Medical office insurance staff members play a critical role in the financial viability of medical practices. Yet they are often thrown into their roles without adequate training. The work they do is ambiguous and complex. Even seasoned insurance staff members face situations where they are unsure of which actions are best.
This course provides billing staff with the foundation from which to work and grow in all aspects of medical practice billing. Participants will gain step-by-step knowledge in the elements of billing and payments, plus a thorough understanding of each stage of the revenue cycle. Solve the mystery of how to read explanation of benefits. You will also have access to listen to detailed billing information through podcasts.
Learning objectives
- Apply a framework for characterizing the types of health care insurance
- Review all aspects of billing and payment responsibilities
- Outline the role of insurance staff in the revenue cycle
Course agenda
Unit 1
- Why is a claim filed?
- Claim vocabulary
- Knowledge check
- Examples impacting payment
- Knowledge check
- Payment considerations
- Knowledge check
- Podcast - Framework and elements
- Medicare
- Medicaid
- TRICARE
- Commercial for profit
- Non-governmental non-profit
Unit 2
- Fraud and abuse
- Elements of coding
Unit 3
- Explanation of benefits (EOBs)
- Account follow-up
This course has been approved for 9 credit hours as assigned by ACMPE.
With paid registration, you will also receive a free copy of the book Get the Money in the Door: Physician Billing Basics, up to a $74 value.
See facilitator Sarah Holt explain how this course will help your staff understand what they need to know to become more effective in the billing department
Following completion of this course, you may be interested in
Ultimate Collections: Managing Billing Process Improvement
Facilitator-led dates
Note: This Facilitator-led course is available for six weeks (42 days) from the first time you login to your course.
Course agenda
Unit 1
- Why is a claim filed?
- Claim vocabulary
- Knowledge check
- Examples impacting payment
- Knowledge check
- Payment considerations
- Knowledge check
- Podcast - Framework and elements
- Medicare
- Medicaid
- TRICARE
- Commercial for profit
- Non-governmental non-profit
Unit 2
- Fraud and abuse
- Elements of coding
Unit 3
- Explanation of benefits (EOBs)
- Account follow-up
Who should participate:
- Billing office staff/novices
Career level:
Credit hours:
-
9 credit hours as assigned by
ACMPE
System Requirements
-
A personal computer with a Pentium processor with either speakers or headphones
-
Internet connection with a minimum speed of 56K baud dial-up (DSL, cable or T1 connection is recommended for viewing necessary archived lectures),
Internet Explorer
or
Mozilla Firefox
as well as
Adobe Flash Player
and
Adobe Acrobat Reader
-
A computer with speakers or headphones is necessary for audio sections
-
Note: The MGMA online platform uses “frames” and may not be compatible with software for those who are sight-impaired
What's different about online courses?
- Taking a course on the computer can be both different from and similar to a traditional classroom experience. The learning process is the same, but an online course provides immediate resources.
- Facilitators and students maintain their traditional roles. The facilitator places lessons and materials online for you to use – you set your own pace. The instructor is available to have a conversation with you, but won’t be online at the same time.
- You interact with the course content on the screen, just as though you were in a classroom, and have discussions with classmates on an online discussion board.
- You can ask questions or reply to others' questions or responses at any time. You will have exercises to complete on your own. And, as with classroom-based courses, you will have a multiple-choice assessment at the end of each week to gauge your comprehension and progress.
How are the courses formatted?
Generally, online courses follow this weekly format:
- Overview – Learning objectives are explained
- Readings and resources – Read from your textbook and other online materials
- Content – The main topic is presented
- Case studies – Examples illustrating the main topic are provided, based on either small or large group practices
- Practice activities – An assignment related to the main content is given
- Assessment – Complete a multiple-choice exam
- Summary – The week’s content is reviewed, which prepares you for the following week
- Discussion – Participate in a facilitator-led discussion board to get your questions answered and see how your peers apply the information
How does working online add to your education experience?
Online courses provide these convenient features:
- Search – Search for course content
- Notes – Take notes you can save for reference
- Calendar – Review scheduled tasks from the facilitator
- Chat – Talk directly to one or all class participants
- Discussion board – Ask questions and discuss course topics in an open forum with facilitator and classmates
- E-mail – Communicate with the facilitator or any course participant
- Location – View your progress relative to each week’s content
- Assessment – Complete 10-15 multiple-choice questions (not graded) at the end of each week (you can retake the assessment as often as you like)
- Bookmark – Save your place if you need to leave the course and pick up later
MGMA Online Course - Transfer Policy
- If there are unexpected demands on your time or you are not able to complete the course within the six weeks, MGMA strongly recommends you transfer into another course.
- Your transfer request must be received within the first two weeks of the course. After that time, you will be charged a $100 administrative fee after two weeks have passed.
- Transfer requests by telephone are not valid.
All transfer requests must be submitted in writing to the:
MGMA Learning & Networking Center
Attention: John Crawford
104 Inverness Terrace East
Englewood, CO 80112-5306
Letters may be faxed to 303.784.6099
Cancellation Policy
All registration cancellations must be received by MGMA no later than 48 hours prior to the start of each program and are subject to a $100 processing fee per course.
- No credit or partial or full refund will be made for failure to attend after this date
- Cancellations by telephone will not be accepted
- No credit is available for text materials sent (when applicable)
- All cancellations must be submitted in writing to:
MGMA Service Center
104 Inverness Terrace East
Englewood, CO 80112
Cancellation letters may also be faxed to 303.784.6110
If for any reason, MGMA must cancel one of its programs or turn you away due to limited attendance your registration fee will be refunded in full. However, you are responsible for your own airline and hotel reservations. MGMA cannot be held accountable for any cancellation charges caused by program cancellation or attendance limitations.
Please call the MGMA Service Center toll-free at 877.275.6462, ext. 1888, if you need to send someone in your place. If the new attendee has a different MGMA membership status, the registration fee will be adjusted accordingly.
Please log in to submit a review.