Medical Billing and Coding Specialist Total Program Cost with Prerequisite Courses: $4, Total Program Hours with elective

Transcription

1 Medical Billing and Coding Specialist Total Program Cost with Prerequisite Courses: $4, Total Program Hours with elective Medical Billing and Coding Specialists are responsible for translating and sequencing medical documentation into formal standardized, numerical codes for diagnoses and procedures. Medical billing and coding supports the billing process by coding and processing claims. Career Opportunities This program prepares individuals for employment in the medical community that involve medical billing, coding, and claims processing. Various organizations in the community offer opportunities for employment including medical practices, hospitals, nursing/rehab facilities, coding and billing services, insurance companies, government agencies, and consulting firms. Competency Profile This curriculum is designed to prepare students to: Code professional medical services and diagnoses Prepare student to use of variety of coding manuals Monitor accounts receivable and perform collection procedures Create reports for management tools Research and review insurance claims Maintain patients financial and accounting records Enter payment information, adjustments, and balances into computer software programs Analyze health records and assign codes for diseases and procedures Abstract key information from health records for reimbursement, statistics, and research purposes Research and review health records for auditing purposes Monitor compliance with policies and procedures relevant to clinical data management and making suggestions for improvements Take the national certification examination administered by the certifying agencies of the profession PROGRAM REQUIREMENTS Prerequisite Courses: Introduction to Healthcare Medical Terminology Introduction to Anatomy and Physiology Human Illness and Disease Core Curriculum: Introduction to Medical Coding Introduction to CPT Coding Introduction to Medical Insurance Insurance Reimbursement Calculations Hospital Billing Advanced Coding I Advanced Coding II Course Elective* Certification Prep Course (Optional) 18 hours 30 hours 45 hours 45 hours 36 hours 33 hours 24 hours 15 hours 15 hours 24 hours 24 hours 6 hours 6 hours *Select one elective course from the following list: Appeals, Fair Hearings and Collections or Coding and Auditing of Evaluation and Management Services (subject to change) Medical Billing and Coding Specialist (Rev 06/16/15) Page 1

2 RECOMMENDED SEQUENCE FOR STUDENTS Students can complete this program by taking courses in 13 months, attending classes two (2) nights per week OR in 27 months attending class one (1) night per week. Prerequisite Courses: Introduction to Healthcare 18 hours // (6) 3 hour sessions Tuition: $243 This course serves as an introduction to allied health professions. The course reviews the US healthcare delivery system and identifies roles within that system. The course also introduces the student to concepts of cultural diversity, healthcare law and ethics, Universal Precautions, stress in the workplace, professionalism, communication and interpersonal relations and strategies for becoming a successful healthcare employee. Accepted credit transfer: AH 140 (grade C or higher) Medical Terminology 30 hours // (10) 3 hour sessions Tuition: $384 This course will provide the participant with an overview of medical terminology. Beginning with the frequently used prefixes and suffixes, the course will progress to include commonly used terms from each of the major body systems. Frequently used medical abbreviations will also be included. At the end of this program the student will be able to correctly spell the commonly used medical terms, pronounce the medical terms, define the frequently used medical terms, and utilize medical terms in the work place. Accepted credit transfer: BIOL 105 (grade C or higher) Introduction to Anatomy and Physiology 45 hours // (15) 3 hour sessions Tuition: $559 This course serves as an introduction for any career in the healthcare field. Basic body organization and review of all body systems are included within this course. There is no lab required. Accepted credit transfers: BIOL 111 or BIOL 121 & 122 (grade C or higher) Human Illness and Disease 45 hours // (15) 3 hour sessions Tuition: $559 Prerequisites: Medical Terminology and Anatomy and Physiology. This course provides a condensed and simplified overview of the most common clinical disorders found in the health field. Core Curriculum: The following classes are to be completed after prerequisites. Courses are to be taken in recommended sequence. Introduction to Medical Coding 36 hours // (12) 3 hour sessions Tuition: $419 This course will begin with an overview of medical coding. This course will provide instruction for using ICD-10-CM/PCS and ICD-9 CM coding. In the healthcare arena, specific codes describe diseases, injuries, and procedures. To become a proficient coder, it is necessary to have a working knowledge of medical terminology and ICD-9 and ICD-10 characteristics, terminology and conventions. Classes will include instruction and exercises to assist the learner in developing these skills. Introduction to CPT Coding 33 hours // (11) 3 hour sessions Tuition: $419 This course will provide a basic understanding of CPT Coding, which is a system developed by the AMA for standardizing the terminology and coding used to describe medical services and procedures. These codes allow for comparability in pricing, billing and utilization review. The course combines lecture and hands-on applications. The classes are designed for individuals who have minimal CPT coding experience. Introduction to Medical Insurance 24 hours // (8) 3 hour sessions Tuition: $314 Class provides a review of insurance and third-party payment systems. Focus will be on government programs. A basic overview of CMS1500 claims reporting will also be provided. Medical laws and ethics pertaining to health information and HIPAA will be reviewed and discussed. Proper disclosure of health information will be reviewed. Insurance Reimbursement Calculations 15 hours // (5) 3 hour sessions Tuition: $208 This course covers the system for calculating and determining the correct reimbursement for medical fee schedules, including resource-based relative value system (RBRVS), relative value units (RVUs), and Perspective Payment Systems (PPSs). Focus will also be on reading and understanding explanation of benefits (EOBs). Medical Billing and Coding Specialist (Rev 06/16/15) Page 2

