Medical Billing & Reimbursement

Medical Billing & Reimbursement

The business of healthcare requires certified medical billers with skills to handle all aspects of the revenue cycle. Without expertise in medical billing and the nuances of payer requirements, reimbursement may be compromised. A professional medical billing and reimbursement specialist knows how to submit claims in accordance with government regulations and private payer policies, follow-up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. CPB™ medical billing certification is vital to the financial success of the professional services claims process. Medical billing specialists are trained professionals, skilled in these activities and because they work with confidential patient records, medical billing specialists are required to be professional and discreet.

Opportunity

When a healthcare organization performs a procedure or services and gets payment from either the patient or from an insurance provider, that is known as medical billing and reimbursement. It is an integral part of any healthcare organization, and individuals who are certified and trained in medical billing and reimbursement most likely will always be able to find employment. If you are looking for a secure career in a fast growing field, then Medical Billing and Reimbursement could be your answer.

With the major changes in health care, Medical Billing and Reimbursement is quickly becoming one of the fastest growing professions in the United States.

Experienced medical billing and reimbursement specialists are earning an average of $34,304 a year.

See a copy of the latest US Bureau of Labor Statistics report for medical records and health information management technicians.

Let our Medical Billing and Reimbursement program help you to achieve your dreams of having a secure career making a great income. Train from the convenience of your home for a new career in medical billing and reimbursement.

Job Description

Medical billing professionals handle daily billing procedures for healthcare providers. Medical billing tasks include processing, adjusting and resubmitting claims, while adhering to current healthcare regulations and complying with insurance procedures and allotted benefits coverage. Characteristics that contribute to the success of a medical coding professional include:

  • Proficient using a computer, the software, and all other office equipment.
  • Possess excellent communication and interpersonal skills.
  • Excellent organizational skills.
  • Driven and self-disciplined.
  • A compelling interest in healthcare.
  • Good organizational skills are essential in dealing with patient files and documents.
  • Attention to detail – when dealing with medical files there is no room for error.
  • Proper phone etiquette.
  • Prefers working in an office setting.
  • Looking for a career that has an excellent future.

Program Overview

Medical Billing & Reimbursement Program
The AHDPG Medical Billing and Reimbursement training program introduces the student to health insurance and reimbursement. In this course the student will become familiar with common medical billing practices, the health insurance industry, legal and regulatory issues and differences in reimbursement methodologies. The student will learn principles of medical billing related to proper claim form preparation, submission and payment processing, and the follow up process.

This course is recommended for anyone who is preparing for a career in a medical billing department at a hospital, physician’s office, clinic or similar positions.

The program provides the basic knowledge needed to become competent, certified and employable.

This course covers the following key areas and topics:

  • Describe the variety of career possibilities and areas of specialization open to those trained as insurance billing specialists.
  • Distinguish between the major classes of health insurance contracts.
  • Understand the legal regulatory considerations involved in health care reimbursement.
  • Explain the process of a physician-based insurance claim including obtaining patient data, claim form completion, insurance carrier processing, and payment received.
  • Demonstrate the ability to use the three major coding manuals, CPT®, ICD-9-CM, and HCPCS.
  • Explain the follow-up process for A/R in a physician’s office, including the top denials by insurance carrier along with their appeals process.

This course is online and is a self-paced, mentor-supported course with instructor feedback and assistance as required. Upon completion of the AHDPG Medical Billing and Reimbursement training program a student will be prepared to sit for the American Academy of Professional Coders (AAPC) Certified Professional Coder (CPB™) certification exam.

Tuition

The Medical Billing and Reimbursement program fee is an all-inclusive fee which covers everything a student needs to successfully complete our program. Our program fee covers:

  • Tuition
  • Textbooks
  • Materials
  • Course fees.

Program Title: Medical Billing and Reimbursement

$2,595.00

Upon successful program completion, a certificate of completion will be earned and support is offered to our graduates to help secure employment.

Funding Options

Option 1 – Pay Upfront Plan – Save 10%!
The pay upfront program offers a 10% discount off the standard cost of our program for those individuals who are willing to pay upfront for their education

Option 2 – Military Discount – Save 10%
As a Military Friendly School a 10% discount is available to active military personnel and their spouses.

*The Pay Upfront Plan and the Military Discount cannot be combined and is limited to only one discount

Option 3 – Monthly Payment Plan (No Interest)
The monthly payment plan includes a one-time initial payment of $295 due at time of enrollment with eight additional monthly payments of $290. There is no finance charge applied to this option and payments are automatically deducted from your credit card or bank account.

Option 4 – MyCAA Funding Program
We know that maintaining a career can be difficult with your military lifestyle. That’s why we provide a flexible way to complete your education in careers that are essential nationwide. Learn at home, on your own schedule for a career that will travel with you wherever you go. With MyCAA your education costs may be 100% covered, meaning you can focus on your future and not tuition costs. The MyCAA Funding program is administered by the Department of Defense.

