Eno’s online course in medical billing training offers students the following benefits:

• Complete Online Training in Medical Billing for the CMCP Exam
• Convenient Anytime, Anywhere Online Training
• Money-Back Certification Guarantee*
• 2,000+ Questions and Exercises
• Extracts of Sample Medical Reports Included
• Detailed Medical Drawings and Animations
• Built-In Online Course Testing
• Audio Included in Limited Sections of Online Course
• Up-to-Date Medical Billing Training Terminology

Foundations of Medical Billing Professional Course Content:

UNIT I

Who Pays and Who Benefits

• The medical billing and reimbursement process is intensely complex
• Understanding medical terminology employed

Provider Structure and Protocols

• The provider’s staff and their responsibilities
• Basic practice elements such as payment policies, etc.
• The patient and the registration process

Hospital Billing

• Types of hospital medical billing: Outpatient, Inpatient and Combination
• Various medical billing functions

Family Relationships

• Integration of information gathered

Billing the Encounter

• What is a “Superbill”?
• Data entry, pre-medical billing protocols Insurance forms and claims processing
• Payments and adjustments
• Appeal process and statements

Practice Economics

• Different types of reports
• Steps to overcome delinquency in payments

Collections

• Managing receivables
• Necessity of monitoring accounts on a regular basis

Coding

• Two main types of coding systems – CPT and ICD
• Coding guidelines and coding summary
• Coding software

Fee Profiles

• Determining attendant fees
• Advantages of CPT system
• Role of insurance companies and physician’s fee schedule

Overview of Medicaid – Medicare

• CMS and its functioning HIPAA – Health Insurance Reform and Administrative Simplification
• Medicare’s EDI and its advantages

UNIT 2

The Health Insurance Specialist

• Basic skill requirements and job description of Health Insurance Specialist
• About ICD 9 (CM) and ICD 10 (CM), their codes and manuals
• HCPCS (Healthcare Common Procedure Coding System)

Billing Terminology

• Commonly used terms in medical billing field
• Evolution of US Healthcare Legislation
• Different types of insurance
• Different types of payment systems used

Healthcare Organization Plans

• Medical biller commonly used terms
• Various healthcare organizations like MCO

Insurance claims

• Actual insurance processing steps
• Place and type of service codes
• Form filling

Payer Processing

• Processing claims, errors and denials
• Insurance regulation

Laws, Rules and Regulations

• Federal, government and state legislations
• Commonly used terminology
• Laws regarding privacy HIPAA - Health insurance portability and accountability act
• Fraud and abuse

Private Insurers

• Blue Cross and Blue Shield, a primary Insurance company
• Different plans and billing rules under this company

Medicare

• About Medicare: its programs and types of coverage
• Medicare Summary Notice

Medicaid

• Various eligibility groups having federal matching funds
• Provider confirmation of eligibility
• Covered service and medical billing information
• Filing claims

Tricare

• About Tricare and its service centers
• CHAMPVA (Civilian Health and Medical Program, Department of Veteran Affairs)
• Medical billing protocol and exceptions

Worker’s Compensation

• Commonly used terminology for medical billers
• Various programs for worker’s compensation; federal and state provider rules
• Claims forms

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