This course is designed for individuals with or without practical medical billing and medical insurance knowledge. Candidates who want to gain knowledge in various areas of HIPAA Compliance in Medical Billing, Electronic Data Interchange (EDI) Claims Transactions, Insurance procedures, CPT codes and ICD-9 codes and State-of-the-Art Medical Billing Software Applications.
The above qualifications combined with in-depth knowledge of HIPAA Privacy and Security regulations prepares a student for an advanced career in Healthcare and Insurance Industries.
Goals of the course
Course Overview:
With the new HIPAA regulation deadline looming, Physicians are overwhelmed with insurance paperwork these days. Medical claims processing has become big business! With the right training, you could have the skills to process medical claims efficiently, handle patient invoices, and obtain reimbursements for both patients and doctors. This program is designed to enable candidates to learn about Medical Billing from initiation to final collections.
In addition, the candidate will be ready for the following two certification exams: Certified HIPAA Professional (CHP) and Certified HIPAA Security Specialist (CHSS).
The HIPAA Professional exam validates knowledge and skills in the core areas of HIPAA administrative Simplification legislation, Transactions and Code Sets Requirements, Privacy Requirements and Security Requirements. The HIPAA Security Specialist exam validates knowledge and skills in the core areas of HIPAA Security Rule, Administrative Procedures, Physical Safeguards, Technical Security Mechanisms, Technical Security Services, Electronic Signatures and Security Policy.
Course Outline:
The Medical Billing program consists of five modules
1. Introduction:
1.1 Medical Billing process
1.2 Data entry
1.3 Paper claims v/s Electronic claims
1.4 Payment and Reports
2. Forms and Procedures:
2.1 Patient demographics
2.2 Insurance types and procedures
2.3 Super bills
2.4 The HCFA 1500 form
3. Medical codes usage:
3.1 CPT (Current Procedural Technology) Codes
3.2 ICD (International Classification of Diseases) Codes
4. Medical Billing Software (Hands on training)
5. Medical Billing lifecycle
5.1 Gathering claim data
5.2 Data entry
5.3 Claim format (Paper/Electronic)
5.4 Claim submission
5.5 Payment posting
5.6 Reporting
The HIPAA Privacy and Security Professional course also has five modules
Course Outline
1. HIPAA
1.1 What is HIPAA?
1.2 HIPAA Compliance and Business Transformation
2. Terminology and Standards
2.1 HIPAA Terminology
2.2 HIPAA's Standard for Electronic Transactions
2.3 HIPAA Privacy Requirement
2.4 HIPAA Security Requirement
3. Planning and Framework
3.1 Planning for HIPAA (Crafting a Plan)
3.2 Framework for HIPAA Compliance (Taking Action)
HIPAA Awareness Training Review (Day 3 Early Afternoon)
Certified HIPAA Professional Exam (Day 3 Afternoon)
4. Case studies and Lab sessions
4.1 Security and Electronic Signature Standards
Scenario:
Securing a Physician's Practice
Administrative Procedures
Technical Security Services
4.2 Class Task:
Developing a Contingency Plan
Physical Safeguards
4.3 Technology:
b Authentication Solutions
Technical Security Mechanisms
5. Techniques
5.1 Firewall Systems
5.2 Technology:
Intrusion Detection Systems
Electronic Signatures
Security Policy
5.3 Reviewing a Security Policy
Getting Started, Security Initiatives
HIPAA Professional Training Review (Day 5 Early Afternoon)
