What Medical Billing Training is Required

If you are considering a career in medical billing or coding then you need to complete a medical billing training program. Medical billing is a very rewarding career and can be done as a job for someone else, a business or a work-from-home job.

Medical billing lends itself to working from home, and many individuals in the billing and coding profession work for themselves by either selling their services to a large health care firm or by working directly with a few independent physicians as clients. Those that prefer to work in a full time job with a monthly salary are hired by pharmacies, insurance companies, the government and other health care institutions.

Medical Billing Training Educational Requirements

Whilst there are no set educational standards for medical billing, the job does require that one has a good knowledge of the human body, medical terminology, what the various medical codes are and how to apply them as well as how to complete the various forms that are required for claiming.

There are, however, many training programs that are offered, on-campus and online, some of them by well-known, reputable institutions. Even though there are no set education requirements, many medical billers and coders have an associate degree and are certified by the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). This requires that you do two years of medical billing training, which takes two years and then sit for the certification examination on qualifying from the program.

Although you do not need to earn a degree to become a medical coder or biller, and can often get work in a physician’s office, but if you intend on making a career out of medical coding and or billing then it is advisable to get a degree and get certified, as this will stand you in good stead with the bigger institutions and hospitals, and also if you want to work for yourself, as it shows skill and commitment.

Doing extra courses and obtaining certificates or certifications in HIPAA, Workman’s Compensation, etcetera will also increase your earning potential exponentially as it shows that you are interested in continuing education and dedicated to the work.

The only educational requirement in order to be enrolled in a medical billing training program is that you have a high school qualification or your GED.

Skills Required for Medical Billing

Medical coding and billing requires that you have strong computer skills and a can type a minimum of 35 words per minute. You will also be using specific billing and coding software, so you will need to understand how to use it and be able to use it effectively and efficiently.

Good customer service skills are also necessary as you will be dealing with various physicians, hospital billing staff and other medical personnel, insurance companies, Medicaid, and often also with patients who may be ill or under stress.

Medical Billing Training Options

There is a whole spectrum of medical billing training, and the type of training that you do will depend on what your goals are. If you are intending to work in a hospital, a large medical practice or an insurance company then the more training you get the better. If you want to start your own medical coding and billing business then it is also better to get at least an associate’s degree and get certified. If you want to work in a smaller practice then you can get away with just doing a certificate or diploma course and not getting certified, as they are generally more informal about things like that.

There are various programs offered on-campus and online from community colleges and vocational schools. These courses can cost from as little as $500 to as much as $15 000, depending on where you study, at which school and whether it is an online course or a classroom medical billing training program.

Associates Program

An associate’s degree in Health care Reimbursement is the longest program, and also the most comprehensive medical billing training program.

Duration: 18 months to 2 years

Estimated cost: $12,000 to $15,000

Typical Curriculum:

  • Advanced billing and reimbursement
  • Basic keyboard skills
  • Billing and insurance reimbursement
  • Career planning
  • Communications
  • CPT, ICD, & HCPCS coding
  • Fine arts or humanities
  • Human anatomy
  • Mathematics
  • Medical ethics and law
  • Medical terminology
  • Office procedures
  • Social Sciences

The associates program will prepare you to take the certification examination by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). If your goal is to work for a big institution or to start your own medical and coding business then this is the medical billing training that you should do.

Diploma Program

This medical billing training program is shorter than the associate’s training, and would include more thorough training in procedures and the nuances of healthcare billing. The diploma program contains approximately twice as many courses as the certificate training program does.

Duration: 9 months to 1 year

Estimated cost: $6,000
Medical Billing Training
Typical Curriculum:

  • Basic keyboard skills
  • Billing and insurance reimbursement
  • CPT, ICD, & HCPCS coding
  • Human anatomy
  • Medical ethics and law
  • Medical terminology
  • Office procedures

The diploma program will give you more medical billing training than a certificate program will but less than an associate’s program, and will allow you to get work in a small to medium medical health care facility, physician’s office or pharmacy.

Certificate Program

The certificate medical billing training program is a basic course which is aimed at an individual with no previous medical experience and who wants to have a foundation in medical billing.

