Programs

Medical Billing and Coding Program Curriculum

600 Hrs (35 weeks in a.m. 50 weeks p.m.)

CIP Code: 51.0714

Medical Billing and Coding Program Requirements

1. All students must me at least eighteen (18) years of age before the first day of class.
2. A High School Diploma or a General Education Development (G.E.D.) Diploma.
3. The Ability to benefit which is defined as ninth (9th) grade reading/math level as measured by the Wonderlic Basic Skills Test (WBST).
4. Interview for reviewing WBST score

Program Description

Our program is designed to generate multi-skilled Medical Biller and Coder with basic knowledge and training needed to succeed in the fundamental areas of medical billing. At Imagine The Future the objective of this program prepares the graduate to apply for entry-level as a Medical Billing and/or Coding Specialist. Students will learn to demonstrate knowledge of Medical Terminology, Anatomy and Physiology, Health Insurance and Reimbursement, Practical Applications, Medical Billing and Medical Coding. Our graduates will be able to handle administrative office procedures such as accounts receivable, accounts payable, collections, computer applications and filing insurance claims. A Medical Biller assures that health insurance companies and patients are accurately billed and paid for all procedures provided by a healthcare professional. Coders will analyze encounter forms to compile operative reports, discharge summaries and data for billing statements. Our graduates will be familiar with different types of insurance plans, regulations, and codes. They will use standard industry codes like ICD for diagnostic codes, CPT for procedure codes and HCPCS for medical claims.

Medical Billing and Coding Pre-requisites

A candidate for the Medical Billing and Coding certificate program is expected to participate fully in activities required by all courses in the program. A student in the program must have abilities and skills of four varieties: observation, communication, motor and behavioral.

Reasonable accommodations will be made for disabilities; however, a candidate is expected to perform in a reasonably independent manner. The skills listed below are essential requirements for this program. Applicants and students should possess these abilities or be able to demonstrate the ability to satisfy these criteria with the help of compensatory techniques, assistive devices or other reasonable accommodations. We invite any candidate for the program to meet with an admissions representative to discuss any potential issues associated with meeting these requirements.

Visual Observation: The applicant must be able to participate actively in all demonstrations, exercises and classroom activities in the program.

Communication Skills: The applicant must be able to communicate effectively with patients in order to elicit information, describe changes in mood, activity, posture, and assess non-verbal communication. The applicant must be able to effectively transmit information to patient, peers, faculty and staff in addition to all members of the health care team.

Motor Function: The applicant must possess sufficient motor functions to perform all skills necessary to carry out required techniques.

Behavioral and Social Attributes: The applicant must be able to demonstrate rational and appropriate behavior. Individuals should give careful consideration to the mental and physical demands of the program prior to registration.

Medical Billing and Coding program consist of:

Course Number	Course Title	Clock Hours
BC 110	Medical Terminology	48 Hours
BC 111	Anatomy & Physiology	143 Hours
BC 113	Health Insurance and Reimbursement	50 Hours
BC 114	Medical Billing	145 Hours
BC 115	Medical Coding	160 Hours
BC 116	Practical Applications	54 Hours

48 hours of medical terminology where students will learn how to study the component parts of medical terms: prefixes, suffixes and word roots. Practice formation, analysis and reconstruction of terms. Emphasize spelling, defining and pronouncing medical terms. Introducing body systems, operative, diagnostic and therapeutic terminology.

143 hours of anatomy and physiology which will introduce students to a general overview of the human body, including its structure, functions of all body systems, and an introduction an diseases. Students will learn how to apply this information while performing billing and coding functions.

50 hours of healthcare insurance and reimbursement which is designed to teach students about major insurance programs, federal healthcare legislation programs and claims. Students will gain knowledge is completing claim forms efficiently, effectively and in compliance with guidelines and regulations. Students will learn CMS reimbursement issues, coding for medical necessity, CMS claim forms, commercial claims, Medicare, Medicaid, Tricare, and Workers Compensation.

