Medical Billing Deep Dive: Systems, Regulations, Reimbursement Models, Insurance, Claims, and Coding Basics for Success.
What you will learn
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Understand the complete medical billing process and its role in the U.S. healthcare system
Identify key participants in billing, including medical billers, coders, providers, and payers
Explain how different types of insurance (Medicare, Medicaid, commercial) affect billing procedures
Describe various healthcare providers and facilities, and how billing varies among them
Comprehend core billing concepts like deductibles, copayments, coinsurance, and out-of-pocket limits
Navigate the medical billing cycle from patient registration to final payment posting
Recognize and define key billing terms such as claims, EOBs, superbills, and clearinghouses
Understand the purpose and structure of coding systems including ICD, CPT, and HCPCS
Learn how proper documentation supports accurate billing and compliance
Differentiate between paper and electronic claims, and understand standard forms like CMS-1500 and UB-04
Identify common reasons claims are rejected and how to prevent them
Explore healthcare reimbursement models including fee-for-service, capitation, and bundled payments
Identify types of billing fraud and abuse, and understand the consequences
Learn key HIPAA regulations and patient privacy standards in the billing process
Learn best practices for ensuring accurate, timely, and compliant billing
Explore career paths in medical billing, required skills, and job market expectations
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