Medical Insurance - Billing
E-Learning
Description
Learn hands-on skills to enter as an entry level Insurance Biller and Basic Coder and will be prepared for certification as a Certified Billing and Coding Specialist. This course may be taken by itself or with Medical Insurance – Types.
Learn hands-on skills to enter as an entry level Insurance Biller and Basic Coder and will be prepared for certification as a Certified Billing and Coding Specialist. This course may be taken by itself or with Medical Insurance – Types.
| Lesson Id | Title | Description |
|---|---|---|
| 1 | Role Of Insurance Billing Specialist |
Identify the background and importance of accurate insurance claims submission, coding and billing Name at least three skills possessed by insurance billing specialists List personal qualifications and skills to be acquired by an insurance billing specialist Differentiate between medical ethics and medical law |
| 2 | Basics Of Health Insurance |
Explain the difference between implied, expressed/informed consent (physician/patient contract) Describe in general terms the important Federal State and Private Insurance plans Define common insurance terms Explain the administration life cycle of a physician-based insurance claim from services rendered to completion of payment cycle Determine the appropriate questions to ask a question in order to maintain a complete patient record List the functions of an “aging report” in computerized practices or in a paper environment Record proper information and post to the patient’s ledger after claims submission and payment is received |
| 3 | Medical Documentation |
Explain reasons medical documentation is required Explain Medical Necessity and why it is required Define common medical diagnostic and legal terms Identify component parts of the SOAP format, used for documentation Understand various methods of mailing and their benefits Learn the component parts of a standard letter and various formats |
| 4 | Cms 1500 Form Completion |
Know when to use the 1500 claim form Expedite the handling and processing of the 1500 claim form Explain the difference between clean and dirty claims Abstract from the patient record – relevant information for completing the 1500 insurance claim form Describe reasons why claims are rejected Become familiar with guidelines for completing the current CMS 1500 claim form for Federal, State and private payor insurance contracts |
| 5 | Receiving Payments & Insurance Problem Solving |
Knowledge of timely filing Reimbursement time periods for paper vs electronic billing Define terminology pertinent to insurance claims Identify reasons for rebilling a claim (problem solving) Account follow-up; evaluate unpaid claims/accounts Claim review for denied claims |
| 6 | Office & Insurance Collection Strategies |
Discuss ways to determine fees Describe an office’s fee policy Define accounts receivables and how it is handled Recite types of adjustments available to patients Perform verbal and written communication collection techniques State the role of a billing service, collection agency and credit bureau in the collection process Identify possible solutions to collection problems Explain the purpose of small claims court, in the collection process Explain handling the SKIP account |
Self-Paced
Free
This course includes: :
Full lifetime access