Medical Billing & Coding Program in Houston, TX
Medical Billing and Coding is the process of translating medical diagnoses and procedures into codes used in medical records and claims submitted to payers for reimbursement. Billing and coding are actually separate processes that are equally important to the healthcare revenue cycle, ensuring that providers are accurately reimbursed for their services.
Healthcare in the United States has undergone tremendous change in the recent past and future changes are promised in the field of medical coding. These changes have resulted in an increased demand for qualified medical coders. Ever changing regulations and reimbursement procedures have created a complicated rules and regulations system that requires specialized training and knowledge. Students are given the knowledge and tools necessary to navigate the complex world of medical coding. We offer hybrid learning that utilizes both online and in-person instruction.
Medical Billing & Coding Program Overview
Medical coders are responsible for the collection of physician charges and patient data to ensure that claims are submitted to insurance carriers accurately and in the most efficient and expeditious manner. Medical coders locate and identify codes for physician procedures and diagnosis using ICD 10 and CPT coding protocols for third party billing purposes. Our comprehensive program includes:
- Courses: Medical Terminology A&P; Insurance, Reimbursement & Billing; Procedure & Diagnostic Coding
- Subject Hours: 50 lecture hours + 34 administrative lab and self-study
- Program Length: 12 weeks
- Materials: 5 textbooks
- Externship: None
Frequently Asked Questions
Upon completion of this program; the student will be able to:
- Describe the medical coders job responsibilities, professional training, and employment opportunities.
- Explain the importance of confidentiality and the necessity of accurate documentation in medical coding and billing.
- Differentiate Medicare, Medicaid, Workers Compensations Benefits, Third Party Payers, Managed Care Organizations and Private Health Insurance.
- Describe the roles and responsibilities of the coder, physician, and patient in regard to the legal and ethical aspects of medical coding.
- Demonstrate how to abstract information from the patient record, apply coding guidelines and follow reimbursement procedures to optimize physician’s reimbursements.
- Explain the importance of keeping current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.
- Describe explanation of benefits from payers, evaluation of denied claims and the process for filing appeals for denied claims.
- Explain the importance of optimizing, not maximizing a code only for the service provided to the patients that are documented in the medical record.
- Give patient record information, determine accurate codes for diagnosis procedures and services performed by physicians.
- Demonstrate correct preparation and submission of CMS 1500 forms for services and procedures performed by physicians and non-physician providers including RN Care Managers, Nurse Practitioners and Physician Assistants.
- Explain the importance of continuing education and the benefits of joining available professional organizations.
- Medical Terminology -Get Connected! 2nd Edition, Suzanne S. Frucht
- Medical Insurance – A Revenue Cycle Process Approach 8th Edition, McGraw Hill
- Bucks 2023 Step-by-Step Medical Coding 2023 Edition, Elsevier
- Current Procedural Terminology 2023 CPT Professional Edition
- International Classification of Diseases ICD-10 2023: The complete Official Book.
The program is taught through lectures, power points, class discussions, group discussions, case studies, and hands on practice with insurance forms and insurance claims. Hands on coding with CPT & ICD-10 coding books includes hospital services.
On the other hand, grades are determined through class participation, quizzes, administration lab, and examinations.
Students satisfactorily completing the Medical Billing and Coding Program will be awarded a Certificate of Completion.
Staying Current as a Medical Biller & Coder Specialist (MBCS)
In order for students to be professional Coders, they must stay current! Coders will need to make a plan to remain current and implement their plan. A Coding Specialist must be in a constant and continuous state of learning as this is a requirement for this profession.
Each year the coding manuals for all coding sets are updated, new codes are added, and old ones are deleted. Many codes are revised to make them more detailed or to communicate the diagnosis or procedures more clearly. Coders need to update their skills and knowledge regularly to keep up with the changing medical and insurance fields.
Medical coders must understand how to stay current and how to use the latest coding manuals and instructions. Using old codes result in insurance claim rejections which ultimately result in the provider or facility not being reimbursed for services rendered to patients and a lot more work in recoding claims or submitting appeals for denied claims, which overall results in the medical entities losing money.