Medical Billing and Coding Career Prep Complete is a growing career field with numerous job opportunities. This course combines the basics of medical coding, medical billing, and medical terminology to provide a comprehensive program that will prepare you to work as a Medical Coding and Billing Specialist in a professional medical office. In this course, you will learn about the necessary medical terminology, insurance guidelines and compliance requirements, medical billing functions, and legal and ethical issues. Upon completion of this course, you will be fully prepared to begin working in a professional medical office. Students will be prepared to take the NHA Billing and Coding Specialist Certification (CBCS) national certification exam.
Delivery: Live Online, Instructor Led
160 Hours: 100 hours synchronous learning / 60 hours online learning
PREREQUISITES
Student must have a high school diploma, GED, or other higher education degree.
NOTICE
It is common for employers to require a background check before hiring a Medical Coding and Billing Specialist. This is because these professionals handle sensitive patient information, including medical records and billing details, which are protected under laws like the Health Insurance Portability and Accountability Act (HIPAA). Employers want to ensure that candidates have a clean legal record and are trustworthy when working with confidential data.
The background check may include:
- Criminal history check: To ensure there are no criminal records that could pose a risk in handling sensitive information.
- Verification of education and credentials: To confirm that the candidate has the necessary qualifications and certifications.
- Employment history verification: To check previous work experience.
- Credit check: In some cases, employers may also conduct a credit check, especially if the role involves financial responsibilities.
The exact requirements can vary depending on the employer and state regulations.
TUITION COST: $3,989
includes Book/s, Materials, and Exam Voucher
CERTIFICATION
Students will be prepared to take the NHA Billing and Coding Specialist Certification (CBCS) national certification exam.
Topics Covered:
- Describe the role of the Certified Medical Billing Specialist
- Describe the origin of medical language.
- Analyze the component parts of a medical term.
- List and define basic prefixes, suffixes, and combining forms.
- Use basic prefixes, suffixes, and combining forms to build medical terms.
- Explain common rules for proper medical term formation, pronunciation, and spelling.
- Assess the responsibilities assigned to insurance billing and coding specialists and electronic claims processors.
- Describe the health care delivery system.
- Explain the responsibilities of the billing and coding specialist to protect patient rights under HIPAA.
- Demonstrate a basic understanding of the anatomy and physiology of body systems and related medical terminology in order to properly process clean claims.
- Utilize the ICD‐9-CM manual, including V codes, E codes, and the Neoplasm and Hypertension tables.
- Demonstrate a basic understanding of the ICD-10-CM and ICD-10-PCS
- Utilize the CPT manual and the various guidelines.
- Demonstrate diagnostic and procedural coding.
- Describe basic guidelines for submitting insurance claims.
- Explain the difference between clean, pending, rejected, incomplete, and invalid claims.
- Identify solutions for denied and rejected paper and electronic claims.
- Identify when a paper claim can and cannot be used.
- Explain the relationship of transactions and security with electronic data.
- Communicate (verbally and non‐verbally) effectively and appropriately in the workplace
Modules:
- Role of an Insurance Billing Specialist
- Privacy, Security, and HIPAA
- Compliance, Fraud, and Abuse
- Basics of Health Insurance & The Blue Plans, Private Insurance, and Managed Care Plans
- Medicare
- Medicaid and Other State Programs & TRICARE and Veterans Health Care
- Workers Compensation
- Disability Income Insurance and Disability Benefit Programs & Medical Documentation and the Electronic Health Record
- Diagnostic Coding
- Procedural Coding & The Paper Claim CMS-1500
- The Electronic Claim
- Receiving Payments and Insurance Problem Solving & Collection Strategies
- Ambulatory Surgery Center
- Hospital Outpatient and Inpatient Billing & Seeking a Job and Attaining Professional Advancement
- Midterm
- Reimbursement, HIPAA, and Compliance
- An Overview of ICD-10-CM
- ICD-10-CM Outpatient Coding and Reporting Guidelines & Using ICD-10-CM
- Specific Guidelines (ICD-10-CM Chapters 1-10)
- Specific Guidelines (ICD-10-CM Chapters 11-14)
- Chapter-Specific Guidelines (ICD-10-CM Chapters 15-21)
- Introduction to CPT
- Introduction to the Level II National Codes (HCPCS) & Modifiers
- Evaluation and Management EM Services & Anesthesia
- Surgery Guidelines and General Surgery & Integumentary System
- Musculoskeletal & Respiratory System
- Cardiovascular System & Hemic, Lymphatic, Mediastinum, and Diaphragm
- Digestive System & Urinary and Male Genital Systems
- Reproductive, Intersex Surgery, Female Genital System, Maternity Care and Delivery &Endocrine and Nervous Systems
- Eye, Ocular Adnexa, Auditory, and Operating Microscope & Radiology
- Pathology Laboratory & Medicine
- Inpatient Coding
- Final Exam
Instructional Strategies:
- Lecture
- Skills Demonstration
- Group Activities
- Individual Activities
Methods of Evaluation:
- Quizzes/Exams
- Written Assignments
- Skills Demonstration
Grading System:
Student must pass all quizzes, exams, and national exam (if applicable) at a passing rate to be eligible for a Certificate of Training Completion. If an internship is included in your course you will be required to complete the internship prior to receiving a Certificate of Training Completion.
ATTENDANCE
Students are expected to arrive on time and participate in course discussions and activities. Successful completion of the course of study recommends 100% attendance. If during the course period the student’s attendance level drops below 80%, they will be encouraged and given the opportunity to attend the next scheduled class for the course they enrolled in. Should materials change, student is responsible for all additional cost.
REFUND POLICY
There is no refund for this course once the first class has been concluded or if any course material including the eBook is accessed.
STUDENT CONDUCT
All students are expected to conduct themselves in an orderly and professional manner. Any student not conducting themselves in an orderly and professional manner may be dismissed from classes and will not be able to complete the course. Disorderly and unprofessional behaviors include but are not limited to use of drugs and alcohol during school hours, dishonesty, disrupting classes, use of profanity, excessive tardiness, insubordination, violation of safety rules, improper usage of course materials, equipment or facilities, or not abiding by the school rules.
SYSTEM REQUIREMENTS
- Cable and DSL internet connections are recommended for the best experience.
- Speakers / Headphones
- Microphone (Webinar / Live Online sessions)
- Microsoft Windows 7 or 10 (Home, Pro)
- Latest Google Chrome is recommended for the best experience.
- Office suite software (Microsoft Office, OpenOffice, or LibreOffice)
- PDF reader program (Adobe Reader, FoxIt)
- While we understand that this course can be viewed on Android and iPhone devices, we do not recommend using these devices. The size of these devices do not provide a good learning environment for students taking online or live online based courses.
For more information and to enroll please call, email or visit us:
Beaufort Mather Campus
Coleman Hall (Building 2)
Beaufort South Carolina
Monday–Thursday, 8:30AM to 5:30PM
Phone 843-525-8205 or email cewd@tcl.edu
Colleton Adult Learning Center
500 Forest Circle
Walterboro, South Carolina
Mr. Phillip Taylor, Colleton Workforce Solutions Manager, TCL
Monday, 4PM to 9PM
Office 843-782-0014 or cell 843-599-1711
Email: ptaylor@tcl.edu
