You’re Just One Step Away

Here’s everything you get:

• Medical Terminology: Understanding medical terms for accurate coding and billing.
• Anatomy and Physiology: Basic knowledge of the human body for understanding procedures and diagnoses.
• Insurance Basics: Familiarity with different insurance types, coverage, and reimbursement processes.
• Healthcare Reimbursement: Understanding how providers are paid for services.

Revenue Cycle Management (RCM)

• Patient Registration: Accurate data collection for patient demographics and insurance information.
• Insurance Verification: Checking eligibility and benefits before services.
• Authorizations: Obtaining prior approvals for procedures and treatments.
• Charge Capture: Accurately recording services rendered and related charges.
• Coding and Billing: Assigning appropriate codes to services and submitting claims.
• Claims Submission and Follow-up: Sending claims electronically or on paper and pursuing denied or unpaid claims.
• Payment Posting: Recording and applying payments to patient accounts.
• Denial Management: Addressing and resolving claim denials.
• Patient Billing and Collections: Generating statements and collecting patient payments.
• Account Receivable Management: Monitoring outstanding balances and implementing collection strategies.

Regulatory Compliance

• HIPAA: Understanding and adhering to patient privacy and security regulations.

Advanced Topics

• Practice Management Software: Learning to use billing software efficiently.
• Fraud and Abuse Prevention: Identifying and preventing fraudulent billing practices.
• Performance Analysis: Measuring RCM efficiency and identifying areas for improvement.

Essential Skills

• Customer Service: Effective communication with patients, providers, and payers.
• Attention to Detail: Accuracy is crucial in medical billing.
• Problem-Solving: Resolving billing issues and finding solutions.
• Organizational Skills: Managing patient records and claims efficiently.

By mastering these topics, you’ll gain a comprehensive understanding of medical billing and RCM, essential for a successful career in healthcare finance.