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Medical Billing and Coding Program (Physician)

Medical Billing and Coding (Physician) Program

The Medical Billing program prepares graduates to work with medical coding  in healthcare settings including physician offices, nursing homes, ambulatory surgery centers, rehabilitation centers, home health services,  and medical billing offices. The employment objective is to be a medical coder, medical records clerk, medical insurance claims processing clerk or medical record management clerk. At the completion of the program, learners are prepared to take the credentialed exam with AAPC or AHIMA on physician coding.  The program has a strong emphasis in coding with a solid understanding of billing.

 

Program Duration:  36 weeks

Prerequisite:

  • High School Diploma or GED
  • Basic Computer Skills
  • Math and English competencies at college entrance level or
  • Pearson Test of English (PTE) Academic Score 40 (minimum)

 

Medical Terminology

 

The student will be able to build medical terms by combining forms, word roots, plurals, prefixes, and suffixes. The student will take exams to correctly spell and define medical terms; understand and identify medical prefixes, suffixes, and common medical abbreviations..

 

Anatomy and Physiology

 

This course covers the systems of the human body. Topics covered include; cells and tissues; the senses; the integumentary, musculoskeletal, nervous, immune, digestive, endocrine, circulatory, respiratory, and genitourinary systems. In addition, this course covers the fluid and electrolyte balance, blood, acid-base balance, principles of nutrition and metabolism, reproduction, and growth and development. This course is designed to enable the student to understand the health problems of the patient as they relate to the various systems.

 

 

Fundamentals of Medical Coding

 

This course covers: ICD-9 CM Part I, ICD-9 CM Part II, Introduction to CPT and HCPCS, Billing and Reimbursement.   The course introduces diagnostic coding, guidelines and how-to steps, coding conventions, tips, and understanding of ICD-9-CM Volumes 1 and 2.  Instructor introduces ICD-10 where appropriate.  HCPCS codes for physician and provider procedures and services reporting will also be discussed.  The instructor will also introduce CPT coding conventions and usage.  Learners will recognize and comprehend the CPT-4 (Level I), HCPCS (Level II) and ICD-9-CM coding system and apply the rules to code patient services, apply guidelines and rules to a wide range of original source medical documents, including for insurance claim submission in the clinical setting. The application of the medical coding to billing and reimbursement medical health insurance forms will be introduced.

This course also familiarizes the learner the meaning and importance of documentation, guidelines and compliance.  The significance of accuracy, quality, and ethics are discussed.  The practice is applied to the accurate completion of medical claims and medical documents. Learner acquires a fundamental understanding that accuracy is crucial for coding and reimbursement.

 

Evaluation and Managment Physician Services

 

This course focuses on medical claim submission and  introduces the Evaluation and Medical codes (E/M) principles and for application to medical claim submission. E/M code definitions of key components, reporting consultations, emergency department visits, critical care, preventive medicine, and home health services will be discusses. The learner advances to reporting to providers and understanding various types of audits common to medical practices.

 

Pathophysiology Part 1

Pathophysiology is the study of how normal physiology processes are altered by disease.  This course will include the study of the causes, symptoms, and treatment of neoplasms, congenital disease, respiratory system diseases, circulatory system diseases, musculoskeletal system diseases and cardiovascular system diseases.  The focus of the course gives an overview of code ranges, application and proper documentation.

Pathophysiology Part 2

 

This course continues from Pathophysiology Part I to include the study of the causes, symptoms, and treatment of urinary system diseases, reproductive system diseases, digestive system diseases, endocrine system diseases, nervous system diseases, lymphatic system diseases, skin, eye, and ear diseases.  The focus of the course gives an overview of code ranges, application and proper documentation.

 

Advanced Medical Coding

 

The AMA coding guidelines and the application of proper use of modifiers will be discussed.  The instructor will introduce the coding procedure and guidelines for anesthesia and radiology, pathology and laboratory and clinical and physical medicine.

 

Health Insurance and Medical Billing

 

This course will familiarize the student with the history of the health insurance industry in America, HIPAA, the importance of accurate completion of claims, and the terminology that is required for insurance claim submission in the clinical setting. All commercial insurances, Medicare, Medicaid, and Managed Care including HMOs will be introduced. Instruction will include reimbursement methodologies and collection practices.

 

Medical Office Billing Administration

 

This course provides students with a basic understanding of their duties and responsibilities in the medical billing office. Students will develop communication skills specifically directed toward the medical/billing/facility office including projecting a professional image. This course also includes instruction in billing, taking medical histories, advanced financial administration using Medisoft software, fees, credits, medical transcription procedures, and collection procedures.

 

Final Review

This course is a review and focuses on the final exam preparation for AdSum Medical Billing and Coding Certification.

 

 

Tuition: $7,000

Duration: 9 months

Tuition fees does not include books and credentialed exams.

Upon passing the credentialed exam, AdSum will reward you a reimbursement of the exam application fee.

 

 

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