Medical Billing Training 2022 | Revenue Cycle Management

Learn Medical Billing Concepts, Charge Entry, Payment Posting, Denial Analysis, Accounts Receivable, AR Days, Follow-up

What you'll learn
Medical Billing Concepts, Job Opportunities in Medical Billing
Parties Involved in Medical Billing
Medical Billing Cycle
Types of Insurances, Types of Health Insurance Plans, CMS1500, UB04
Charge Entry, Payment Posting, Revenue Cycle Management, Accounts Receivable,
Denial Analysis, Working on Unpaid Claims
16 Insurance Calling Scenarios
Requirements
No need of prior experience in Medical Billing!
Description
In this Medical Billing Training course, you will learn the following points and much more: Parties Involved in BillingParties Involved in Medical BillingTypes of ProvidersTypes of PatientsFederal & Commercial CarriersPrimary, Secondary, Tertiary InsuranceCopay, Co-Insurance, Deductible & OOPIn -Network & OONTypes of Health Insurance plans (HMO, PPO, HDHP..)MVA, WC , Self PayMedical Billing CyclePatient Scheduling , No ShowInsurance VerificationPatient DemographyFee Schedule, Place of ServiceCharge Posting, Cross overEDI EnrollmentClearing House, Claim Submission, Electronic & PaperBilled, Allowed, Paid & Write offERA, EOB & Payment Posting, FFS, Capitation, With hold, Offset, RefundInterest Payment, Late Charges, Medical Record Payment & NSFDenial ScenariosAR AnalysisAR Follow-upCredit Balance ReviewPatient Statements & CollectionsBad DebtBankruptcyAR Days, Net Collection & Denial RateReportingDenial Analysis:1) Patient & Demographic Based Denials:Coverage / ID Problem Waiting for Additional Info from PatientInsurance Address ChangePatient Not in SystemPre-Existing Condition2) Coding based Denials:Procedure (CPT)/Diagnosis ProblemIncluded w/ Primary or Other ProcedureIncluded in Global RulesDown Coding Explanation Modifier Required 3) Payment Based Denials:Inappropriate Payment AmountMaximum Benefits Paid by Primary InsRefund Request OverpaymentsWithhold Amount4) Provider Based Denials:W9 RequestPhysician / Group Info NeededNeed Physician SignatureMedical Records NeededNot Medically Necessary5) Other Denial Categories:Insurance Needs Additional Info / Re Submit ClaimNeed Copy of EOBNeed to Contact Ins Co. for further Info Bankruptcy Letter ReceivedAttorney Requesting InformationInsurance Follow Up Scenarios:Claim not on fileClaim in processClaim PaidDenied as DuplicateClaim PendedAdditional info required from ProviderAdditional info required from PatientClaim denied for PCP ReferalDenied for authorizationDenied as Dx Code InconsistentUntimely Filing DenialProvider not available with Insurance recordThird Party PricingOONClaim paid to incorrect addressClaim Offset

Overview

Section 1: Chapter 1 – Healthcare in US

Lecture 1 Healthcare in the US | Job Opportunities | Parties Involved in Medical Billing

Lecture 2 Job Roles and Duties of Medical Biller

Section 2: Chapter 2 : Medical Billing Cycle

Lecture 3 Medical Billing Cycle

Lecture 4 10 Most Important Concepts

Section 3: Chapter 3 - Health insurances

Lecture 5 Definition and Basic Concepts of Health Insurance

Lecture 6 Types of Insurances

Lecture 7 Types of Health Insurance Plans

Section 4: Chapter 4 - Jobs of Medical Practice's Front Desk staff

Lecture 8 Front Desk's Job

Section 5: Chapter 5 - Insurance Verification

Lecture 9 Insurance Verification (Traditional and Smart Method)

Section 6: Chapter 6 - Demographic Entry Into Billing System

Lecture 10 Demographic Entry

Section 7: Chapter 7 - Super Bills & Charge Entry | Claim Forms | Payment Posting

Lecture 11 Super Bills & Charge Entry

Lecture 12 CMS 1500 Form

Lecture 13 UB04 Claim Form

Lecture 14 EOB & Payment Posting

Section 8: Chapter 8 - Revenue Cycle Management

Lecture 15 RCM Introduction & Steps involved in RCM

Section 9: Chapter 9 - Knowledge required to become a RCM Expert

Lecture 16 Basic Knowledge Required to Become an Expert in RCM

Section 10: Chapter 10 - Accounts Receivable (A/R)

Lecture 17 Accounts Receivable (A/R)

Lecture 18 How to bring the AR days under control?

Section 11: Chapter 11 - Denial Analysis

Lecture 19 Denial Analysis

Lecture 20 Top 20 Denials and How to Fix them | (Denial number 1 to 8)

Lecture 21 Top 20 denials (Denial number 9 to 20)

Section 12: Chapter 12 - Unpaid claim Analysis & Other Important Concepts in AR

Lecture 22 Unpaid claim Analysis & Claim Status Look up Methods

Lecture 23 Other Main Concepts In Accounts Receivable & Credit Balances

Lecture 24 Patient AR

Lecture 25 Practice setup & Provider Credentialing

Section 13: Chapter 13 - Insurance Calling Scenarios

Lecture 26 Scenario 1 - No Claim on File

Lecture 27 Scenario 2 - Claim In Process

Lecture 28 Scenario 3 - Claim has been paid already

Lecture 29 Scenario 4 - Denied as Duplicate Claim

Lecture 30 Scenario 5 - Pended Claim

Lecture 31 Scenario 6 - Additional information required from the Provider

Lecture 32 Scenario 7 - Additional information required from the patient

Lecture 33 Scenario 8 - Denied for PCP Referral

Lecture 34 Scenario 9 - Denied as No authorization on file

Lecture 35 Scenario 10 - Denied as Dx code Inconsistent

Lecture 36 Scenario 11 - Denied as Untimely Filing

Lecture 37 Scenario 12 - Provider Not available on file

Lecture 38 Scenario 13 - Third Party Pricing

Lecture 39 Scenario 14 - Out of Network Provider Service

Lecture 40 Scenario 15 - Claim was paid to incorrect address

Lecture 41 Scenario 16 - Offset Applied

Section 14: Chapter 14 - Conclusion

Lecture 42 Conclusion

This course is for Graduates or the one who is interested to learn more on medical billing and willing to work for a Hospitals, Medical Billing Companies, etc.,