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Medical Billing Course
1459 Upper Middle Creek
Sevierville, TN 37876
(865) 286-9124


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Course Outline by Chapters
Chapter 1: Introduction to Medical Billing
  • About Medical Billing

  • The Basics Overview
     - Gathering & Entering Data
     - Paper Claims Processing
     - Electronic Claims Processing
     - Posting Payments
     - Generating Reports
     - Billing Your Clients

  • Types of Insurance Coverage
    -  Group Health
    -  Individual Policies
    -  Medicare
    -  Medicaid
    -  Personal Injury (PIP)
    -  Workers Compensation
    -  Tricare

  • Procedures and Diagnoses

  • Insurance Claim Processing

  • Claim Payment

  • Report Generation

  • Clickable Internet Resources

  • Study Guide

  • Chapter 1 Examination

Chapter 2: Understanding Office Forms
  • Essential Office Forms
     - Patient Demographic Form and Completion
     - Insurance Cards
     - Insurance Verification Form and Verification Procedures
     - Superbill
     - Daysheet

  • Examining Insurance Cards

  • Insurance Verification Process

  • Mock Insurance Verification Conversations

  • Insurance Verification Exercises

  • The Superbill/Encounter Document

  • Calculating Copayments & Deductibles

  • Clickable Internet Resources

  • Study Guide

  • Chapter 2 Examination

Chapter 3: Understanding the CMS 1500 Form
  • The Basics of the CMS 1500 Form

  • Box by Box Breakdown of the CMS 1500 Form

  • Step-By-Step Instructions for Completing a CMS 1500

  • Online CMS Form Completion Exercises

  • Billing Tips

  • Commonly Made Errors

  • Clickable Internet Resources

  • Study Guide

  • Chapter 3 Examination

Chapter 4: Understanding Codes
  • CPT (Current Procedural Technology) Coding
     - Definition
     - Proper Usage
     - Resource & Reference Material

  • ICD (International Classification of Disease) Coding
     - Definition
     - Proper Usage
     - Resource & Reference Material

  • Clickable Internet Resources

  • Study Guide

  • Chapter 4 Examination

Chapter 5:  The Life Cycle of an Insurance Claim
  • The Time-Line of an Insurance Claim

  • The Collection of Claim Data
    Patient Demographics
    - Guarantor Information & Handling
    - Insurance Coverage Information
    - Patient Condition Information
    - Patient Treatment Information
    - Clinic Billing Information

  • Claim Information Data Entry

  • Claim Submission
     - Paper Claims
     - Electronic Claims
     - Secondary Claims
     - Claims Attachments

  • Receiving & Posting Payments
     - Full Payment
     - Partial Payment
     - Deductible

  • Clickable Internet Resources

  • Study Guide

  • Chapter 5 Examination

Chapter 6:  Working with Billing/Practice Management Software
  • Basic Components of Billing Applications

  • Clinic Data
    -
    Billing Identification Numbers

  • Physician Data
    - Tax ID, UPIN, License Numbers
    - Assignment

  • Patient Data
     - Demographics Information
     - Insurance Information
     - Procedure Information
     - Diagnosis Information

  • Claim Generation
    -
    Charge Entry
    - Payment Entry
    - Financial Adjustments
    - Transaction Notes

  • Electronic & Paper Claims

  • Report Generation

  • Clickable Internet Resources

  • Study Guide

  • Chapter 6 Examination

Chapter 7:  Medical Billing/Practice Management Software Application

You will receive DAQbilling® Medical Billing Software for training, a software training workbook, a mock data manual for data entry and CMS 1500 forms.

This chapter is quite comprehensive and will have you actually entering data, generating claims, posting payments, running reports, etc.  These are considered the "daily operations" of a medical billing center.

  • Study Guide

  • Chapter 7 Examination

Chapter 8:  Operating a Medical Billing Business
  • Naming Your Business

  • Setting Up Your Business
    -
    Writing a Business Plan
    - Pricing Your Services

  • Office Equipment & Essentials

  • Services You Can Provide

  • Transferring of Data

  • Relationship Selling

  • Steps to Writing a Proposal

  • Clearinghouse Selection

  • Attorney & Accountant Services

  • Financing Your Business

  • Legal Structure
    - Sole Proprietorship
    - General Partnership
    - Corporation
    - Limited Liability Corporation

  • Clickable Internet Resources

  • Study Guide

Chapter 9:  Marketing Your Medical Billing Business
  • Promoting Your Business

  • Advertising that Sells
    - Attention
    - Interest & Desire
    - Action

  • The Benefits of Selling Benefits

  • Targeting Specialties

  • Your Market

  • Revenue Enhancement

  • Sample Documents
     - brochures, flyers, post-cards, letters, contracts

  • Clickable Internet Resources

Chapter AC1: Understanding HIPAA
  • Introduction to HIPAA
    - Health Insurance Portability
    - Accountability
    - Administrative Simplification
  • Transactions & Code Sets Standards
  • Unique Identifier Standards
  • Security & Electronic Signature Standards
  • Implementation Specifications
  • Administrative Safeguards
  • Physical Safeguards
  • Technical Safeguards
  • Privacy & Confidentiality
    - Consumer Control
    - Boundaries: Medical Records
    - Security of PHI
    - Accountability: Medical Records
    - Public Responsibility
  • Consent and Authorizations
  • Marketing & Fundraising
  • De-identification
  • Business Associates
  • Penalties for Non-Compliance
  • Clickable Internet Resources
  • Study Guide
  • HIPAA Examination
  • Certificate of Course Completion
Chapter AC2: Calculating Copayments & Deductibles
  • 100 Copayment & Deductibles Problems & Answers
Chapter AC3:  Understanding Workers' Compensation
  • Introduction to Workers Compensation
    - Medical Claims
    - Temporary Disability
    - Permanent Disability
    - Vocational Rehabilitation
    - Survivor Benefits
  • Federal Workers Compensation Overview & Claim Filing
  • State Workers Compensation Overview & Claim Filing
  • First Report of Injury
  • CMS 1500 Completion for Workers Compensation Claims
    - Box by Box Instruction
  • Appeals & Adjudication
  • Fraud & Abuse
  • Tips for Successful Workers Compensation Claim Filing & Handling
  • Glossary of Workers Compensation Terms
  • Clickable Internet Resources
  • Study Guide