If you're seeking entry into the healthcare industry, this comprehensive program will provide you with all of the information you need to earn a certification in medical billing and coding.

You will build a foundation of medical vocabulary, to help you better understand the contents of a patient's medical record, as well as notes from practicing physicians. In addition, you'll learn current medical coding standards, so you can be successful within the industry.   Upon completion of this program, you will be prepared to sit for the Certified Billing and Coding Specialist (CBCS) exam, offered by National Healthcareer Association (NHA). The registration fee for this exam is included with this program.    

Course Details

Whether you're just starting out or transitioning into a different field, there has never been a better time to enter the field of Medical Billing and Coding. More than 900,000 practicing physicians in the United States rely on medical billers and coders to receive payment for their services. Aside from medical facilities, positions are available with health insurance companies, pharmacies, medical suppliers, consulting firms, and medical billing companies. Healthcare workers are in high demand due to the increased medical needs of an aging population and the increased number of Americans qualifying for health insurance.

This program offers valuable training in legal, ethical, and regulatory concepts that are central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims. You will gain hands-on, practical experience in medical billing and coding and work with the main coding manuals: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II. You will also learn how to code diagnoses, services, and procedures for all systems of the body.

Medical Terminology is the language of medicine. You will study word parts and the structures and functions of the human body. You will also learn about the disorders and medical procedures common to each body system, including musculoskeletal, cardiovascular, respiratory, digestive, nervous, endocrine, integumentary, genitourinary, lymphatic, and immune. You'll also have the option to complete the all-new Career Roadmap lesson for Medical Billing and Coding. This lesson will help you find, land, and keep a job in your new field. These job-finding and job-landing skills will serve you now and throughout the rest of your career. Upon completion of this program, you should be well prepared to find your place in this rewarding healthcare career. You will also be able to take the Certified Billing and Coding Specialist (CBCS) exam offered by National Healthcareer Association (NHA), the registration fee for this exam is included with the program. This program will also prepare you to sit for the Certified Professional Coder (CPC) exam and the Certified Coding Associate (CCA) exam. 

This program is offered by our partner, ed2go. It is entirely online and is completed at your own pace. When you register, you receive twelve (12) months to complete this program. 

Date: Open enrollment. Start anytime - up to 12 months to complete.

Textbooks

You will be provided the required textbooks for this program:

  • A Guide to Health Insurance Billing
  • CPT Standard Edition
  • HCPCS Level II
  • ICD-10-CM Professional for Physicians
  • ICD-10-PCS
  • Merriam-Webster's Medical Desk Dictionary
  • Medical Terminology for Health Professions

  After successfully completing your program, you'll also receive access to the National Healthcare Association (NHA) online practice exams and study guide, to help you study for your certification exam.

Prerequisites

In order to sit for national certification exams, candidates must have a high school diploma or equivalent; therefore, it is recommended you have this before enrolling for this program.

Continuing Education Units (CEUs): 34
Course Code: UETG 201
Certificate Price: $2,195 (financing available through our partner, ed2go)

Course Outline

Medical Billing and Coding
I.    Introduction to Medical Billing and Coding
                A.    Personal Qualifications
                B.    Career Opportunities
                C.    Certifications
II.    Healthcare Law
                A.    HIPAA Privacy Rule and Security Rule
                B.    Protected Health Information
                C.    Fraud and Abuse
                D.    Stark Law
                E.    False Claims Act
III.    Introduction to Health Insurance Terms
                A.    Health Insurance Terms
                B.    Managed Care
                C.    Healthcare Provider Terms
                D.    Third-Party Reimbursement Methods
IV.    Pharmacology for Coders
                A.    Definition of Pharmacology
                B.    Generic and Brand Names
                C.    Drug Classifications
                D.    Therapeutic Uses of Medications
                E.    Routes of Administration
                F.    Formularies
                G.    Medication Lists
V.    ICD-10-CM
                A.    Overview of ICD-10-CM
                B.    Format of ICD-10-CM
                C.    ICD-10-CM Coding Guidelines
                D.    ICD-10-CM Coding Conventions
                E.    Steps for Assigning ICD-10-CM Codes
VI.    CPT and HCPCS Level II Coding
                A.    Healthcare Common Procedure Coding System
                B.    Organization of the CPT Code Book
                C.    CPT Coding Conventions
                D.    Organization of the HCPCS Level II Code Book
                E.    Steps for Assigning CPT and HCPCS Level II Codes
VII.    Abstracting Information from Medical Documents
                A.    Coding from SOAP Notes
                B.    Coding from a Consultation Report
                C.    Coding from Operative Reports
                D.    Coding from Emergency Room Records
                E.    Coding from Procedure Reports

VIII.    New Patients, Insurance Claims and EOBs
                A.    Electronic, Paper and Hybrid Medical Records
                B.    Practice Management Software
                C.    Patient Portal
                D.    Developing an Insurance Claim
                E.    New Patient Procedures
                F.    Medical Necessity
                G.    Explanation of Benefits (EOB)
                H.    Collection Practices
IX.    Submitting Electronic Claims and CMS 1500
                A.    Electronic Data Interchange (EDI)
                B.    Electronic Claims Submission
                C.    1500 Claim Form
                D.    National Uniform Claim Committee

