Medical billing skills are essential to the economic viability of the healthcare industry. Medical billing involves the process of creating a bill or claim that gets submitted to the insurance company for evaluation to determine the amount of payment from each the insurance company and the patient, ensuring the healthcare provider is properly compensated for their services. The healthcare industry, which includes hospitals, physicians’ offices, clinics, nursing homes, home health agencies, HMO’s, and government agencies, all utilize individuals who perform functions that require this knowledge and these skills. This program will prepare students with the skills to follow a systematic billing process to create claims for the various payers. The program also provides students with knowledge on medical terminology, anatomy, and physiology which is essential to work in any healthcare environment.
Upon completion of this program, students are expected to be able to:
- Interpret basic ICD-10, CPT, and HCPCS codes.
- Identify and define common medical terms.
- Describe the structure and function of the various body systems and identify the pathophysiologic conditions and disorders, diagnostic procedures, and treatment options for each.
- Create and submit accurate claims, create patient bills, and apply industry-standard payment methodologies.
Listed below are summaries of each course within the program.
|Introduction to Medical Billing and Coding
|This course introduces the basics of medical billing and coding, as well as providing a general understanding of medical insurance and the various payers. It offers a broad overview of the revenue cycle and introduces how to successfully utilize the medical insurance claim process. This course also introduces the major code sets used in the health care industry.
|This course introduces students to the language of medicine. Students will gain an understanding of the way medical terms are formed and how to build medical terms using combining forms, prefixes, and suffixes. Students will learn the structure and function of various body systems and about the diagnostic, procedural, laboratory, pathological, surgical, and pharmacological terms and abbreviations associated with each body system.
|Anatomy and Physiology I
|This is the first of a two-course series that provides a comprehensive study of the anatomy and physiology of the human body. In this course, students will review the overall organization of the human body and will identify the anatomical locations of the various organs and systems. The course will discuss genetic and congenital disorders, and the structure and function of cells and cell division. The nervous, sensory, integumentary, muscular, and skeletal systems will be covered including the structure, function, common pathology, diagnostic procedures, and treatments. The course is designed for students who have little formal knowledge of the human body who wish to pursue a career in health-related professions.
|Anatomy and Physiology II
|This course is a continuation of Anatomy and Physiology I. This course covers the respiratory, circulatory, immune, digestive, urinary, endocrine, and reproductive systems in detail including the structure and function of each system, diseases and disorders, diagnostic procedures, and treatment options.
|3 Sem. Cr.
|This course focuses on the medical billing processes providing information on medical insurance and the various payers, revenue cycle management, reimbursement methodologies, claim follow-up and payment processing, as well as the legal aspects pertaining to health insurance and claims processing. Online simulation exercises will provide the opportunity to practically apply what is covered throughout the course.
|Health Insurance Processing
|3 Sem. Cr.
|This course focuses on claim preparation and transmission, working with payers (private payers/Blue Cross and Blue Shield, Medicare, Medicaid, TRICARE and CHAMPVA, and Workers’ Compensation and Disability), and compliance. Online simulation exercises will provide the opportunity to practically apply what is covered throughout the course.