3 Hospital Billing 15 hours // (5) 3 hour sessions Tuition: $208 This course will explore billing, coding and payment for hospital outpatient and inpatient services. The class will place a focus on applicable Medicare payment systems, Diagnosis Related Groups (DRG), ICD-9-CM, ICD-10-CM and PCS, HCPCS coding, and the UB-04 as it relates to facility billing. Learned concepts will be exercised through the utilization of case studies. Advanced Coding I 24 hours // (8) 3 hour sessions Tuition: $384 This course builds on coding skills with case studies in CPT, ICD-9 coding, ICD-10 coding, and a focus on Category II and II codes, PQRI, HCPCS level II and an overview of ICD-10. Advanced Coding II 24 hours // (8) 3 hour sessions Tuition: $384 This course further builds on coding skills with a focus on chart auditing, fee-for-service payments versus DRG s, HMO s, etc. CMS (HCFA) reviews and appeals, accounts receivable management and collection procedures, NCCI and compliance. Electives (choose one of the following): Check schedule for availability Coding and Auditing of E and M Services 6 hours // (2) 3 hour sessions Tuition: $103 This course is for physician and outpatient hospital billers and coders and will introduce the concepts of correct coding of Evaluation and Management (E&M) services, the current CMS Evaluation and Management guidelines, and current audit tools available. Appeals, Fair Hearings & Collections 6 hours // (2) 3 hour sessions Tuition: $103 This course will cover the basic processes involved in generating appeals to third-party payers (i.e. insurance companies), basic skills of telephone appeals, creation of written appeals. Also included are Medicare s appeal process and the basic guidelines of collections including legal aspects. Optional Certification Preparation Course: (not included in total program cost) Medical Coding Certification-Prep Course 6 hours // (2) 3 hour sessions Tuition: $103 Students will be given the necessary information to prepare and apply for coding certification, explore exam-taking skills, and review case studies. Please Note: The student may be required to submit Act 33 Child Abuse and/or Act 34 Pennsylvania State Police Criminal Background Checks prior to obtaining employment. The student should consider this factor before enrolling in the program. The complete program is available at the Harrisburg Campus. Prerequisites and some core curriculum courses in this program may also be available at the Lancaster and York Campuses, as well as online. Medical Billing and Coding Specialist (Rev 06/16/15) Page 3

