ED2GO GES1014 - Medical Billing and Coding (Voucher Included)

Course Description

Overview

Whether you are just starting work or transitioning from a different field, there has never been a better time to enter a career in medical billing and coding. More than one million practicing physicians in the U.S. rely on medical billers and coders to receive payment for their services. Medical billing and coding positions are in-demand within medical facilities, health insurance companies, specialty pharmacies, medical suppliers, consulting firms, and national medical coding and billing companies. With the right medical billing and coding training, the opportunities are nearly endless!

Our Medical Billing and Coding course will prepare you for success as you learn about legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections.

This comprehensive medical terminology course introduces key concepts of medical language and human anatomy, emphasizing the interconnectedness of body systems in health and disease. The curriculum covers topics such as the musculoskeletal, cardiovascular, respiratory, nervous, and immune systems, along with mental health and special senses, with exams at the midterm and final stages. Students with prior knowledge can optionally test out by achieving a minimum score of 80%, replacing course content if desired. It is important to understand that this course feature only applies to the online Medical Terminology course, the standalone course, or advanced career training course bundles that include Medical Terminology.

After successfully completing the Medical Billing and Coding course requirements, you should be well prepared to find your place in this rewarding healthcare career. According to the AAPC 2023 Salary Survey results, certified medical records specialists earn 15% more than their non-certified colleagues. You will get to choose a voucher for the professional medical billing and coding certification exam that best aligns with your interests and career goals:

• Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
• Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
• Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)

Funding Disclaimer: For Workforce Innovation and Opportunity Act (WIOA) funded students, please consult with your funding source representative before taking advantage of this course's test-out feature. Different funding programs may have specific requirements and/or restrictions. If you attempt the test-out feature(s) in the Medical Terminology course without getting approval, your funding benefits may be jeopardized.

Objective

What you will learn

• Get a better understanding of the value this course provides from our medical billing and coding certification video overview
• Medical coding terminology is required for medical coding, including the structures and functions of the human body
• The disorders and medical procedures common to each body system
• Legal, ethical, and regulatory concepts central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims
• The main coding manuals: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II
• How to code diagnoses, services, and procedures for all systems of the body
• Fundamentals of medical billing and coding and medical terminology
• Word parts and the structures and functions of the human body
• Hands on exposure to an encoder application: Codify (AAPC)

How you will benefit

• Gain comprehensive training in medical billing and coding through coursework designed to prepare you for the job
• Receive a Certificate of Completion and an exam voucher for the professional exam of your choice
• Receive access to study materials and prepare to sit for the medical billing and coding certification exam that best aligns with your interest and career goals:
  • Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
  • Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
  • Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)

