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.
Orientation: Learning at AshworthLesson: Learning at Ashworth
This introduction covers 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 1: Introduction to Allied HealthLesson: Allied Health Careers
This lesson covers healthcare, the healthcare industry in the United States, and the roles that healthcare workers play in that industry.
- Describe the United States healthcare system and settings
- Compare the professional roles of healthcare workers within various community settings
- Compare the professional roles of healthcare workers within hospital practices
- Distinguish among government (public) and private health insurance plans
- Explain the primary elements of the Affordable Care Act
- Describe the proper legal and ethical behaviors of a healthcare worker
- Identify the characteristics of professional behavior and issues related to cultural differences
- Identify communication methods within the healthcare field and teamwork strategies
Lesson Group 2: Medical Billing and Health InsuranceLesson: Reimbursement Methodologies
This lesson provides important information that’s essential to your allied health career. By the end of this lesson, you’ll have a thorough understanding of the reimbursement process and the various methodologies involved.
- Describe the history of healthcare reimbursement
- Identify various reimbursement methodologies
- Outline the Medicare acute care prospective payment system
- Discuss other various payment systems
- Explain reimbursement claims processing and support processes
- Define coding quality and compliance standards
This lesson provides important information that’s essential to your allied health career. By the end of this lesson, you’ll have a thorough understanding of health insurance and the processes involved.
- Define prepaid health plans and commercial insurance
- Discuss the different government-sponsored healthcare programs
- Explain how managed care works
Students learn the fundamentals of the medical billing and coding field. Program topics include insurance plans; medical ethics; HIPAA; ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding; coding compliance and auditing; physician and hospital billing; Medicare, Medicaid, and TRICARE; EOBs, refunds, and appeals; and workers’ compensation.
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 Insurance 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).
Insuring job path preparedness
You'll gain job skills from every lesson in the Medical Billing Career Certificate course and prep for your job search at the same time. The online tools available through the Ashworth College Central Network are integrated into your studies so you'll be ready to deliver a polished presentation of your qualifications to potential employers as soon as you graduate. You'll also be able to revisit the Ashworth College Central Network whenever you need to after you've earned your certificate. Learn more about it at the Ashworth College Career Services page.