Medical Billing Online, Certificate Program (Online)

The Medical Billing course provides the most up-to-date information relating to the health insurance industry and different reimbursement methodologies for correct claim submission. Successful completion will prepare the student to work in a medical billing department at a physician’s office, clinic, facility, other healthcare entity, or as a claims examiner for insurance carriers.

Admission to the Program
Applicants must present:
1. An official High School Diploma or an official transcript from each college and university attended.
2. A completed Application for Admission form.
3. Knowledge of Medical Terminology and Human Anatomy and Physiology

Objectives
The objectives of the Medical Billing Online Program are to:
● Provide students with the basic knowledge on health insurance industry.
● Prepare students with the basic knowledge on reimbursement methodologies and processes such as:
o Claim Forms CMS-1500
o UB-04
● Provide students with the basic knowledge on Health Industry Billing Processes such as:
o A/R and Collection Concept
o Government Carriers (Medicare, Medicaid, and TRICARE), Blue Cross/Blue Shield, Commercial Insurance Carriers, Workers’ Compensation)
● Express the importance of growing a Christ-like character as a pivotal component of preparation for service across a range of callings.

Learning Outcomes
Upon completion of the Medical Coding Online Program, students will be able to successfully:
● Demonstrate knowledge of the health insurance industry
● Demonstrate skill in the use and preparation of reimbursement forms in the health industry
● Apply knowledge in handling claims with government healthcare carriers
● Apply in an entry level position as a medical biller

Requirement for the Certificate of Completion (Hours)
To receive a Certificate of Completion, a student must:
1) Satisfactorily complete the required courses listed below
2) An attempt of all required assignments
3) A passing score of 70% or higher on all chapter review exams
4) A passing score of 70% or higher on final exam
5) An overall final course score of 70% or higher

All students are required to take the total of 184 hours of the courses as follows:

Course Requirements:  Hours
HSC 401 Introduction to Claims Processing  18
HSC 402 Data Applications and Healthcare Quality  36
HSC 403 Health Insurance and Reimbursement Processing  90
MBO 630 Health Information Practicum  40
Totals  184

Course Description:
HSC 401: Introduction to Claims Processing
This course introduces students to the reimbursement and payment methodologies applicable to healthcare professionals. Students are introduced to the forms, processes, practices, and the roles of health information professionals.

HSC 402: Data Applications and Healthcare Quality
This course explores use of information technologies for data search and access. Principles of clinical quality, utilization review and risk management are introduced, as are organizational approaches, and regulatory and accreditation implications of quality assessment activities. Methods, tools and procedures for analyzing data for variations and deficiencies are examined and used. Research techniques and statistical methods are applied to transform data into effective informational displays and reports to support a quality improvement program. Case studies

HSC 403: Health Insurance and Reimbursement Processing
This course covers the concepts related to insurance products, third-party and prospective payment, and managed care organizations. Issues of data exchange among patient, provider and insurer are analyzed in terms of organizational policy, regulatory issues and information technology operating systems. Charge master management and the importance of coding integrity are emphasized. Case studies.

MBO 630: Health Information Practicum
This course is designed to provide students with hands-on experience with coding authentic patient records. Included is a minimum of (40) hours of practical experience in medical billing for a variety of patient types and encounters. Students can apply their knowledge and skills to complex case studies in a virtual setting.