Outline

1. Medical Terminology
   1. Getting Started
   2. How to Take This Course
   3. Test-Out Exam 1: Lessons 1–Midterm Exam
   4. Introduction to Medical Terminology and the Human Body in Health and Disease
   5. The Musculoskeletal System
   6. The Cardiovascular System
   7. The Lymphatic and Immune Systems
   8. The Respiratory System
   9. The Digestive System
   10. The Urinary System
   11. Midterm
   12. Test-Out Exam 2: Lessons 8–Final Exam
   13. The Nervous System
   14. Special Senses: The Eyes and Ears
   15. The Integumentary System
   16. The Endocrine System
   17. Mental Health
   18. Male and Female Reproductive Systems
   19. Diagnostic Procedures, Nuclear Medicine, and Complementary Medicine
   20. Final Exam
2. Medical Billing and Coding
   1. Introduction to Medical Billing and Coding
      1. Career Opportunities
      2. Personal and Technical Qualifications
      3. Employment Settings
      4. Telecommunications
      5. Professional Certifications
   2. Introduction to Health Insurance
      1. Health Insurance Terminology
      2. Commercial and Government Payers
      3. Healthcare Documentation
      4. Electronic Health Record
   3. Managed Healthcare
      1. Types of Reimbursement
      2. Managed Care Providers
      3. Managed Care Models
      4. Consumer-Directed Health Plans
   4. Revenue Cycle Management
      1. Phases of Revenue Cycle Management
      2. Encounter Form, Chargemaster
      3. Insurance Claim Cycle
      4. New Patient Registration
      5. Collection Practices
   5. Legal Aspects of Health Insurance and Reimbursement
      1. Laws Affecting Healthcare
      2. Protected Health Information
      3. Health Insurance Portability and Accountability Act (HIPAA)
      4. Fraud and Abuse in Medical Billing and Coding
      5. Release of Information
   6. VI. ICD-10-CM Coding
      1. Overview of ICD-10-CM
      2. Key Features
      3. Organization of the Codebook
      4. Index to Diseases and Injuries
      5. Tabular List of Diseases and Injuries
      6. Coding Conventions
      7. Official Guidelines
   7. CPT Coding
      1. Overview of Healthcare Common Procedure Coding System (HCPCS)
      2. Category I, Category II, and Category III Codes
      3. Organization of the Codebook
      4. Main CPT Sections
      5. Evaluation and Management
      6. Anesthesia
      7. Surgery
      8. Radiology
      9. Pathology and Laboratory
      10. Medicine
      11. Code Modifiers
   8. HCPCS Level II Coding
      1. Overview of HCPCS Level II
      2. Organization of the Codebook
      3. Durable Medical Equipment
   9. ICD-10-PCS Coding
      1. Overview of ICD-10-PCS
      2. Code Structure
      3. Definitions
      4. Index
      5. Code Tables
      6. Coding Steps
   10. Pharmacology for Coders
       1. Pharmacodynamics and Pharmacokinetics
       2. Routes of Administration
       3. Drug Classifications
       4. Prescription Drugs and Over-the-Counter Drugs
       5. Controlled Substances
       6. Medication Lists and the Electronic Health Record
       7. MIDTERM
   11. Clinical Documentation Improvement (CDI)
       1. Deficiencies in Documentation
       2. Medical Necessity
       3. Auditing
       4. Coding From Patient Documentation
   12. Coding with Your Codify Encoder
   13. Insurance Claims
       1. National Uniform Claim Committee
       2. CMS-1500 Claim Form
       3. Patient and Insured Information
       4. Physician or Supplier Information
       5. UB-04 Claim Form
   14. Commercial Insurance
       1. Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
       2. Completing Commercial Health Insurance Claims
   15. Blue Cross Blue Shield
       1. History of BCBS
       2. Types of BCBS Plans
       3. Participating/Nonparticipating Providers
       4. BCBS Billing and Payment Guidelines
   16. Medicare
       1. Medicare Eligibility
       2. Medicare Part A, B, C, and D
       3. National Coverage Determinations/Local Coverage Determinations
       4. Participating/Nonparticipating Providers
       5. Physician Fee Schedule
       6. Medicare Billing and Payment Guidelines/NCCI
   17. Medicaid, CHIP, TRICARE, Workers' Compensation
       1. Medicaid
       2. Children's Health Insurance Program (CHIP)
       3. TRICARE
       4. Workers' Compensation
   18. Certification
       1. Selecting the Right Certification
       2. Study Strategies for the Certification Exam
       3. Prior to the Exam
       4. Morning of the Exam
       5. During the Exam
   19. How to Find a Job in Medical Billing and Coding
       1. Formulating Your Career Goals
       2. What Employers Want
       3. Showcasing Your Skills
       4. Resume Tips
       5. Cover Letter Tips
       6. Interview Questions
   20. Land the Job
   21. Mock Exam
   22. Final Exam
   23. ICD-11 Preview

Requirements

Requirements:

Hardware Requirements:

• This course can be taken on either a PC, Mac, or Chromebook.

Software Requirements:

• PC: Windows 8 or later.
• Mac: macOS 10.6 or later.
• Browser: The latest version of Google Chrome or Mozilla Firefox is preferred. Microsoft Edge is also compatible.
• Microsoft Word or equivalent (not included with enrollment)
• Adobe Acrobat Reader.
• Software must be installed and fully operational before the course begins.

Other:

• Email capabilities and access to a personal email account.

Instructional Material Requirements:

The instructional materials required for this course are included in enrollment.

The following digital textbook for the Medical Terminology course is accessed via links in the course lessons:

• Comprehensive Medical Terminology for Health Professions, 1st Edition (eBook)

The following digital textbooks for Medical Billing and Coding are accessed via links in the course lessons:

• Understanding Health Insurance: A Guide to Billing and Reimbursement, by Michelle A. Green
• Accompanying Workbook: Understanding Health Insurance: A Guide to Billing and Reimbursement

The following textbooks will be shipped to you approximately 7-10 business days after enrollment in Medical Billing and Coding:

• ICD-10-CM Expert for Physicians
• CPT Professional
• HCPCS Level II Professional

Choice of study guide/voucher package upon course completion:

• Certified Professional Coder, CPC (AAPC): AAPC Membership, CPC Online Review Course, CPC Study Guide Bundle, Practice Exam Bundle, Practicode CPC-A Practicum, CPC Exam Voucher (2 exam attempts) and Codify Student (free upgrade to Codify Basic)
• Certified Coding Associate, CCA (AHIMA): AHIMA Student Membership, CCA Study Guide, and CCA Exam Voucher
• Certified Billing and Coding Specialist, CBCS (NHA): CBCS Study Guide, CBCS Practice Test, and CBCS Exam Voucher

Please note: You will receive a digital book if the physical book is on backorder.

*The course includes the current year of coding books, and you will be responsible for purchasing your updated coding books from year to year.