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Whether you're just starting work or transitioning into a different field, there has never been a better time to enter a career in Medical Billing and Coding. This course will prepare you for success in this rewarding career as you learn about legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will also be able to choose a voucher for the professional certification that best aligns with your interests and career goals.

More than one million practicing physicians in the United States rely on medical billers and coders to receive payment for their services. Besides medical facilities, positions are available with health insurance companies, specialty pharmacies, medical suppliers, consulting firms, and national medical coding and billing companies, so the opportunities are nearly endless!

Medical billers and coders are in high demand. This course offers valuable training in legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will also come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections. You will also learn common medical terminology to help you converse with others in healthcare easily and with confidence. You will study word parts and the structures and functions of the human body. Also presented are the disorders and medical procedures common to each body system, including musculoskeletal, cardiovascular, respiratory, digestive, nervous, endocrine, integumentary, genitourinary, lymphatic, and immune.

After successfully completing the course requirements, you should be well prepared to find your place in this rewarding healthcare career. You will receive a Certificate of Completion from the school through which you enrolled, and you will also be able to choose a voucher for the professional certification that best aligns with your interests and career goals.

Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)

 

Course Details


What you will learn

Medical Billing and Coding
Medical coding terminology is required for medical coding, including the structures and functions of the human body
The disorders and medical procedures common to each body system
Legal, ethical, and regulatory concepts central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims
The main coding manuals: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II
How to code diagnoses, services, and procedures for all systems of the body
Fundamentals of medical billing & coding and medical terminology
Word parts and the structures and functions of the human body

How you will benefit

Get hands-on, practical experience in medical billing and coding that will help you on the job
Receive a certificate of completion and prepare to sit for the professional certification that best aligns with your interest and career goals
Receive a voucher for the professional certification exam of your choice
Receive access to study materials that align with the exam option you choose
Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)

How the course is taught

Self-paced, online course
12 Months to complete
Open enrollment, begin anytime
370 course hours
 


Medical Terminology

  • Introduction to Medical Terminology
  • The Musculoskeletal System
  • The Cardiovascular System
  • The Lymphatic and Immune Systems
  • The Respiratory System
  • The Digestive System
  • The Urinary System
  • The Nervous System
  • The Special Senses The Eyes and Ears
  • The Integumentary System
  • The Endocrine System
  • The Reproductive System
  • Diagnostic Procedures, Nuclear Medicine, Pharmacology

Medical Billing and Coding

  • Introduction to Medical Billing and Coding
  • Career Opportunities
  • Personal and Technical Qualifications
  • Employment Settings
  • Telecommunications
  • Professional Certifications

Introduction to Health Insurance

  • Health Insurance Terminology
  • Commercial and Government Payers
  • Healthcare Documentation
  • Electronic Health Record

Managed Healthcare

  • Types of Reimbursement
  • Managed Care Providers
  • Managed Care Models
  • Consumer-Directed Health Plans

Revenue Cycle Management

  • Phases of Revenue Cycle Management
  • Encounter Form, Chargemaster
  • Insurance Claim Cycle
  • New Patient Registration
  • Collection Practices

Legal Aspects of Health Insurance and Reimbursement

  • Laws Affecting Healthcare
  • Protected Health Information
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Fraud and Abuse in Medical Billing and Coding
  • Release of Information

VI. ICD-10-CM Coding

  • Overview of ICD-10-CM
  • Key Features
  • Organization of the Codebook
  • Index to Diseases and Injuries
  • Tabular List of Diseases and Injuries
  • Coding Conventions
  • Official Guidelines

CPT Coding

  • Overview of Healthcare Common Procedure Coding System (HCPCS)
  • Category I, Category II, and Category III Codes
  • Organization of the Codebook
  • Main CPT Sections
  • Evaluation and Management
  • Anesthesia
  • Surgery
  • Radiology
  • Pathology and Laboratory
  • Medicine
  • Code Modifiers

HCPCS Level II Coding

  • Overview of HCPCS Level II
  • Organization of the Codebook
  • Durable Medical Equipment

ICD-10-PCS Coding

  • Overview of ICD-10-PCS
  • Code Structure
  • Definitions
  • Index
  • Code Tables
  • Coding Steps

Pharmacology for Coders

  • Pharmacodynamics and Pharmacokinetics
  • Routes of Administration
  • Drug Classifications
  • Prescription Drugs and Over-the-Counter Drugs
  • Controlled Substances
  • Medication Lists and the Electronic Health Record

MIDTERM

Clinical Documentation Improvement (CDI)

Deficiencies in Documentation
Medical Necessity
Auditing
Coding From Patient Documentation

Insurance Claims

  • National Uniform Claim Committee
  • CMS-1500 Claim Form
  • Patient and Insured Information
  • Physician or Supplier Information
  • UB-04 Claim Form