X.    Blue Cross/Blue Shield
                A.    Participating and Nonparticipating Providers
                B.    Allowable Fee
                C.    Usual, Customary and Reasonable (UCR)
                D.    Blue Shield Claims Submission
XI.    Medicare
                A.    Medicare Parts A, B, C and D
                B.    Participating and Nonparticipating Providers
                C.    Advance Beneficiary Notice (ABN)
                D.    Supplemental Insurance
                E.    NCCI
                F.    Medicare Claims Submission
XII.    Other Healthcare Programs
                A.    Medicaid
                B.    TRICARE
                C.    CHAMPVA
                D.    Workers' Compensation
                E.    Claims Submission
XIII.    ICD-10-PCS
                A.    Overview of ICD-10-PCS
                B.    ICD-10-PCS Code Structure
                C.    Index and Table Conventions
                D.    Code Components
                E.    Definitions Used in ICD-10-PCS
XIV.    Survey of Hospital Billing
                A.    Hospital Revenue Cycle
                B.    Chargemaster
                C.    Master Patient Index
                D.    Prospective Payment Systems
                E.    Principal Diagnosis
                F.    Present On Admission

XV.     Career Roadmap for Medical Billing and Coding - Find a Job Fast
                A.    Introduction
                B.    Succeeding in the Gig Economy
                C.    Your Skills and Talents
                D.    Your Résumé and Cover Letter
                E.    Using Email and Social Media
                F.    Connecting with Others
                G.    Acing the Interview
                H.    Negotiating Your Salary
                I.    After You Land the Job
                J.    Review and Reflect

Medical Terminology
I.    A Foundation in Medical Terminology
                A.    The Fundamentals of Medical Terminology
                B.    Overview of the Human Body
                C.    Practicing What You've Learned
II.    The Skeletal and Muscular Systems
                A.    Overview of the Skeletal System
                B.    Overview of the Muscular System
                C.    Practicing What You've Learned
III.    The Cardiovascular and Respiratory Systems
                A.    Overview of the Cardiovascular System
                B.    Overview of the Respiratory System
                C.    Practicing What You've Learned
IV.    The Digestive, Urinary, and Reproductive Systems
                A.    Overview of the Digestive System
                B.    Overview of the Urinary System
                C.    Overview of the Reproductive System
                D.    Practicing What You've Learned
V.    Nervous and Integumentary Systems and Special Senses
                A.    Overview of the Nervous System
                B.    Overview of the Integumentary System
                C.    Overview of Special Senses
                D.    Practicing What You've Learned
VI.    The Lymphatic, Immune, and Endocrine Systems
                A.    Overview of the Lymphatic System
                B.    Overview of the Immune System
                C.    Overview of the Endocrine System
                D.    Practicing What You've Learned

Can I register for programs if I am an international student?
Yes, because ed2go programs are online you never have to actually travel to the school.  Most schools offer telephone or online registration.

How long does it take to complete a program?
All of our programs are self-paced and open enrollment, so you can start them when you want and finish them at your own pace. This program is entirely online and is completed at your own pace. When you register, you receive twelve (12) months to complete this program.

What if I don't have enough time to complete my program within the time frame provided?
The time allotted to complete your program has been calculated based on the number of hours for each program, so don't worry too much about not completing in time. If, after a concerted effort, you are still unable to complete, your Student Advisor will help you work out a suitable completion date. Please note that a fee will be charged for an extension.

Do I have to buy additional materials?
All the materials you'll need are included, and their cost will be covered by your tuition. ed2go will ship all materials ground service upon enrollment.

Can I get financial assistance?
ed2go courses are non-credit courses, so they do not qualify for federal aid. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses. Additionally, some students may qualify for financial assistance when they enroll, if they meet certain requirements.

What happens when I complete the program?
Upon successful completion of the program, you will be awarded a certificate of completion. In addition, NHA Certified Billing & Coding Specialist (CBCS) exam voucher are provided to you in the format of a digital registration process to enroll for the exam after successful completion of the program and financial obligation.

Am I guaranteed a job?
ed2go programs will provide you with the skills you need to obtain an entry-level position in most cases. We don't provide direct job placement services, but our facilitators and career counselors will help you build your resume and are available to give advice on finding your first job. Facilitators will also be available to use as a professional reference upon completion of the program. Potential students should always do research on the job market in their area before registering.

Who will be my instructor?
Each student is paired with a facilitator for one-on-one interaction.  The facilitator will be available (via e-mail) to answer any questions you may have and to provide feedback on your performance. All of our facilitators are successful working professionals in the fields in which they teach.

What software or hardware do I need in order to take online programs and what are the system requirements?
In order to take our online programs, you must have access to a computer and the Internet. You can access the program contents from any Web-enabled computer. You don't have to use the same computer to log-in to the program every time. We recommend that you have a word-processing program (Microsoft Word is best) and the latest version of Internet Explorer.

Can I use a Mac?
Yes.

How can I get more information about this program?
You can find out more information at our partner's website: ed2go

When can I start the program?
Our programs are all open enrollment. You can register and start the program as soon as you are ready.

Please note: Once the program curriculum is accessed online or through submission of a material shipment confirmation, refunds cannot be issued.

Does this program prepare for a certification?
Yes, you will be prepared to sit for the Certified Billing & Coding Specialist (CBCS) exam offered by National Healthcareer Association (NHA) and receive an exam voucher after successful completion of the program and financial obligation.