Certified Professional Medical Billing Online Course

• Register By: 25th of each month
• Start Date: First of each month

Open Enrollment: Course starts the first of every month. Course Fee: $2,000.00 (Includes the following: Medical Billing Training: CPB 2018; AAPC; AAPC publisher (available online only in PDF format) 12 months to complete the course. *Coding books are not included and can be purchased at a discounted price* The instructional methods used include reading assignments, practice exercises, interactive video/audio lectures, chapter review tests, and final exam. To receive a certificate of completion, students must successfully complete the course within the allotted time frame of 12 months or less.

• Prerequisites: Knowledge of medical terminology and anatomy.
• Clock Hours: 80 (Note: 80 clock hours accounts only for time spent in the online course, and does not include time spent outside the course or study time. Study time will vary widely per individual.)
• Course Length: To be completed at student’s own pace within a 12 month period or less. Enrollment date begins on the first of the month.
• Class Hours: Days/Times Per Week: Online course, independent self-study, no classroom meetings; student may login to course at their own time schedule, no specific login times. If you complete one chapter per week, you will stay on track. Students may email course content questions to Northern California Medical Billing & Coding Institute coaching staff.
• Certificate of Completion Issued: Yes.
• Course Description: This course introduces the student to health insurance and reimbursement. In this course the student will become familiar with the health insurance industry, legal and regulatory issues, and differences in reimbursement methodologies. The student will learn principles of medical billing related to proper claim form preparation, submission and payment processing, and the follow up process. This course is recommended for anyone who is preparing for a career in a medical billing department at a physician’s office, clinic, or similar positions. This course is strongly recommended for anyone who is preparing for AAPC’s CPB certification exam.

Course Objectives

1. Review an introduction to healthcare from a medical billing perspective.
2. List a variety of health insurance models and how they affect medical entities.
3. Understand the legal regulatory considerations involved in health care reimbursement and collections.
4. Explain the process of a physician-based insurance claim including obtaining patient data, claim form completion, insurance carrier processing and payment received.
5. Demonstrate the ability to use the three major coding manuals, CPT®, ICD-10-CM, and HCPCS Level II, and apply medical necessity standards.
6. Explain the follow up process for A/R in a physician’s office, including the top denials by insurance carrier along with their appeals process.

Course Content

• Introduction to Healthcare
• Health Insurance Models
• Patient Registration Process/Data Capture
• Introduction to ICD-10-CM Coding
• Introduction to CPT® Coding
• Introduction to HCPCS Level II Coding
• Medical Necessity
• Claim Forms (CMS-1500 and UB-04)
• Billing
• A/R and Collection Concepts
• Government Carriers (Medicare, Medicaid, and TRICARE)
• Blue Cross/Blue Shield
• Commercial Insurance Carriers
• Workers’ Compensation
• Final Exam

Methods of Evaluation

The instructional methods used include reading assignments, practice exercises, interactive video/audio lectures, chapter review tests, and final exam. To receive a certificate of completion, students must successfully complete the course within the allotted time frame of 12 months or less.

Successful course completion includes:

• An attempt of all required assignments
• A passing score of 70% or higher on all chapter review exams
• A passing score of 70% or higher on final exam
• An overall final course score of 70% or higher

No reduced hours in the course or tuition discount for previous education or training will be granted.

Included Reading Material

1. Medical Billing Training: CPB™ 2019; AAPC; AAPC publisher (available online only in PDF format, no textbook will be issued with this course.)

Required Textbooks (Not Included):

1. CPT®Professional Edition (current year), AMA publisher
2. ICD-10-CM (current year)
3. HCPCS Level II Professional (current year)

Required textbooks may be purchased through AAPC or any major bookseller.

Recommended Textbooks/Supplies (Not Included):

1. Medical dictionary

Computer Requirements:

1. High-speed internet connection with Blackboard supported Operating System & Web browser
2. Adobe Flash Player
3. Adobe Acrobat Reader

*For best experience, use of a mobile device is not recommended.