Commercial Insurance

  • Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
  • Completing Commercial Health Insurance Claims

Blue Cross Blue Shield

  • History of BCBS
  • Types of BCBS Plans
  • Participating/Nonparticipating Providers
  • BCBS Billing and Payment Guidelines

Medicare

  • Medicare Eligibility
  • Medicare Part A, B, C, and D
  • National Coverage Determinations/Local Coverage Determinations
  • Participating/Nonparticipating Providers
  • Physician Fee Schedule
  • Medicare Billing and Payment Guidelines/NCCI

Medicaid, CHIP, TRICARE, Workers' Compensation

  • Medicaid
  • Children's Health Insurance Program (CHIP)
  • TRICARE
  • Workers' Compensation

Certification

  • Selecting the Right Certification
  • Study Strategies for the Certification Exam
  • Prior to the Exam
  • Morning of the Exam
  • During the Exam

How to Find a Job in Medical Billing and Coding

  • Formulating Your Career Goals
  • What Employers Want
  • Showcasing Your Skills
  • Resume Tips
  • Cover Letter Tips
  • Interview Questions
  • FINAL

 

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Financial assistance information can be found on Rice Financial Aid's Visiting and Continuing Education Students page.
The estimated Cost of Attendance (COA) is $XX.

Registrations are considered final as of 10 working days before class starts. No refunds will be issued after these dates and credits will not be given for future classes. No refunds will be granted for participants who miss a portion of a program. Refund requests before the deadline are subject to a 10% processing fee and must be made in writing to gscs@rice.edu


What is medical billing and coding?

Medical Billers and Coders are responsible for processing patient data including medical records and related insurance. In this position, you will code a patient's diagnosis and then request payment from the patient's insurance company. You will play an important role in ensuring that healthcare providers are quickly and accurately paid for the treatment they give patients.

Where do you work as a Medical Biller and Coder?

Medical Billers and Coders work in a variety of settings. The most common settings include hospitals, doctors' offices and insurance agencies. Some medical billing and coding professionals work for companies that develop medical software, and some work for education institutions that work to train other medical billers and coders. Government agencies have also been known to employ medial billers and coders including the National Center for Health Statistics and Medicaid offices. You may also have the ability to work for a reputable company from your own home!

Is medical billing and coding in high demand?

Yes. There is a high demand for qualified medical billing and coding professionals in the healthcare industry today. Demand will increase as the population in the Unites States ages. Jobs for these professionals are on the rise and expected to grow faster than average through 2026 according to the Bureau of Labor Statistics.

What is the salary for a Medical Biller & Coder?  

According to the AAPC 2022 Salary Survey results, non-certified medical records specialists average $46,321 per year, while certified medical records specialists can average $56,290 annually — 17.7% more than their noncertified colleagues.

How long do you have to go to school to be a Medical Coder?  

Our medical coding courses are self-paced and completed in 12 months or less. You will then have the option to prepare and sit for one of the following national certifications: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA). Once you are certified, you'll have the qualifications you need to find an entry-level job.

How do I get medical coding certification online?  

To become a Certified Medical Coder, you need to take an online training course that teaches you the CPT®, ICD-10-CM, and HCPCS Level II code sets. Most employers are looking for applicants to have a medical coding certification. After successfully completing this course, you will have the knowledge and skillset to become a medical coder and can sit for one of three national certification exams included in your tuition: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA).

Does this course prepare you for certification?

Yes, this course prepares you for three certifications: 1) Certified Billing and Coding Specialist (CBCS) exam, offered by the National Healthcareer Association (NHA), 2) Certified Professional Coder (CPC) exam, offered by American Academy of Professional Coders (AAPC), and Certified Coding Associate (CCA) exam, offered by AHIMA. You will receive a voucher for the certification exam of your choosing after successfully completing the course. Online certification exams through NHA and AAPC are offered in the US only.

What happens when I complete the course?  

Upon successfully passing the final exam, you will be awarded a certificate of completion from the school or organization that you registered through. In addition, you will receive an exam voucher and applicable study materials for your choice of the following national certification exams: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA).

Am I guaranteed a job?

ed2go courses will help you gain the skills you need to obtain an entry-level position in most cases. However, you should always research the job market in your area before enrolling.

About Certification.

American Academy of Professional Coders (AAPC)
The American Academy of Professional Coders (AAPC) is one of the world's most recognized institutions for professional medical coders, with more than 175,000 members. The AAPC offers more than 30 certifications that include medical billing and coding, compliance, and management, among other topics. These certifications are an excellent way to prove you have a working knowledge of specific aspects of healthcare, and the skills you need to practice in the field. All AAPC certifications share a common goal: help everyone from beginners to experienced professionals advance their careers and contribute positively to the industry.
 

 

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