Medical Insurance Billing

This six-course program is designed for those who are new to the medical field and for those currently working in the field who wish to expand their knowledge in specific areas.

 

  • MB1- Medical Terminology

    This course is designed for individuals who want to pursue a career or enhance their potential for advancement in the healthcare field. Examples of key and relevant topics, which will be presented, analyzed, and discussed, are the following: the rules and structure of medical terminology, anatomy and functions of the organ/system being studied, and the etiology, diagnostic procedures and management of pathological conditions. HIPAA Compliance Regulations included.

    Upon the successful completion of this course, students will be able to:

    • Demonstrate a proficiency in medical terminology and an understanding the rules and structure of medical language. 
    • Demonstrate the ability to accurately analyze and utilize medical terms in the context of healthcare discussions and documentation.
    • Demonstrate a comprehension of anatomy and functions of various organ systems.
    • Analyze and discuss the causes (etiology) of various pathological conditions, the diagnostic procedures used to identify them, and appropriate management strategies.
  • MB2- Coding: ICD-10 Coding

    ICD10-CM coding is required by third-party payers when submitting and processing insurance claims.   In this class, students will learn to interpret accurately and describe diagnoses, procedures and supplies used in the physician offices, medical record department, emergency rooms, urgent care and hospice care facilities. In CPT-4 coding, students will learn how to effectively use evaluation and management codes in compliance with CMS regulations, the correct usage of modifiers that Best describes inpatient procedures, and services in compliance with CMS. Students will be informed about the changes and updated code requirements. Hands-on diagnoses and including problem solving of case studies using ICD10-CM will be covered in class.   

    Cost of textbooks is approximately $187.00 (ICD10 & CPT4) plus $20.00 for material fee payable in class. 

    Prerequisite: MB1 Medical Terminology

    Upon the successful completion of this course, students will be able to:

    • Understand basic to advanced coding principles and regulations.
    • Perform hands-on actual coding of ICD10-CM/CPT-4 /HCPCS.
    • Code accurately, specifically, and in a timely manner.
    • Professionally handle patients concerns, co-workers, and physicians in compliance with HIPAA.
  • MB3- Medical Insurance Billing Principles

    Students will learn the basic principles of medical billing, recognize the different forms used by third-party payers, create a clean claim (1500 form) and define insurance billing terminology and types of coverage. Students will learn the responsibilities of a medical insurance specialist, the life cycle of insurance claim, and various templates of billing commercial insurance. Learning coding ICD-10-CM is important, anticipating the major changes in processing claims effective October 1, 2015 the effective date of ICD-10-CM in the United States. Uses textbooks from previous classes.

    Prerequisite: MB2 ICD-10 Coding

    Upon the successful completion of this course, students will be able to:

    • Demonstrate proficiency in medical billing principles and claim creation, including the ability to recognize different forms utilized by third-party payers.
    • Demonstrate a comprehensive understanding of insurance billing terminology and types of coverage. 
    • Apply ICD-10-CM coding and knowledge to the claim life cycle.
  • MB4- Medical Credit and Collection: Recovery of Unsecured Assets

    This course will teach you how to work more efficiently in following up on unpaid claims for Medicare, HMO/PPO, and private insurance. Learn to analyze monthly reports, accounts receivable, revenue outstanding and delinquent accounts. Learn to file tracers, CIF's and appeals on denied claims for Medi-Cal.

    Upon the successful completion of this course, students will be able to:

    • Demonstrate efficiency in claim follow-up and revenue management.
    • Demonstrate proficiency in handling denials and appeals for Medi-Cal claims.
    • Demonstrate application of analytical skills for financial reporting and decision-making.
  • MB5- Legal Issues and Risk Management

    Students will learn the importance of confidentiality of medical records in California; when to release or retain medical records; when to resort to arbitration versus civil courts; how to prevent malpractice claims and the importance of informed consent. HIPAA Compliance Regulations included.

    Upon the successful completion of this course, students will be able to:

    • Demonstrate an understanding of confidentiality and legal aspects of medical records in California.
    • Demonstrate knowledge of dispute resolution methods and malpractice prevention.
    • Demonstrate an understanding of informed consent and compliance with HIPAA regulations.
  • MB6- Computerized Medical Insurance Billing

    Participants will learn the basics of how to input patient information and insurance data, generate insurance claim forms, statements, and collection letters, edit lists and other required forms in a business office to facilitate productive operations. This hands-on workshop is highly recommended for billing service businesses and good preparation for working in medical facilities. HIPAA Compliance Regulations included.

    Prerequisites: MB5 Legal Issues and Risk Management and previous computer experience is necessary.

    Upon the successful completion of this course, students will be able to:

    • Demonstrate proficiency in patient information and insurance data management.
    • Demonstrate expertise in editing and customizing business office forms.
    • Demonstrate an understanding and application of HIPAA Compliance Regulations.

MIB Program Map

MIB Curriculum Map

 

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