145 hours of medical billing emphasizing the usage of billing software. Includes preparing patient databases, making entries to accounts, preparing billing statements and insurance forms, differentiates between the manual and static coding process. Students perform static coding with ICD and CPT coding manuals, and complete financial statements, as well as familiarize themselves with different medical reports and hoe to use these reports to bill for service and rendered. Students will review collection practices for overdue accounts and establishes a format for collection policies in a medical facility and also learn how to use and complete hospital billing forms properly.

160 hours of medical coding designed to administer the fundamentals needed for basic understanding of diagnosis coding. Introduction to ICD-9-CM Coding will stress the importance of the conventions and instructional data of the ICD-9-CM system, and will introduce the most up-to-date coding guidelines necessary to use the system correctly. Students will be able to assign E/M codes according to HCFA guidelines, by analyzing the key components.

54 hours of practical applications where students will practice the skills that they have learned throughout the program of proper billing techniques and the collection of payment. Includes patient registration and perpetration of ledger card. Students will review ambulatory penitent groups, cycle billing, monthly billing, computerized billing and collection. We will focus on completion of claim forms for commercial and government insurance carriers including Medicare, Medicaid, HMO's, CHAMPUS, TRICARE, CHAMPVA, Blue Cross/Blue Shield, and Workers' Compensation.

Program Length

The program consist of 600 clock hours
Day Classes:
Mon.-Thus. 8:30am–2:30pm
Breaks: 10:30am–10:50am, 12:50pm–1:10pm
20 hours per week (excluding breaks) × 30 weeks = 600 hours
Evening Classes:
Mon.–Thurs. 6:00pm–10:00pm
Break: 7:40pm–8:00pm
14 hours per week (excluding breaks) × 43 weeks = 600 hours

Upon completion of this program students will be able to demonstrate both clerical and clinical competency in the areas of professional practice. Upon graduation students will be prepared to seek secure employment as a Medical Biller and/or Coder in hospitals, clinics, medical offices, and other health care facilities.

Facility

Lectures will be offered in our classrooms where instructors will provide anatomy models, and billing data when necessary. Clinical practice will be offered in our school's laboratory where the room is designed as a medical setting for students to perform the practical part of the program. The lab consist of two examination tables with an EKG machine on the side of each one, and two phlebotomy chairs with arm models where our students will have hands on training in patient preparation and proper performance skills.

Instructional Staff

A Certified Medical Biller and Coder with a minimum of two years hand-on experience in all modalities will teach the Medical Billing and Coding program.

Method of Instruction

1. Lecture
2. Discussions
3. Class participation
4. Audio Visuals
5. Written Handouts
6. Homework assignments
7. Skills demonstration
8. Practical Experience

Method of Evaluation

1. Class assignments
2. Homework assignments
3. Written Quizzes and Tests
4. Final Exam
5. Direct observation
6. Skills Check list

Enrollment

There will be a maximum of 10 students per class.

Program Goals:

Students will also be able to properly complete an insurance claim form for most insurance carriers. Recognize and identify insurance cards and the necessary information on them and the basic coverage that apply to specific providers. Accurate code from the medical record using ICD-9 and CPT. Possess working knowledge of collection procedures, posting payments and reimbursement methods. Be familiar with electronic billing and submitting claims. Complete a computerized simulation on patient billing.

Program Objectives:

Upon Completion of this program the student will demonstrate knowledge of the health care delivery system, medical billing and coding, medical terminology, basic understand of the anatomy and physiology of the body systems and anatomic terminology in order to relate major areas of clinical settings to general pathologic conditions associated with body systems, health insurance and reimbursements.

We expect students to show/demonstrate a critical and analytical approach that recognizes multiple perspectives. We expect students to apply the appropriate theories, terminologies, and techniques in their work. This course meets these goals because students will have to demonstrate critical and analytical thought, identify theories, terms, technique and the concept of patient care with emphasis on complementary roles of a Medical Biller and Coder.

This curriculum is aligned to meet the National Skill Standards.

Textbooks

Medical Insurance Billing and Coding An Essential Worktext
By Marilyn Fordney, CMA-AC, CMT and Linda L French, CMA-C, NCICS, CPC

Equipment and Supplies

A fully equipped room with ten (10) computers will be accessible to our medical billing and coding students.