4 The Medical Billing and Coding Specialist program is offered at the Harrisburg Campus in a two night per week accelerated format OR a one night per week format. Listed below is the accelerated schedule. Students starting the prerequisite courses in July 2015 will start the core courses in January Students who have already completed the prerequisite courses may follow the second schedule listed below -- Core Courses Only. Please contact the program coordinator to assist with scheduling courses. **HACC reserves the right to change the curriculum at any time based upon occupational and program needs. Scheduled class dates and instructors can change without notice. JULY 2015 Course Schedule (including Prerequisites) HARRISBURG CAMPUS - ACCELERATED Attend class two nights per week Prerequisite Courses Intro to Healthcare 07/07/15 07/23/15 Tues/Thurs 6pm-9pm Eisenhour Medical Terminology 08/04/15 09/03/15 Tues/Thurs 6pm-9pm Eisenhour Intro to A & P 09/08/15 10/27/15 Tues/Thurs 6pm-9pm Sanchez Human Illness & Disease 11/03/15 01/14/16 Tues/Thurs 6pm-9pm Eisenhour no class 12/22, 12/24, 12/29 & 12/31 Core Courses Intro to Medical Coding 01/19/16 02/25/16 Tues/Thurs 6pm-9pm TBA CPT Coding 03/03/16 04/07/16 Tues/Thurs 6pm-9pm TBA Intro to Med. Insurance 04/12/16 05/05/16 Tues/Thurs 6pm-9pm TBA Insurance Reimbursement 05/10/16 05/24/16 Tues/Thurs 6pm-9pm TBA Hospital Billing 06/07/16 06/21/16 Tues/Thurs 6pm-9pm TBA Elective-Collections 06/28/16 06/30/16 Tues/Thurs 6pm-9pm TBA CRNs available Summer 2016 Elective 07/05/16 07/07/16 Tues/Thurs 6pm-9pm TBA Advanced Coding I 07/12/16 08/04/16 Tues/Thurs 6pm-9pm TBA Advanced Coding II 08/09/16 09/01/16 Tues/Thurs 6pm-9pm TBA Coding Prep Course 09/06/16 09/08/16 Tues/Thurs 6pm-9pm TBA JULY 2015 Course Schedule (Core Courses Only) HARRISBURG CAMPUS - ACCELERATED Attend class two nights a week Student must have Prerequisite courses completed prior to following this sequence of classes. Core Courses Intro to Medical Coding 07/14/15 08/13/15 Tues/Thurs 6pm-9pm Roeting CPT Coding 08/20/15 09/24/15 Tues/Thurs 6pm-9pm Roeting Intro to Med. Insurance 10/06/15 10/29/15 Tues/Thurs 6pm-9pm Jones Insurance Reimbursement 11/03/15 11/17/15 Tues/Thurs 6pm-9pm White Elective-Collections 11/19/15 11/24/15 Tues/Thurs 6pm-9pm Jones Elective-Coding & Auditing 11/19/15 11/24/15 Tues/Thurs 6pm-9pm Roeting Hospital Billing 12/01/15 12/15/15 Tues/Thurs 6pm-9pm Jones Advanced Coding I 02/09/16 03/03/16 Tues/Thurs 6pm-9pm Hunter Advanced Coding II 03/08/16 03/31/16 Tues/Thurs 6pm-9pm Hunter Coding Prep Course 04/05/16 04/07/16 Tues/Thurs 6pm-9pm Roeting Medical Billing and Coding Specialist (Rev 06/16/15) Page 4

5 The Medical Billing and Coding Specialist program is offered at the Harrisburg Campus in a two night per week accelerated format OR a one night per week format. Listed below is the schedule for classes that occur one night per week, students starting the prerequisite courses in July 2015 will start the core courses in July, Students who have already completed the prerequisite courses may follow the second schedule listed below Core Courses Only. Please contact the program coordinator to assist with scheduling courses. **HACC reserves the right to change the curriculum at any time based upon occupational and program needs. Scheduled class dates and instructors can change without notice. JULY 2015 Course Schedule (includes Prerequisites) HARRISBURG CAMPUS Attend class one night per week Prerequisites Intro to Healthcare 07/06/15 08/14/15 online N/A Coryer Medical Terminology 08/17/15 10/23/15 online N/A Lyter Intro to A & P 10/26/15 02/19/16 online N/A Coryer no class 12/21 & 12/ Human Illness & Disease 02/29/16 06/10/16 online N/A Coryer Intro to Healthcare 07/08/15 08/12/15 Wednesday 6pm-9pm Meiser Medical Terminology 08/19/15 10/21/15 Wednesday 6pm-9pm Eisenhour Intro to A & P 10/26/15 02/15/16 Monday 6pm-9pm Eisenhour no class12/21 & 12/ Human Illness & Disease 02/29/16 06/13/16 Tuesday 6pm-9pm TBA Core Courses CRNs available Summer 2016 Intro to Medical Coding 07/06/16 09/21/16 Wednesday 6pm-9pm TBA CPT Coding 09/28/16 12/07/16 Wednesday 6pm-9pm TBA Intro to Med. Insurance 01/04/17 02/22/17 Wednesday 6pm-9pm TBA Insurance Reimbursement 03/08/17 04/05/17 Wednesday 6pm-9pm TBA Hospital Billing 04/12/17 05/10/17 Wednesday 6pm-9pm TBA Elective 04/03/17 04/10/17 Monday 6pm-9pm TBA Advanced Coding I 05/07/17 07/05/17 Wednesday 6pm-9pm TBA Advanced Coding II 07/19/17 09/06/17 Wednesday 6pm-9pm TBA Coding Prep Course 09/13/17 09/20/17 Wednesday 6pm-9pm TBA JULY 2015 Course Schedule (Core Courses Only) HARRISBURG CAMPUS Attend class one night a week Student must have Prerequisite courses completed Intro to Medical Coding 07/06/15 09/28/15 Monday 6pm-9pm Zigman CPT Coding 10/07/15 12/16/15 Wednesday 6pm-9pm Hunter Intro to Med. Insurance 01/13/16 03/02/16 Wednesday 6pm-9pm TBA Insurance Reimbursement 03/14/16 04/11/16 Monday 6pm-9pm TBA Hospital Billing 04/20/16 05/18/16 Wednesday 6pm-9pm TBA Elective 05/25/16 06/01/16 Wednesday 6pm-9pm TBA Elective 05/23/16 06/06/16 Monday 6pm-9pm TBA Advanced Coding I 06/09/16 07/28/16 Thursday 6pm-9pm TBA CRN s available Summer 2016 Advanced Coding II 08/11/16 09/29/16 Thursday 6pm-9pm TBA Coding Prep Course 10/03/16 10/10/16 Monday 6pm-9pm TBA Medical Billing and Coding Specialist (Rev 06/16/15) Page 5

