1. Understand the responsibilities of a medical biller/coder, ethics required in this profession.
2. Explore and avail opportunities available to trained and certified personnel.
3. Builds a vocabulary of medical terminology and accurately use it to describe human anatomy, physiology and pathology of body systems.
4. Understand the purpose and impact of the Health Care Portability and Accountability Act (HIPAA) and learn how change in laws and regulations affect professional working.
5. Compare and contrast the major types of commercial and government insurance health plans, including Medicare, Medicaid, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans.
6. Understand billing guidelines for inpatient medical, inpatient/outpatient, medical/surgical, and minor surgical procedures.
7. Explain the life cycle of a typical insurance claim, the processing steps that must be completed before the submission to the insurance company.
8. Explain the purpose of medical coding and how to code diagnoses and procedures, accurately. Using industry-standard coding systems published by the World Health Organization (WHO) and the American Medical Association (AMA).
9. Accurately use ICD-10-CM/PCS, CPT, and HCPCS codes for diagnoses, procedures, and medical services as part of the insurance reimbursement process.