Skilled medical billing and coding technicians are in high demand these days! In recent years, there has been a rapid increase in medical tests, treatments, and procedures that will be increasingly scrutinized by health insurance companies, regulators, courts, and consumers. Also, patient information must be entered into computer databases to comply with new Federal legislation requiring the use of electronic patient records. Finally, health care facilities are having difficulty attracting qualified workers, mostly because of the lack of both formal training programs and sufficient resources to provide on-the-job training for coders.

All of these factors have combined to create a huge potential job market for qualified medical records technicians, and this course will provide you with the skill set and expertise that will make you irresistible to prospective health care employers. Upon successful completion of the Medical Billing and Coding course, students will be prepared for an entry-level position doing medical billing or coding in a medical office setting and will be prepared to sit for the CCA national certification exam.

Some typical tasks for the Medical Billing/Coding Professional include:

1. Registering of patient information.
2. Performing insurance verification, pre-authorization and referral tasks.
3. Preparing and posting transactions on day sheets, charge tickets and patient accounts.
4. Coding and billing insurance claims.
5. Collecting patient payments and performing collection activities.

Please Note: This course prepares you for the CCA certification. You must also meet the Professional Association's Eligibility Requirements for the examination. The American Health Information Management Association's (AHIMA) eligibility requirement is a high school diploma or equivalent.

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TOPIC HIGHLIGHTS

Module 1 - Introduction to Healthcare

• Various professions and opportunities
• Medical Specialties

Module 2 - Compliance, Law, & Ethics

• HIPAA
• CMS Regulations
• Medical Ethics

Module 3 - Medical Terminology

• Essential Information for Learning by This Quick and Easy Method
• Writing Terms with Suffixes and Combing Forms
• Writing Terms with Prefixes, Suffixes, and Combining Forms
• Diagnostic Procedures and Therapeutic Interventions
• Organization of the Body
• The Musculoskeletal System
• The Circulatory System
• The Respiratory System
• The Digestive System
• The Urinary System
• The Reproductive System
• The Integumentary System
• The Nervous System and Psychologic Disorders
• The Endocrine System

Module 4 - Diagnostic Coding

• The ICD-9-CM Manual
• Federal Law Regarding Use
• Primary Diagnosis vs. Principal Diagnosis
• Organization
• Volume I: Tabular Index
• Volume II: Alphabetic Index to Disease
• Conventions
• Main Terms
• Notes
• Tables
• 4th and 5th Digit Modifiers
• V Codes
• E Codes
• Chapter Descriptions
• Infectious and Parasitic Diseases (001-139)
• Neoplasms (140-239)
• Endocrine, Nutritional and Metabolic Diseases, and Immunity Diseases (240-279)
• Diseases of the Blood and Blood-Forming Organs (280-289)
• Mental Disorders (290-319)
• Diseases of the Nervous System and Sense Organs (320-389)
• Circulatory System (390-459)
• Respiratory System (450-519)
• Digestive System (520-579)
• Genitourinary System (580-629)
• Complications of Pregnancy, Childbirth, and the Puerperium (630-677)
• Diseases of the Skin and Subcutaneous Tissue (680-709)
• Diseases of the Mucoskeletal System and Connective Tissue (710-739)
• Congenital Anomalies (740-759)
• Conditions in the Perinatal Period (760-779)
• Symptoms, Signs and Ill-Defined Conditions (780-799)
• Injury and Poisoning (800-999)

Module 5 - Procedural Coding

• What is Coding?
• The CPT Manual Layout
• CPT Main Index
• CPT Main Index Format and Conventions
• CPT Appendices & Addendums
• CPT Alphabetical Index
• Steps for Procedural Coding
• Using the Alpha Index to Search
• Coding Steps
• Code Modifiers
• CPT Main Index Sections
• Evaluation and Management
• Evaluation and Management Categories
• Most Commonly Used E&M Categories
Levels of Service
• Anesthesia
• Surgery
• Surgical Packages
• Surgery - Integumentary
• Multiple Laceration Repair
• Surgery - Musculoskeletal System
• Surgery - Respiratory System
• Surgery - Cardiovascular System
• Surgery - Hemic: Lymphatic, Mediastimum and Diaphragm
• Surgery - Digestive System
• Surgery - Urinary System
• Surgery - Male Genital System
• Surgery - Intersex, Laparoscopy, Femal Genital and Maternity
• Surgery - Endocrine and Nervous Systems
• Surgery - Eye and Ocular Adnexa
• Surgery - Auditory System
• Radiology Section
• Pathology and Laboratory
• Medicine
• HCPCS Level II
• HCPCS Sections
• HCPCS Modifiers

Module 6 - Insurance Billing

• Industry basics
• CMS-1500 Claim Form
• UB-92 Claim Form
• Electronic Filing & Remittance

Module 7 - Patient Billing and Collections

• Processes
• Rules & regulations

Module 8 - CCA Prep

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CERTIFICATE REQUIREMENTS

A 70% or better must be achieved in order to receive a Certificate of Completion.

