medical billing and coding

The Medical Billing and Coding Specialist Certification program is accredited by the National Commission for Certifying Agencies. Performance Based Outcomes for Billing & Coding Specialist Training Programs as approved by the National HealthCareer Association. At the completion of this course, each student will be eligible to challenge the National certification exam in Billing and Coding Specialist. In order to become Billing & Coding Specialist, you will have to achieve a minimum passing score of 70% on the national certification exam. Upon completion of the course, the student should be able to:

· Discuss an insurance company claim process.

· Discuss the process for obtaining authorization for additional treatment by a healthcare specialist.

· Discuss the authorization process for a patient requesting an initial appointment with a health care specialist.

· Discuss the difference between the terms “primary diagnosis” and “principal diagnosis”.

· Identify and properly use special terms, marks, abbreviations, and symbols used in ICD-9-CM coding system.

· Explain the format of the CPT system.

· Discuss the qualifications for a “preventative medicine visit”.

· Code diagnoses and procedures from source documents to complete insurance information on the HCFA-1500 claim form.

· State the four processing steps that must occur before a completed form can be mailed to the insurance company.

· Explain function of National Blue Cross and Blue Shield Association.

· List six categories of persons eligible for Medicare coverage.

· List and define seven types of insurance programs that are primary to Medicare.

· State the deadline for filing Medicare claims. 

· List Medicaid federal guidelines.

· List services covered under the federal portion of Medicaid assistance.

· Explain how to verify a patient’s Medicaid eligibility.

· List Tricare eligibility categories.

· List and define the levels of Tricare coverage.

· List the categories of workers covered by the federal compensation program.

· List and describe types of workers compensation available at state level.

· Describe the correct billing procedures for workers compensation cases.

· Describe how to set-up a filing system for completed claim forms.

SALARY

The average Medical Billing and Coding Clerk salary in the United States is $40,000 as of June 28, 2021, but the range typically falls between $36,200 and $43,900. Salary ranges can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession.