Essex County

Certified Medical Billing and Coding (CMBC)

Provided by Academy of Allied Health Sciences

The addition of enhanced skills in Electronic Health Records [EHR] in this course package will provide the student with an edge in the job market in this competitive field. In this course students get an overview of medical insurance billing procedures as used in hospitals and today’s medical practices. They learn coding protocols, and insurance billing procedures. At our center, students learn through computerized billing simulations how to create, save, retrieve, edit, and maintain patient files. In addition, post payments to patient accounts, produce insurance claim forms, correct and resubmit rejected claims, produce insurance claim activity reports and enter electronic claims. Topics covered include: current procedural terminology, international classification of diseases, clinical modification, healthcare procedure coding system, resource-based relative value scale, insurance form preparation, Medicare, Medicaid, Tricare, Blue Cross/Blue Shield, Workers’ Compensation, No Fault, HMO’s, diagnosis-related groups, peer review organizations, and ambulatory patient groups. Students will also learn Medical & Insurance Terminology & Abbreviations, Duties of the Medical Biller, Procedures For Insurance Forms Completion, HIC Universal Claim Form, ADA Forms, Workers Compensation Forms & No Fault, Superbill, Medicaid/Medicare, Medical Coding: CPT Coding, HCPCS, ICD-9CM, Coding Systems E & V Modifiers, Computerized Medical Billing Software, Audit Trails, Payment Follow-up Methods, Insurance Company Policies, Insurance Follow-up Procedures, Title XIX, CPT4, Dental, Campus. The course also includes application usage of several medical billing & coding software such Medisoft and others as well as Electronic Health Records (EHR). Students are individually prepared for National Certification as part of the course and the course includes a 180 hour internship program on completion accomplished within one of several major medical center associations. Upon successful completion of this course, students will receive a certificate of completion and will be eligible for National Certification through the National Healthcareer Association (NHA).

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