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Medical Billing

Medical billers act as the financial waypoint between patients, providers, and payers. Without billers, healthcare providers couldn’t be reimbursed for the procedures they perform. The training program covers the all concepts and guidelines that underpin the billing process. You will learn how the insurance process works, and what types of payers affect the reimbursement process. We will discuss Medicare, Medicaid, and the regulations enforced under the Health Insurance Portability and Accountability Act (HIPAA). Review the below course curriculum for further understanding on our training program.

Chapter 1 : Introduction to Medical Billing

  • About Medical Billing

    The Basics Overview

    Gathering Data / Entering Data

    Paper Claims

    Electronic Claims

    Posting Payments

    Generating Reports

    Billing your clients

  • Types of Insurance Coverage

    Group Health

    Individual Policies



    Personal Injury

    Workers Compensation


  • Procedures and Diagnoses

  • Insurance Claim Processing

  • Claim Payment

  • Report Generation

  • Resources

  • Study Guide, Examination

Chapter 2 : Understanding Office Forms

  • Essential Office Forms

    Patient Demographics

  • Completion

    Insurance Cards

    Insurance Verification Form

    Verification Procedures



  • Examining Insurance Cards

  • Insurance Verification Process

  • Mock Verification Conversations

  • Insurance Verification Exercises

  • The Superbill/Encounter Document

  • Calculating Copay / deductibles

  • Resources

  • Study Guide, Examination

Chapter 3 : Understanding the CMS 1500 Form

  • The Basics of CMS 1500

  • CMS 1500 box breakdown

  • Step by Step completion instructions

  • CMS 1500 completion exercises

  • Billing tips

  • Common Errors

  • Resources

  • Study guide, Examination

Chapter 4 : Understanding Codes

  • CPT Current Procedural Terminology


    Proper Usage

    Resources / Reference material

  • International Classification of Diseases


    Proper Usage

    Resources / Reference material

  • Resources

  • Study Guide, Examination

Chapter 5 : Life cycle of an insurance claim

  • Time-line of a claim

  • Claim Data Collection

    Patient Demographics

    Guarantor Information / Handling

    Insurance Coverage Information

    Patient Condition Information

    Patient Treatment Information

    Clinic Billing Information

  • Claim Information Data Entry

  • Claim Submissions

    Paper Claims

    Electronic Claims

    Secondary Claims

    Claim Attachments

  • Receiving / Posting Payments

    Full Payment

    Partial Payment


  • Resources

  • Study Guide, Examination

Chapter 6 : Working with Billing / Practice Management Software

  • Basic components of billing applications

  • Clinic Data

    Billing Identification Numbers

    Guarantor Information Handling

  • Physician Data

    Tax ID, UPIN, License Numbers


  • Patient Data

    Demographics Information

    Insurance Information

    Diagnosis Information

  • Electronic and paper claims

  • Reports Generation

  • Resources

  • Claim Generation

    Charge Entry

    Payment Entry

    Financial Adjustments

    Transactions Notes

  • Study Guide, Examination

Chapter 7 : Medical Billing / Practice Management Software Application

  • Medical Billing Software

  • Software Training Workbook

  • Mock Patient Data Manual

  • CMS 1500 Forms

  • Medical Billing Daily Operations

  • Live Data Entry

  • Generating Claims

  • Posting Payments

  • Running reports

  • Study guide, Examination