Certified Professional Biller – CPB

Pre-requisites:

Not Applicable

Skill Level:

Beginner to Advanced

Course Hours:

80 Course Hours

Target Audience:

Medical Coders, Auditors, Billers

Summary:

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.

Course Outline:

• 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