Medical Billing certificate course curriculum
The Medical Billing certificate course curriculum is developed by knowledgeable instructors with years of experience in their field. You'll gain real-world, high-demand skills to succeed in a variety of healthcare settings including hospitals, clinics, and physician offices.
Lesson Group 1: Orientation: Ashworth College Career ProgramLearning at Ashworth
The goals and values of Ashworth College; time management; creating a realistic weekly and monthly study schedule; the nature and purpose of assessments; how to study effectively to prepare for and take an online examination; developing the skill sets necessary for success in the twenty-first century.
Lesson Group 2: Understanding Managed Care LearningIntroduction to Professional Billing and Coding Careers
An introduction to the different types of facilities that employ allied health personnel; job descriptions pertaining to billing and coding careers; options available for certification.
The history and impact of managed care; the organization of managed care and its effect on the provider, employee, and policyholder; patient financial responsibility; types of managed care plans and insurance coverage.
Key elements of managed care contracts; covered services for patients, including preventive medical services and office visits; protected health information; patient information disclosure; HIPAA security standards and regulations compliance; HITECH and EHRs.
Students learn the fundamentals of the medical billing and coding field. Program topics include insurance plans; medical ethics; HIPAA; ICD-9, ICD-10, CPT, and HCPCS coding; coding compliance and auditing; physician and hospital billing; Medicare, Medicaid, and TRICARE; EOBs, refunds, and appeals; workers’ compensation; and electronic claims processing.
After completing the Medical Billing program, students will be able to:
- Outline the typical responsibilities of a medical biller/coder, describe the personal and professional ethics required for success in this profession, and describe the career opportunities available to appropriately trained personnel.
- Describe the purpose and impact of the Health Care Portability and Accountability Act (HIPAA) and explain how medical professionals can learn about changes to the laws and regulations that affect them.
- Compare and contrast the major types of government and commercial insurance health plans, including Medicare, Medicaid, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans.
- Describe the typical billing guidelines for inpatient medical, inpatient/outpatient global surgery, medical/surgical, and minor surgical procedures.
- Summarize the life cycle of a typical insurance claim and explain the processing steps that must be completed before claims and other forms can be submitted to the insurance company.
- Explain the purpose of medical coding and accurately code diagnoses and procedures using industry-standard coding systems published by the World Health Organization (WHO) and the American Medical Association (AMA).
Pursue your professional goals
This career certificate is specifically designed to help you unlock new opportunities in a fast-growing healthcare discipline. But that's not where our career focus ends. As an Ashworth student, you'll have unlimited access to our full range of Career Tools, which includes one-on-one sessions with our knowledgeable advisors.