Medical Billing & Revenue Cycle Management

About the course

Welcome and Course Overview

• Objectives and Structure
• Expectations and Assessment Methods

Introduction to Medical Billing

• Definition and Importance
• Overview of the Revenue Cycle

Scope of Medical Billing

o Role and Key Processes

Career Opportunities in Medical Billing

• Job Titles, Skills, and Certifications

Module 2: Revenue Cycle Management

• Definition and Components
• Best Practices in RCM

Module 3: Medical Coding

• Introduction to Medical Coding
• ICDs, CPTs, and Modifiers

Module 4: HIPAA Compliance

• Overview of HIPAA Regulations
• Importance of Compliance

Module 5: Billing Providers

• Understanding Billing Processes
• Types of providers

Module 6: Health Insurances

• Overview of Health Insurance Types
• Billing Procedures

Module 7: Provider Enrollment and Participation

• Steps in Provider Enrollment
• Credentialing vs. Contracting

Module 8: PMS & EHR Software

• Introduction to PMS and EHR
• Integration in Billing

Module 9: Patient’s Demographics

• Importance and Collection of Demographic Information

Module 10: Superbill

• Definition, Components, and Utilization

Module 11: Claim Submission

• Steps and Formats for Claims Submission

Module 12: Claim Rejection

• Common Reasons and Strategies for Reduction

Module 13: Payment Posting

• Understanding Payment Types and Procedures

Module 14: Follow-Up Strategy

• Importance and Best Practices for Follow-Up

Module 15: Denial Management

• Common Denial Reasons and Corrective Actions

Module 16: Authorization

• Importance and Process of Prior Authorization

Module 17: Appeal Drafting Guidelines

• When and How to Appeal Denied Claims

Module 18: Patient Billing & Collection

• Best Practices and Strategies

Module 19: Communication in Medical Billing

• Importance and Techniques

Module 20: Detailed Review on Medical Billing

• Revision

Assessments

Mid-Term Assessment (20 Points)

• Format: Online Quiz/Exam
• Content: Covering Modules 1-13
• Passing Score: 10 Points (50%)

Final Assessment (30 Points)

• Format: Online Exam/Project
• Content: Covering Modules 1-20
• Passing Score: 15 Points (50%)

Practical Internship (1 Month)

Internship Structure

• Hands-on experience in a medical billing environment
• Application of concepts learned in the online course
• Feedback and evaluation from supervisors

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