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COURSE OBJECTIVES

Upon successful completion of the Medical Billing and Coding program, students will:

• Be proficient in skills such as medical terminology, communication, telephone techniques, organization and time management.
• Have knowledge of Medical Practice Settings and Specialties, as well as the differences in Traditional and Managed Care. Students also learn about Commercial, HMO/PPO, Federal and State insurance plans, including eligibility and coverage, as well as reimbursement methodologies.
• Have knowledge of the legal and ethical responsibilities of an administrative medical specialist, including the HIPAA mandates, the rules for maintaining privacy of medical records and protected health information, and the types of consents and disclosures that are required in a medical office environment.
• Be able to perform tasks associated with the entire Accounts Receivable and Revenue cycle, including registration of patients, posting of accounting transactions, completion of insurance claim forms, and collections.
• Be able to perform the day-to-day tasks associated with medical coding, medical billing and completing insurance forms.
• Be prepared to take an Advanced Coding course to prepare for more advanced national certifications.

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PDF BROCHURE

Please click here to download the PDF brochure for the Gatlin online courses offered by OCPE.

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WHO SHOULD ATTEND

Students should be proficient in keyboarding, have a basic understanding of a word-processing computer program (Microsoft Word recommended), and have a command of English grammar and punctuation. No healthcare or medical office work experience is required.

The target audience for this program is individuals interested in learning job skills for medical office opportunities, changing job skills to become medical office assistants, or changing job skills to become medical coders.

Please Note: This course prepares you for the CCA certification. You must also meet the Professional Association's Eligibility Requirements for the examination. The American Health Information Management Association's (AHIMA) eligibility requirement is a high school diploma or equivalent.

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Patrick Rush:

Patrick currently serves as the Director of Patient Accounting/Managed Care Coordinator at the Key-Whitman Eye Center in Dallas, Texas, and has held that position for nine years. His responsibilities include all aspects of billing and collections for this multi-subspecialty Ophthalmology practice. He negotiates and maintains all insurance company, third-party administrator and managed care network contracts for his five employed physicians, as well as an Ambulatory Surgery Center, Laser Suite and Durable Medical Supply Company. Mr. Rush manages a knowledgeable staff which consistently produces well above expectations.

Mr. Rush is a Certified Ophthalmic Assistant, Ophthalmic Coding Specialist, Certified Medical Office Manager and Certified Medical Insurance Specialist. His involvement with the Texas Ophthalmological Association and the American Academy of Ophthalmic Executives has allowed him to serve as a consultant to several physicians in the areas of coding, billing/collections, and contracting.

Carline Dalgleish:

Carline Dalgleish has been employed in the business office management profession since 1970. She began in the Medical Records department of the Army/Air Force Hospital in Nuremberg, Germany and has, over the years, performed accounts receivable and business office management services for physicians, clinics, and hospitals, as well as the Healthcare Financing Administration (now CMS). She has real-time experience in administrative and financial departments, as well as management experience in business office administration, regulatory compliance, information technology and services. In addition, she has created the curriculum for and instructed accounts receivable and accounts payable educational programs.

In the early 90's, Ms. Dalgleish moved full-time into curriculum development, teaching and management of business and allied health education programs, with special emphasis on business office administration and management.

Ms. Dalgleish is a Certified Medical Assistant-Administrative, a licensed practical nurse, and holds a Bachelor's degree in Business Information Systems. She is currently working on her Master's degree in Leadership.

She is a member of the International Association of Administrative Professionals (IAAB), the National Dean's Scholars List, AHIMA, PAHCOM, AAMA, AAPC, CCST, AAMT and AMTIE. She currently owns and operates COUGAR-Ed.net, which specializes in curriculum development and delivery of continuing education products, seminars and services.

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1. How do I register for a Gatlin online course?

Gatlin does not offer courses directly to the public. It offers courses through George Mason University and other colleges and universities. Please contact our office at 703-993-2113 or click here for more information or to register for a course.

2. How much do Gatlin online courses cost?

To view the prices for all Gatlin courses that are offered by George Mason University, please click here.

3. Why do I have to take Gatlin courses through a participating school?

That is the only way Gatlin Education Services offers its courses. They do not deal directly with the public.

4. Do I have to travel to register for or to attend a Gatlin online course?

All Gatlin courses are delivered entirely online, so you do not have to go to a class or travel to a school. Please contact our office at 703-993-2113 or click here for more information or to register for a course.

5. How long does it take to complete a Gatlin course?

All of our Gatlin courses are asynchronous. You can start and finish the course at your own pace. Most courses are designed to be completed within 180 days. You may request an extension if you think you will need more time to complete a course. Please contact us at 703-993-2113 or click here if you have any questions or if you would like to register for a course.

6. Do I have to buy additional materials?

Please refer to the green Included Materials box located on the upper right hand side of this page. If materials are included in this course, they will be shipped by Gatlin to you via UPS ground service after you have registered for a course.

7. Can I get financial aid for Gatlin courses?

George Mason University offers financial assistance through the Sallie Mae Training Loan Program for qualifying students. Call 703-993-2113 for more information. GES also provides a loan opportunity for students (www.collegeloanapplication.com).

8. What happens when I complete the course?

If you obtain a final passing grade of 70% or greater in a course, we will award you a George Mason University certificate of completion.

9. Who will be my instructor?

Each student is paired up with a George Mason University, OCPE, Gatlin facilitator for one-on-one interaction. The facilitator will be available (by e-mail or by telephone) 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.

10. What are the system requirements in order to take an online course?

Please see the "PC requirements" section listed for individual courses.

11. When can I start the course?

You can register for a course at any time.

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