PHMB 280Med Billing & Reimb Methods

Catalog

This course will cover the tasks and responsibilities of a medical biller. Will define the legal and regulatory role of the Centers for Medicare and Medicaid Services (CMS) in relation to insurance claims and National Correct Coding Initiative (NCCI) edits. The student will learn to verify validity of health information for billing reports (charges, billing reports, and other data sources). Course will examine accounts receivable duties such as posting insurance and patient payments, validating UB-92 forms / HCFA 1500 forms, and how to process denied claims through appeals. Will examine how to verify national and local coverage determination policies to comply with the changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, and Managed Care etc. Will examine healthcare's complete revenue cycle to understand the impact medical billing has on reimbursement. There are no prerequisites for this course. This course is available for web registration. The expanded version of objectives is available from the Health Information Technology director.