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Course Information
Business and Information Technology Education
BT00078
Patient Billing
180.00
This course provides an overview of the medical office accounting procedures, introduces you to the features of a patient billing system, and presents important concepts relating to a medical office accounting function. Simulated practice allows the student to assume the role of a medical billing assistant in a doctor's office using cutting-edge patient billing software.
Jaclyn Arnold
(405) 743-5419
jaclyn.arnold@careertech.ok.gov
Foundations of Medical Office/Medical Terminology
CHAMPUS
-Determine the personal deductible for military retirees on the TRICARE Standard
-Define the Defense Enrollment Eligibility Reporting System (DEERS)

HIPAA
-Explain how HIPAA applies to Electronic Claims, Information Security, and Patient Privacy

Medicaid
-Determine the time frame for submitting a traditional Medicaid claim
-Determine the maximum time frame for filing an appeal for a Medicaid claim
-Define and apply the theory of reciprocity
-Identify which group is excluded from Medicaid cost sharing

Medical Billing Basic Knowledge
-Determine which diagnoses, procedures, modifiers, and multipliers should be placed on a claim form
-Identify and define symbols used in the CPT book
-Define HCPCS Codes
-Define Super bill

Medical Billing Process
-Define upcoding

Medicare
-Identify which agency issues the UPIN codes
-Define Medigap, and prevailing charge
-Determine benefits for Part A and Part B of Medicare
-Identify the information on a Medicare health card
-Determine the qualifications for Medicare disability coverage
-Define the basis of fraud for Medicare purposes
-Determine a primary and secondary payers for Medicare claiims
-Describe the types of claims handled by fiscal intermediaries

TRICARE
-Determine eligibility
-Identify the plans and the Fiscal Intermediary

Electronic Claims
-Identify the advantages of using electronic claims
-Define clearinghouses

Managed Care
-Define Pre-authorization, Capitation, professional courtesy write-off, managed care

Medical Billing
-Identify the three volumes of the ICD-9-CM
-Define V codes
-Determine the number of chapters for classification of diseases and injuries
-Identify the six sections of the CPT Coding Book
-Identify the key components in the Evaluation and Management code section
-Identify and define symbols used in the CPT book
-Locate where the short code descriptions for the current year in the CPT book
-Determine the time required for medical record retention
-Identify the form indicators on the HCFA Forms
-Define the following terms: Diagnostic Related Groups (DRG) rate, COBRA, claim window, indemnity benefit, fees schedule, and balanced billing
-Determine which diagnoses, procedures, modifiers, and multipliers should be placed on a claim form
-Determine which box on the HCFA form the MEDIGAP information appears
-Determine the place of service code

Medical Billing Documents
-Identify where the date of birth is placed on the CMS Form 1500
-Determine the proper way to bill the repair of multiple lacerations

Medical Terminology
-Define the following terms: malac(o), syndesm, abduction, ule, dolicho, chronic, trophy, radius, rachi, ectasia, obstetrician, specialist and colpospasm.

Specialty Billing
-Define ERISA Benefit Requirements and ERISA Eligibility

Workman's Comp
-Define Workman's Compensation benefits
-Define the FECA Program
Required Certifications (or equivalent industry certification):
Brainbench:
-Medical Billing

Recommended Additional Competency Testing:
ODCTE:
-Accounts Receivable (or Brainbench Accounts Receivable/Billing Fundamentals)
-Accounts Payable (or Brainbench Accounts Payable Fundamentals)

ODCTE: http://www.okcareertech.org/educators/assessments-and-testing/testing

Brainbench:
-Business Ethics Awareness (US)
-Listening Skills

Brainbench: http://www.okcareertech.org/educators/assessments-and-testing/brainbench-testing.
Brainbench: http://www.brainbench.com
Textbooks:
Benchmark Series: Microsoft Access 2010, Level 1, Paradigm.
College Accounting Student Edition, McGraw-Hill.
Coding Basics: Understanding Medical Collections, Cengage Learning.
Getting Started in the Computerized Medical Office: Fundamentals and Practice, Textbook and Workbook, Cengage Learning.
Exploring Electronic Health Records, Paradigm.
Insurance Handbook for the Medical Office, Elsevier.
Law and Ethics for Medical Careers, McGraw-Hill.
Medical Billing 101, Cengage Learning.
Medical Insurance, An Integrated Claims Process Approach, McGraw-Hill.
Patient Billing, McGraw-Hill.

Business Management and Administration Career Cluster:
http://careertech.org/business.

ctYou.org Resources by Subject:
http://moodle.okcareertech.org/mod/book/view.php?id=1268.

Free Resources:
GCF LearnFree: www.gcflearnfree.org.
Microsoft Office Reference Guide: http://freecomputerbooks.comMicrosoft_Office_Reference_Guide.html.
Microsoft: http://office.microsoft.com/en-us/training/.
What's New in Office 2013 - Your Unofficial Overview: http://freecomputerbooks.tradepub.com/free/w_make101/?p=w_make101.

Interactive Tools:
MindTap, Cengage Learning.
SAM, Cengage Learning.
SNAP, Paradigm.

Online:
http://www.lynda.com/.
Keyboardingonline.com, Ten Key Mastery.
YouTube, Medical Office Assistant Training Videos, https://www.youtube.com/results?search_query=medical+office+assistant+training+videos.
Youtube, ICD-10 Coding, https://www.youtube.com/results?search_query=icd-10+coding.

Reference:
Coder's Desk Reference for Procedure, Cengage Learning.
Coder's Dictionary, Cengage Learning.
Current Procedural Terminology (CPT), American Medical Association, http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page.
Gregg College Keyboarding & Document Processing, with Microsoft Word 2013, Ober, Johnson, Zimmerly, McGraw-Hill.
Gregg Reference Manual, McGraw-Hill.
Gregg Reference Manual - Basic Worksheets, McGraw-Hill.
International Classification of Diseases, Clinical Modifications (ICD-9-CM), Centers for Disease Control and Prevention, http://www.cdc.gov/nchs/icd/icd9cm.htm.
Mosby's Dictionary of Medicine, Nursing, & Health Professionals, Mosby's Inc., McGraw-Hill.
Stedman's Medical Dictionary for Health Professions and Nursing, ISBN: 0-781762-12-X.
2013 HCPCS Level II Standard Edition, Saunders Elsevier.
2014 ICD-10-CM Draft Edition, Carol Buck, Saunders Elsevier.
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Career Majors That Sequence This Course
Career Cluster Pathway Career Major
Business Management & Administration Administrative Support Administrative Medical Assistant
Business Management & Administration Business Information Management Electronic Health Record Specialist (EHR Specialist)
Business Management & Administration Business Information Management Medical Insurance Coder
Business Management & Administration Administrative Support Medical Office Assistant
Business Management & Administration Administrative Support Medical Transcriptionist