Unlock Medical Billing Essentials For Success

Medical Billing Deep Dive: Systems, Regulations, Reimbursement Models, Insurance, Claims, and Coding Basics for Success.

What you'll learn

Understand the complete medical billing process and its role in the U.S. healthcare system

Identify key participants in billing, including medical billers, coders, providers, and payers

Explain how different types of insurance (Medicare, Medicaid, commercial) affect billing procedures

Describe various healthcare providers and facilities, and how billing varies among them

Comprehend core billing concepts like deductibles, copayments, coinsurance, and out-of-pocket limits

Navigate the medical billing cycle from patient registration to final payment posting

Recognize and define key billing terms such as claims, EOBs, superbills, and clearinghouses

Understand the purpose and structure of coding systems including ICD, CPT, and HCPCS

Learn how proper documentation supports accurate billing and compliance

Differentiate between paper and electronic claims, and understand standard forms like CMS-1500 and UB-04

Identify common reasons claims are rejected and how to prevent them

Explore healthcare reimbursement models including fee-for-service, capitation, and bundled payments

Identify types of billing fraud and abuse, and understand the consequences

Learn key HIPAA regulations and patient privacy standards in the billing process

Learn best practices for ensuring accurate, timely, and compliant billing

Explore career paths in medical billing, required skills, and job market expectations

Requirements

Willingness to learn Medical Billing for Field Success.

Description

|| Unofficial Course ||This comprehensive course is designed to provide you with a solid foundation in medical billing, whether you are new to the field or looking to enhance your existing knowledge. You will gain a clear understanding of how the medical billing process works within the U.S. healthcare system, including the roles of patients, providers, and payers. From the initial patient visit to final reimbursement, the course walks you through each stage of the billing cycle, highlighting the procedures, terminology, and documentation involved.You'll explore how different healthcare facilities operate, how public and private insurance plans like Medicare and Medicaid impact billing practices, and what responsibilities patients carry in terms of copayments, deductibles, and coinsurance. The course also introduces essential coding systems—ICD, CPT, and HCPCS—and demonstrates how accurate coding and proper documentation are crucial to successful claim submission.As you progress, you’ll learn the differences between paper and electronic claims, how clearinghouses process submissions, and the common reasons for claim rejections. Reimbursement methods are covered in detail, including fee-for-service, capitation, and bundled payments. You will also become familiar with payment documents like Explanation of Benefits (EOB) and Remittance Advice (RA), and understand how to handle claim denials and initiate appeals.Important compliance topics are also addressed, including HIPAA regulations, patient privacy requirements, and common billing fraud scenarios. You'll learn about the significance of internal compliance programs in protecting both healthcare providers and patients.Special topics such as billing for Medicare, Medicaid, workers' compensation, and out-of-network services are included to prepare you for more complex real-world situations. You'll also gain insight into the features and functions of medical billing software and learn best practices to ensure accurate, timely claim management.The course concludes with a look at careers in medical billing, including potential job titles, required qualifications, typical work environments, and salary expectations. Whether you are aiming for an entry-level position, preparing for certification, or exploring a new career in healthcare administration, this course provides the complete training needed to get started confidently in the medical billing profession.Thank you

Overview

Section 1: Introduction to Medical Billing

Lecture 1 What is Medical Billing?

Lecture 2 Key Roles in Medical Billing

Section 2: Understanding the Healthcare System

Lecture 3 The U.S. Healthcare System and Insurance

Lecture 4 Types of Healthcare Providers and Facilities

Lecture 5 Patient Financial Responsibilities

Section 3: Core Concepts in Medical Billing

Lecture 6 The Medical Billing Cycle

Lecture 7 Terminologies in Medical Billing

Lecture 8 ICD, CPT, and HCPCS Code Systems (Overview)

Lecture 9 Encounter Forms and Documentation

Section 4: Insurance and Claims Processing

Lecture 10 Types of Health Insurance Claims

Lecture 11 Claim Submission and Clearinghouses

Lecture 12 Common Claim Rejection Reasons

Section 5: Reimbursement and Payment Processes

Lecture 13 Reimbursement Models in Healthcare

Lecture 14 Explanation of Benefits (EOB) and Remittance Advice (RA)

Lecture 15 Denials and Appeals Process

Section 6: Compliance and Regulatory Requirements

Lecture 16 HIPAA and Patient Privacy in Billing

Lecture 17 Fraud and Abuse in Medical Billing

Lecture 18 Billing Compliance Programs

Section 7: Specialized Billing Topics

Lecture 19 Medicare and Medicaid Billing

Lecture 20 Workers’ Compensation and Auto Insurance Billing

Lecture 21 Out-of-Network and Balance Billing

Section 8: Industry Standards and Best Practices

Lecture 22 Medical Billing Software and Systems (Conceptual Overview)

Lecture 23 Best Practices for Accurate and Timely Billing

Section 9: Careers and Future Trends

Lecture 24 Careers in Medical Billing

Beginners who are new to medical billing and want a step-by-step introduction to the field,Career changers looking to enter the healthcare industry through administrative or billing roles,Students or recent graduates in healthcare, health information management, or medical office administration,Medical office staff who want to better understand the billing process and improve efficiency,Aspiring medical billers and coders preparing for entry-level roles or certification exams,Freelancers or remote workers interested in pursuing medical billing as a flexible career option,Healthcare professionals such as nurses, front desk staff, or administrators seeking to expand their knowledge of the revenue cycle,Small clinic or private practice owners who want to understand how billing works to manage their operations better