In this intensive, 80-hour Medical Billing and Coding Program, students will learn how medical billing records are produced and kept, and how patient charges are billed and calculated. They will understand how claims are filed, using CPT or ICD-10 manual forms, and how to solve insurance billing problems. Students will gain experience in completing common insurance forms, as well as using generic forms (CMS 1500) to streamline billing procedures. Students will also become aware of how to trace delinquent claims (EOB’s). Finally, students will be introduced to billing in the specialty fields of surgery, radiology, and laboratory work.
The course may ultimately lead the student to seek certification through one of the national medical coding exams, such as the American Academy of Professional Coders (AAPC); the Certified Professional Coder Exam (CPC), and others. Students should be aware, however, that the national exams often require a suggested period of practical coding experience (often six months to as much as two years) prior to taking the exam or receiving the full professional certification.
Who Can Enroll?
Students should have a high school diploma or GED to enroll in the program. A working knowledge of basic computer office applications is also helpful, although the use of a computer is not required in this entry-level course.
In more specific detail, the course will cover these areas in approximately this sequence :
- A career as an insurance coding specialist
- Guidelines for documenting claims, legal aspects affecting insurance claims and medical records
- Basics of health insurance and procedural coding
- Introduction to the CPT manual
- Patient evaluation, Management services
- Specialty coding: Anesthesia/Surgery, Radiology and Pathology, Laboratory Medicine
- Diagnosis Coding
- Modifications to CPT coding
- Introduction to International Classification of diseases
- Health Insurance claim form (CMS 1500)
- HIPAA (privacy of patient records) and EDI (electronic data interchange) issues
- Tracing Delinquent claims; Insurance Problem solving
- Managed care systems: Medicare, Blue Cross and Blue Shield plans; Medicaid and other State Programs; Worker’s Compensation issues; Disability Income Insurance, and Disability Benefit Programs
Courses will meet two evenings per week from 6:00 p.m. to 9:30 p.m., exact days to be determined each quarter according to a Monday and Wednesday or Tuesday and Thursday schedule. A total of 80 classroom hours constitutes one complete session of the course. Classes will meet in university classrooms on the campus of Cal State LA Contact (323)343-4900 for classroom location.
The instructor is very experienced and is familiar with the requirements of medical billing and coding certification exams, and professional duties.