Medical Billing Fundamentals

Below is the outline of all the topics covered in the Fundamentals of Medical Billing course

Each of the topics includes a video explaining the particular topic along with a PDF copy of the material. Additionally approximately 35 essential forms are included as listed below.

Includes over $78 of Free BONUS Material!

Also includes the latest Medical Billing Terms Dictionary edition.




Online Medical Billing Fundamentals Course Topics

Health Insurance Plans

  • Insurance Types & Payers
  • Indemnity, Managed Care, & Consumer Plans
  • Referrals & Preauthorizations
  • Medicare & Government Payers
  • Medicare Administrative Contractors
  • Crossover Claims
  • Insurance Verification
  • Coordination of Benefits
  • Provider Credentialing

Medical Coding Basics

  • ICD-10 Diagnosis Codes and Format
  • Medical Treatment Codes
  • Coding Modifiers
  • Level I & II Codes
  • Categories of Codes
  • Practice management Code Entry
  • Medical Coding Errors
  • Bundled & Unbundled Codes
  • Upcoding & Downcoding
  • Coding Specificity
  • Medical Necessity
  • Coding Resources
  • Coding in Practice Management Software Video

Patient & Provider Info

  • Who What Where Why & When
  • Before Claims Can Be Filed
  • Setting up the Provider
  • Credentialing and Clearinghouse Enrollment
  • Provider Fee Schedule
  • The Superbill
  • Customizing the Superbill
  • Setting up the Patient
  • Verifying Insurance
  • Minimum Patient Info
  • First Visit Patient Forms

CMS-1500 Claim Form

  • Introduction
  • Block-By-Block Description
  • When Paper Forms are Used
  • Electronic Claim conventions
  • Patient & Insured Info
  • Physician Info
  • Electronic CMS-1500 Video Demonstration

Creating & Submitting Claims

  • Claim Standards
  • Entering Patient Encounter
  • Creating Claims
  • Uploading Claims to the Clearinghouse
  • Clearinghouse Claim Status
  • Correcting Rejected Claims
  • Claim Attachments

Applying Payments

  • ERA's & EOB's
  • CoPay's, Coinsurance, & Deductibles
  • Interpreting Remittance Advice and EOB's
  • Explanation or Reason Codes
  • Posting Insurance Payments
  • Applying Insurance Payments
  • Posting Patient Payments
  • Secondary Claims
  • Auto Posting ERA's
  • Creating Patient Statements

Claim Problems & Patient Collections

  • Why Claims Don't Get Paid
  • Coding Error's
  • Error Codes
  • Claim Appeals
  • Patient Collections
  • Insurance Aging Reports
  • Patient Aging Reports
  • Tracking Unpaid Claims

Compliance, Fraud, & Patient Privacy

  • HIPAA & HITECH Laws
  • Administrative Simplification
  • Physical, Administrative, & Technical Safeguards
  • Business Associates & Covered Entity's
  • Fraud & Abuse - What's the Difference?
  • Punishment for Non-Compliance
  • Examples of Fraud & Abuse
  • Patient Consent
  • HIPAA Disclosure
  • Good Office Practices
  • Remote Access
  • Communicating Patient Information

Practice Management Software

  • Choosing a Software
  • Software Platforms
  • Cloud Providers
  • Back-Up of Data
  • Electronic Medical Records Integration
  • Basic Features (Video demo)
  • Basic Clearinghouse Features (Video demo)

***BONUS MATERIAL***

Dental Billing

  • Dental Terminology
  • Insurance
  • Dental Procedure Codes
  • Software
  • Helpful Coding Resources
  • ADA J430D Dental Claim Form
  • Medical Necessity
  • CMS-1500 Special Instructions

Hospital Billing

  • Differences from Physician Billing
  • Hospital Services
  • Hospital & Facility Coding
  • Unique Claim Codes
  • Charge Master
  • Reimbursement Process
  • Prospective Payment Systems
  • UB-04 Claim Form (CMS-1450) By Sections

Essential Medical Billing Forms

Below are all of the forms included (MS Word or Excel format) in the Fundamentals Course:

  • Patient Sign In Sheet 1
  • Patient Sign In Sheet 2
  • Patient Sign In Sheet 3
  • Daily Appointment Log
  • Copay Sign
  • Phone Consultation Form
  • Physician Referral Form 1
  • Physician Referral Form 2
  • Patient Responsibility Insurance Sign
  • Return To Work Form
  • Superbill Template
  • HIPAA Checklist
  • Insurance Preauthorization Reques
  • New Patient Form
  • Medication History
  • Medical History
  • Insurance Verification Form
  • Privacy Practices Acknowledgement
  • Patient Information Form
  • Health Information Release Authorization
  • Payment Policy
  • HIPAA Disclosure
  • Office Forms Tracker
  • CMS-1500 Claim Form
  • CMS-1500 Claim Form Instruction Manual
  • Payment Log
  • Appeal Letter Template
  • Sample Collection Letter
  • Claim Tracking Log
  • Acknowledgement of Receipt of Privacy Policy
  • HIPAA Violation Complaint Form
  • Practice Management Software Comparison


More Fundamentals of Medical Billing Course Info



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