risk running into problems with the course software.

  • Windows Users: Firefox, Chrome, Explorer
  • Mac OS Users: Safari, Chrome, Firefox

SCREEN RESOLUTION

We recommend setting your screen resolution to 1024 x 768 pixels.

SUGGESTED PLUGINS

  • Flash Player
  • Real Player
  • Adobe Reader
  • Java

U.S. Department of Labor

Career Information

The information below provides helpful job information, statistics and projections for this program’s related career tracts.

Career Median Salary Job Openings Growth Rate
Billing, Cost, and Rate Clerks $36,150 59,600 10% to 14%

Description

Compile data, compute fees and charges, and prepare invoices for billing purposes. Duties include computing costs and calculating rates for goods, services, and shipment of goods; posting data; and keeping other relevant records. May involve use of computer or typewriter, calculator, and adding and bookkeeping machines.
Job Titles Include
Accounting Assistant, Accounting Clerk, Accounts Payable Clerk, Accounts Receivable Clerk, Administrative Assistant, Biller, Billing Clerk, Billing Coordinator, Billing Specialist, Office Manager

Wages

Bottom 15% Median Salary Top 10%
United States $22,450 $36,150 $52,150

Employment

current employment 2016 projected job openings 2016 - 2026 projected growth 2016 - 2026
United States 501,000 59,600 10% to 14%

typical tasks

  • Verify accuracy of billing data and revise any errors.
  • Prepare itemized statements, bills, or invoices and record amounts due for items purchased or services rendered.
  • Perform bookkeeping work, including posting data or keeping other records concerning costs of goods or services or the shipment of goods.
  • Operate typing, adding, calculating, or billing machines.
  • Answer mail or telephone inquiries regarding rates, routing, or procedures.
  • Resolve discrepancies in accounting records.
  • Type billing documents, shipping labels, credit memorandums, or credit forms, using typewriters or computers.
  • Contact customers to obtain or relay account information.
  • Review documents such as purchase orders, sales tickets, charge slips, or hospital records to compute fees or charges due.
  • Keep records of invoices and support documents.
  • Consult sources such as rate books, manuals, or insurance company representatives to determine specific charges or information such as rules, regulations, or government tax and tariff information.
  • Update manuals when rates, rules, or regulations are amended.
  • Track accumulated hours and dollar amounts charged to each client job to calculate client fees for professional services, such as legal or accounting services.
  • Compute credit terms, discounts, shipment charges, or rates for goods or services to complete billing documents.
  • Review compiled data on operating costs and revenues to set rates.
Bill and Account Collectors $35,350 30,200 -2% or lower

Description

Locate and notify customers of delinquent accounts by mail, telephone, or personal visit to solicit payment. Duties include receiving payment and posting amount to customer's account; preparing statements to credit department if customer fails to respond; initiating repossession proceedings or service disconnection; and keeping records of collection and status of accounts.
Job Titles Include
Account Representative, Accounts Receivable Specialist, Biller, Collections Manager, Collector, Credit Clerk, Debt Collector, Patient Access Specialist, Patient Account Representative, Telephone Collector

Wages

Bottom 15% Median Salary Top 10%
United States $23,620 $35,350 $54,970

Employment

current employment 2016 projected job openings 2016 - 2026 projected growth 2016 - 2026
United States 306,000 30,200 -2% or lower

typical tasks

  • Arrange for debt repayment or establish repayment schedules, based on customers' financial situations.
  • Locate and notify customers of delinquent accounts by mail, telephone, or personal visits to solicit payment.
  • Advise customers of necessary actions and strategies for debt repayment.
  • Persuade customers to pay amounts due on credit accounts, damage claims, or nonpayable checks, or to return merchandise.
  • Confer with customers by telephone or in person to determine reasons for overdue payments and to review the terms of sales, service, or credit contracts.
  • Locate and monitor overdue accounts, using computers and a variety of automated systems.
  • Answer customer questions regarding problems with their accounts.
  • Record information about financial status of customers and status of collection efforts.
  • Trace delinquent customers to new addresses by inquiring at post offices, telephone companies, credit bureaus, or through the questioning of neighbors.
  • Sort and file correspondence and perform miscellaneous clerical duties, such as answering correspondence and writing reports.
  • Perform various administrative functions for assigned accounts, such as recording address changes and purging the records of deceased customers.
  • Receive payments and post amounts paid to customer accounts.
  • Contact insurance companies to check on status of claims payments and write appeal letters for denial on claims.
  • Notify credit departments, order merchandise repossession or service disconnection, and turn over account records to attorneys when customers fail to respond to collection attempts.
  • Negotiate credit extensions when necessary.
Medical Records and Health Information Technicians $38,040 15,800 10% to 14%

Description

Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system. Process, maintain, compile, and report patient information for health requirements and standards in a manner consistent with the healthcare industry's numerical coding system.
Job Titles Include
Coder, Health Information Clerk, Health Information Specialist, Health Information Technician (Health Information Tech), Medical Records Analyst, Medical Records Clerk, Medical Records Coordinator, Medical Records Director, Medical Records Technician (Medical Records Tech), Registered Health Information Technician (RHIT)

Wages

Bottom 15% Median Salary Top 10%
United States $25,070 $38,040 $62,840

Employment

current employment 2016 projected job openings 2016 - 2026 projected growth 2016 - 2026
United States 206,000 15,800 10% to 14%

typical tasks

  • Protect the security of medical records to ensure that confidentiality is maintained.
  • Review records for completeness, accuracy, and compliance with regulations.
  • Retrieve patient medical records for physicians, technicians, or other medical personnel.
  • Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.
  • Process patient admission or discharge documents.
  • Transcribe medical reports.
  • Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings.
  • Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.
  • Identify, compile, abstract, and code patient data, using standard classification systems.
  • Release information to persons or agencies according to regulations.
  • Plan, develop, maintain, or operate a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information.
  • Prepare statistical reports, narrative reports, or graphic presentations of information, such as tumor registry data for use by hospital staff, researchers, or other users.
  • Manage the department or supervise clerical workers, directing or controlling activities of personnel in the medical records department.
  • Post medical insurance billings.
  • Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.

U.S. Department of Labor

Career Information

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-Rita, NAS JRB Fort Worth

 

"I had someone there every step of the way. They walked me through what could have been a very stressful process. It put me on a path that started an epic journey."

-Kasey, Fort Riley

"Everything was easy and my advisor with The Major Group walked me through it all. This was my third time going to college and by far the least stressful enrollment process."

-Felicia, Ft. Campbell

"I loved the whole process. Everyone was very helpful and made sure that the program I wanted to join was something I wanted to do. It also helped me put my goals in place."

-Crystal, Fort Riley

"There was a lot of help along the way, which was great. It was smooth and everything went well."

-Elizabeth, Fort Gordon

"It was easy, simple, and quick. There was someone there every step of the way to help you fill out all the required documents. I would recommend to all military spouses who want to go to school, especially if you’re a stay-at-home spouse."

-Aeisha, Hunter Army Air Field

"Everything was very easy to do and got done rather quickly from start to finish."

-Anne, Schofield Barracks, Hawaii

"The enrollment process was quick and easy. Lots of help when needed."

-Rita, NAS JRB Fort Worth

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Military Spouse Employment Partnership Logo Military Spouse Mentor Logo National Military Family Association Logo Hiring Our Heroes Logo USA Cares Logo

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