Medical Insurance, Billing, and Coding learning course are essential to student success in all healthcare programs. This course introduces health insurance and reimbursement and familiarizes students with the health insurance industry, legal and regulatory issues, and differences in reimbursement methodologies. Students will learn about the principles of medical billing related to proper claim form preparation, submission, payment processing, and the follow-up process. The MBCC course is the second of the four courses taken for the Medical Billing and Coding Certificate.
This course prepares students for the NHA Certified Billing and Coding Specialist (CBCS) certification exam and provides insurance training essentials, including:
Assigned Modules 60 hrs
- Roles 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
- Diagnosis Coding - ICD-10CM
- Procedural Coding -CPT/HCPCS Books
- The Paper Claim CMS -1500
- The Electronic Claim
- Receiving Payments and Insurance Problem Solving
- Collection Strategies
- Ambulatory Surgery Center
- Hospital Outpatient Billing
The MBCC course provides students with foundational knowledge for learning the essentials to gain proficiency using various medical coding systems. The ability to translate medical record documentation into the appropriate diagnosis and procedure’s universal alphanumeric codes and report them on the national medical claim forms for reimbursement. Students learn the skills to manage all phases of the health insurance revenue cycle for government and commercial payors, ensure accuracy and aid in the insurance claim payment process. Students learn employer sought problem-solving and customer services skills needed to work in a clinic, outpatient, and inpatient settings.