Medical Billing

Exam Contents Outline

1. Introduction to Medical Billing and Office Procedures
   • What is Medical Billing ?
   • The Basic Overview of Office Procedures
   • How To Collect and Enter Data
   • The Paper Claims Process
   • The Electronic Claims Process
   • The Payment Posting Process
   • How To Create and Edit Reports
   • How To Charge Your Clients and Their Patients
   
   
2. Documentation: Understanding Office Forms
   • Essential Office Forms You Must Be Familiar With
   • Patient Demographic Form and How To Complete Them Properly
   • Insurance Cards, How To Read and Process Them
   • Insurance Forms and Verification Procedures
   • What Superbills/Daysheets Are and How To Read/Complete Them
   • The Basics of the CMS 1500, UB92 and ADA Forms
   • Commonly Made Errors On Forms You should Avoid
   
   
3. Code Usage: Understanding Codes
   • CPT (Current Procedural Technology) Coding
   • The Definitions
   • Proper Usage of CPT Codes
   • The CPT Manual, How To Read and Use It Properly
   • ICD (International Classification of Disease) Coding
   • The Definitions
   • Proper Usage of ICD Codes
   • The ICD Manual, How To Read and Use It Properly
   
   
4. Billing and Reimbursement: Understanding the Life Cycle of an Insurance Claim
   • The Collection of Claim Data
   • Claim Information Data Entry
   • The Claims Submission Process (Paper Claims, Electronic Claims, Secondary Claims, Claims Attachments)
   • The Posting Payments (Full Payment, Partial Payment, Deductible)
   
   
5. Software Usage: Working with Practice Management Software
   Medical Billing courses at this stage in the process should supply you with medical billing software, software training workbook, a mock data manual for data entry purposes and a supply of CMS 1500 forms. This is a must because you will need to get all the hands-on experience you can get. You will be actually be doing the following like you were already in business:
   • Entering Clinic Data From Superbills and Daysheets
   • Entering Physician Data From Superbills and Daysheets
   • Entering Patient Data From Superbills and Daysheets (Demographics Information, Insurance Information, Procedure Information, Diagnosis Information)
   • Using Software to Generate Claims
   • Using Software to Generate Reports