More information about the MyCAA funding program!

Option 5 – Jump-start Program ($500 off)
Our Jump Start Program is designed for individuals with previous experience with medical terminology, anatomy and physiology and pharmacology.  For individuals who can provide documentation of competency in these areas AHDPG will allow individuals the opportunity to accelerate their progress through our Medical Billing and Reimbursement or Outpatient Medical Coding programs without the need to retake those sections of the program.

The Jump-start Program is designed for experienced Allied Health Professionals interested in advancing their current healthcare career or launching a new career in medical billing or coding.  The Jump-start Program provides a $500 discount in addition to the time savings associated with accelerating one’s progress through the program.

MBR Certification

Medical Billing and Reimbursement professionals are certified by the American Academy of Professional Coders (AAPC). Graduates from the AHDPG Medical Billing and Reimbursement program are encouraged to sit for the American Academy of Professional Coders Certified Professional Biller (CPB™) exam.

The Certified Professional Biller (CPB™) has proven by rigorous examination and experience that he or she knows how to submit claims in accordance with government regulations and private payer policies, follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. CPB™ medical billing certification is vital to the financial success of the professional services claims process.

More information on the American Academy of Professional Coders certification exams.

FAQs

Q: What is the Difference between Billing and Coding?

The job of a Medical Coder is to read your chart, match up what was wrong with you with its corresponding numerical code from the most current ICD-9 book, and then assign the proper diagnosis code with its numerical code from the CPT 4 book. Those two codes and any modifier codes that may need to be used to better describe your problem and its treatment are then placed onto a patient encounter form or superbill.

This patient encounter form or superbill is then given to a Medical Biller or Medical Billing Specialist, as they are known as in the industry. The Medical Biller or Medical Billing Specialist then inputs the information provided by the Medical Coder into whatever software package is used by the practice exactly as it is written. That information is recorded onto either a CMS 1500, UB-04, or ADA form. The information is then either electronically submitted directly to the patient’s insurance carrier, sent directly to an electronic clearinghouse and when neither of those options is available, the form is printed out and mailed to the appropriate insurance carrier. If there is no software program available, the claim will be hand written onto a CMS 1500, UB 04, or ADA form and mailed to the appropriate insurance company for processing.

However, a medical billing specialist responsibility does not end there. Once the information is submitted, the medical billing specialist then has to follow up on each and every claim to make sure that it is paid. Sometimes that can be a burden because they have to spend a lot of time on the phone with insurance carriers trying to get information about specific claims that come back rejected or denied. They have to deal with patients throughout the day that have concerns about their bills. They have to deal with the accounts receivable process where the insurance company sends back the physician’s payment and explanation of benefits (EOB’s) for posting into their software. They have to deal with verifying the status of the patient’s insurance coverage. The biller has to create patient invoices for any money you may owe the practice for co-pays, co-insurances, and any non-covered services. A medical billing specialist has to deal with denied claims and adjustments to a claim by filing appeals to the correct insurance carrier by getting the necessary paperwork needed to get the claim paid and resubmit them to the proper carrier. They have to run reports for their employers and be able to explain any the discrepancies that are found and have a plan in place to correct the problems in a timely manner.

Q: What are the minimum requirements for this course?

The minimum computer requirements in order to successfully complete the course are as follows:

  • Computer: Pentium-class PC with 1.7 Ghz processor or better
  • CDROM Drive: (internal or external)
  • RAM: 1GB min for 32bit; 2GB min for 64bit OS
  • Operating System: Windows Vista, 7, 8/8.1 or 10,  MAC OS X
  • High Speed Internet
  • Internet Explorer (9 or higher), latest versions of Mozilla Firefox and Google Chrome
  • Windows users: Microsoft PowerPoint viewer (free) or full Microsoft PowerPoint
  • MAC users: Apple Keynote or PowerPoint for MAC and Windows Media Components for Quicktime (Flip4Mac Standard)
  • Adobe Reader or equivalent PDF reader

Instructor Bio

Debra Vance
Medical Billing / Coding Instructor

Debra is our online instructor in our Billing and Coding Programs.  She has over 30 years of experience in the healthcare industry, starting as a medical transcriptionist/receptionist and working her way up to Director of Patient Accounts/Business Services for one of the largest health centers in the United States.  In 2006, Debra started on the career path of teaching and has been hooked ever since.  She has experience teaching both in classroom and online.

Debra is a certified coder (CCS-P) through AHIMA since 2000.  She received a Masters of Public Administration in 2009 through Suffolk University in Boston, MA

Debra lives in Groveland, MA which is in the northeast corner of Massachusetts (close to the beaches and New Hampshire).  She has two grown children and two grandchildren.  She enjoys spending time with her grandchildren.  Debra’s favorite hobby is going to the barn with her grandchildren and spending time with their horse and pony.

REQUEST FOR INFORMATION

The Nation’s Leader in Healthcare Documentation Services, Staffing, and Training.