Training: Manuals

1. Setting Up Your Business and Getting Started...
• INTRODUCTION TO THE MEDICAL BILLING BUSINESS
• WHY MEDICAL BILLING?
• A NOTE ABOUT TERMINOLOGY
• SIZE OF THE MEDICAL BILLING MARKET
• THE BENEFITS OF A MEDICAL BILLING BUSINESS
• INCOME POTENTIAL
• FIRST STEPS - SETTING UP YOUR BUSINESS
• SETTING UP YOUR OFFICE
• MARKETING YOUR BUSINESS - OVERVIEW
• MARKETING STEP 1 - IDENTIFY THE SPECIFIC MARKET FOR YOU
• MARKETING STEP 2 - UNDERSTANDING MEDICAL OFFICES
• STEP 3 MARKETING - FIVE STRATEGIES TO GET AN APPOINTMENT WITH POTENTIAL CLIENTS
• CHOOSING THE RIGHT MIX OF MARKETING STRATEGIES
• MAKING THE SALES PRESENTATION
• SIGNING THE CONTRACT
• PRICING YOUR MEDICAL BILLING SERVICES
• ANCILLARY SERVICES YOU CAN OFFER
• ONCE YOU HAVE SIGNED A CLIENT

2. Understanding Health Insurance...
• INTRODUCTION TO THE HEALTH INSURANCE INDUSTRY
• THE BASICS OF HEALTH INSURANCE
• THE TYPES OF HEALTH INSURANCE
• HEALTH MAINTENANCE ORGANIZATIONS (HMOs)
• PREFERRED PROVIDER ORGANIZATIONS (PPOs)
• BLUE CROSS/BLUE SHIELD
• COORDINATION OF BENEFITS
• MEDICARE
• MEDIGAP SUPPLEMENTAL INSURANCE
• MEDICAID
• OTHER GOVERNMENT INSURANCE
• COBRA

3. Medical Coding and Fees...
• MEDICAL BILLING CODING
• ICD-9 CODES
• THE CPT-4 CODES
• THE HCPCS PROCEDURE CODING SYSTEM
• HOW MEDICAL BILLING FEES ARE ESTABLISHED
• COST CONTROL AND REVIEW SYSTEMS
• DENTAL BILLING CODING AND FEES
• MEDICAL BILLING CODING EXERCISES

4. How to Process Medical Claims...
• WHAT TO DO ONCE YOU HAVE CLIENTS
• SETTING UP THE DOCTOR'S ACCOUNT AT THE CLEARINGHOUSE
• SETTING UP THE DOCTOR'S DATABASE IN YOUR SOFTWARE
• GETTING THE DATA ON THE SUPERBILL
• FILING YOUR FIRST BATCH OF CLAIMS
• FILING CLAIMS ON PAPER UNTIL YOUR DOCTOR IS AUTHORIZED FOR ELECTRONIC CLAIMS
• FILING CLAIMS ELECTRONICALLY
• SETTING UP A REGULAR SCHEDULE TO FILE CLAIMS
• COMPLETING STANDARD DENTAL CLAIM FORMS
• FORMS YOU NEED TO MAKE SURE THE DOCTOR HAS ON FILE
• UNPROCESSABLE CLAIMS
• MONITORING CLAIMS FOR PAYMENT

5. Billing, Auditing, Collections, and Other Services...
• FULL PRACTICE MANAGEMENT
• PREPARING PATIENT STATEMENTS
• HANDLING PHONE CALLS FROM PATIENTS
• HANDLING COLLECTIONS
• SPECIAL COLLECTION PROBLEMS
• USING A COLLECTION AGENCY
• FILING IN SMALL CLAIMS COURT
• DOING PREAUTHORIZATION AND PREDETERMINATION SERVICES
• THE BASICS OF HIPAA

6. Complete Directory of Medical Terms...
• APPENDIX 1: MEDICAL SPECIALTIES
• APPENDIX 2: STATE DEPARTMENTS OF INSURANCE/ STATE INSURANCE COMMISSIONERS
• APPENDIX 3: STATE MEDICARE CARRIERS
• APPENDIX 4: STATE MEDICAID OFFICES
• APPENDIX 5: FEDERAL EMPLOYEES' COMPENSATION ACT DISTRICT OFFICES
• APPENDIX 6: ESSENTIAL REFERENCE MATERIALS
• APPENDIX 7: PLACE OF SERVICE (POS) CODES AND DEFINITIONS
• APPENDIX 8: HCFA-1500 TYPE OF SERVICE (TOS) CODES
• APPENDIX 9: COMPARISON OF HOW TO FILE PAPER CLAIMS FOR COMMERCIAL INSURANCE VS. MEDICARE / MEDICAID
• APPENDIX 10: THE FIVE LAWS OF HIPAA
• APPENDIX 11: FREQUENTLY ASKED QUESTIONS ABOUT HIPAA