6 The Medical Billing and Coding Specialist program is offered at the Lancaster Campus in a one night per week format. Listed below is the schedule for classes that occur one night per week. Students starting the prerequisite courses in July, 2015 will start the core courses in July Students who have already completed the prerequisite courses may follow the second schedule listed below -- Core Courses Only. Please contact the program coordinator to assist with scheduling courses. **HACC reserves the right to change the curriculum at any time based upon occupational and program needs. Scheduled class dates and instructors can change without notice. Prerequisite Course JULY 2015 Course Schedule (includes Prerequisites) LANCASTER CAMPUS Attend class one night per week Intro to Healthcare 07/06/15 08/10/15 Monday 6pm-9pm White Medical Terminology 08/19/15 10/21/15 Wednesday 6pm-9pm Meiser Intro to A & P 11/03/15 02/23/16 Tuesday 6pm-9pm Kindrew no class 12/22 & 12/ Human Illness & Disease 03/02/16 06/08/16 Tuesday 6pm-9pm Eisenhour Core Courses- CRN s available Summer 2016 Intro to Medical Coding 07/11/16 10/03/16 Monday 6pm-9pm TBA CPT Coding 10/10/16 12/12/16 Wednesday 6pm-9pm TBA Intro to Med. Insurance 01/09/17 03/06/17 Monday 6pm-9pm TBA Insurance Reimbursement 03/13/17 04/10/17 Monday 6pm-9pm TBA Hospital Billing 04/17/17 05/15/17 Wednesday 6pm-9pm TBA Elective 04/04/17 04/11/17 Tuesday 6pm-9pm TBA Advanced Coding I 05/07/17 07/05/17 Wednesday 6pm-9pm TBA Advanced Coding II 07/19/17 09/06/17 Wednesday 6pm-9pm TBA Coding Prep Course 09/13/17 09/20/17 Wednesday 6pm-9pm TBA JULY 2015 Course Schedule (Core Curriculum) LANCASTER CAMPUS Attend class one night a week Students must have Prerequisite courses completed Intro to Medical Coding 07/08/15 09/23/15 Wednesday 6pm-9pm Meiser CPT Coding 09/23/15 12/16/15 Wednesday 6pm-9pm Meiser no class 11/25/ Intro to Med. Insurance 01/12/16 03/01/16 Tuesday 6pm-9pm TBA Insurance Reimbursement 03/15/16 04/12/16 Tuesday 6pm-9pm TBA Hospital Billing 04/19/16 05/17/16 Tuesday 6pm-9pm TBA Elective 05/24/16 05/31/16 Tuesday 6pm-9pm TBA CRN s available Summer 2016 Advanced Coding I 06/09/16 07/28/16 Thursday 6pm-9pm TBA Advanced Coding II 08/11/16 09/29/16 Thursday 6pm-9pm TBA Coding Prep Course 10/03/16 10/10/16 Monday 6pm-9pm TBA Medical Billing and Coding Specialist (Rev 06/16/15) Page 6