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Course Information
Business and Information Technology Education
Patient Billing
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
Foundations of Medical Office/Medical Terminology
-Determine the personal deductible for military retirees on the TRICARE Standard
-Define the Defense Enrollment Eligibility Reporting System (DEERS)

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

-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

-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

-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):
-Medical Billing

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


-Business Ethics Awareness (US)
-Listening Skills

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: Resources by Subject:

Free Resources:
GCF LearnFree:
Microsoft Office Reference Guide: http://freecomputerbooks.comMicrosoft_Office_Reference_Guide.html.
What's New in Office 2013 - Your Unofficial Overview:

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

Online:, Ten Key Mastery.
YouTube, Medical Office Assistant Training Videos,
Youtube, ICD-10 Coding,

Coder's Desk Reference for Procedure, Cengage Learning.
Coder's Dictionary, Cengage Learning.
Current Procedural Terminology (CPT), American Medical Association,
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,
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.
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