Duration: 6 months to 9 months

Estimated cost: $3,000

Typical Curriculum:

  • Basic coding
  • Billing and insurance reimbursement
  • Keyboarding skills
  • Medical law and ethics
  • Medical office procedures
  • Medical terminology

This basic medical billing training will afford you sufficient training to be able get an entry-level job in a small physician’s office or pharmacy where they are not that formal about qualifications, and there is not such a large patient/client base.

CMBP Online Medical Billing Training

The Certified Medical Billing Professional online medical billing training program offered by Medical Billing Course.com is a comprehensive course that will prepare you for a career as a medical biller or to open your own medical billing business. This is because all courses are taught by medical billing professionals and medical billing business owners.

One of the best things about this course is that you will not only receive instruction on medical billing, but will also get hands-on experience by applying what you have learned in a fully functional medical billing software program. During your medical billing training you will get the opportunity to physically post charges and payments, create CMS 1500 forms, run reports, and enter patient data.

Duration: 3 months to 6 months

Estimated cost: $500 to $700 (they offer various payment plans)

CMBP Medical Billing Training Curriculum:

Chapter 1: Introduction to Medical Billing
About Medical Billing; The Basics Overview; Types of Insurance Coverage; Procedures and Diagnoses; Insurance Claim Processing; Claim Payment; Report Generation; Clickable Internet Resources; Study Guide; Chapter 1 Examination

Chapter 2: Understanding Office Forms
Essential Office Forms; Examining Insurance Cards; Insurance Verification Process; Mock Insurance Verification Conversations; Insurance Verification Exercises; The Superbill/Encounter Document; Calculating Copayments & Deductibles; Clickable Internet Resources; Study Guide; Chapter 2 Examination

Chapter 3: Understanding the CMS 1500 Form
The Basics of the CMS 1500 Form; Box by Box Breakdown of the CMS 1500 Form; Step-By-Step Instructions for Completing a CMS 1500; Online CMS Form Completion Exercises;
Billing Tips; Commonly Made Errors; Clickable Internet Resources; Study Guide; Chapter 3 Examination

Chapter 4: Understanding Codes
CPT (Current Procedural Technology) Coding – Definition – Proper Usage – Resource & Reference Material; ICD (International Classification of Disease) Coding – Definition – Proper Usage – Resource & Reference Material; Clickable Internet Resources; Study Guide; Chapter 4 Examination

Chapter 5: The Life Cycle of an Insurance Claim
The Time-Line of an Insurance Claim; The Collection of Claim Data; Claim Information Data Entry; Claim Submission; Receiving & Posting Payments; Clickable Internet Resources; Study Guide; Chapter 5 Examination

Chapter 6: Working with Billing/Practice Management Software
Basic Components of Billing Applications; Clinic Data; Physician Data; Patient Data; Claim Generation; Electronic & Paper Claims; Report Generation; Clickable Internet Resources; Study Guide; Chapter 6 Examination

Chapter 7: Medical Billing/Practice Management Software Application
You will be provided with Medical Billing Software for training, a software training workbook, a mock data manual for data entry and CMS 1500 forms. This is a rather comprehensive chapter in which you will physically enter data, generate claims, post payments, run reports, etc, everything that is considered to be regular daily operations of a medical billing center; Study Guide; Chapter 7 Examination

Chapter 8: Operating a Medical Billing Business
Naming Your Business; Setting Up Your Business; Office Equipment & Essentials; Services You Can Provide; Transferring of Data; Relationship Selling; Steps to Writing a Proposal; Clearinghouse Selection; Attorney & Accountant Services; Financing Your Business; Legal Structure – Sole Proprietorship – General Partnership – Corporation – Limited Liability Corporation; Clickable Internet Resources; Study Guide

Chapter 9: Marketing Your Medical Billing Business
Promoting Your Business; Advertising that Sells; The Benefits of Selling Benefits; Targeting Specialties; Your Market; Revenue Enhancement; Sample Documents – brochures, flyers, post-cards, letters, contracts; Clickable Internet Resources

Chapter AC1: Understanding HIPAA Introduction to HIPAA
Transactions & Code Sets Standards; Unique Identifier Standards; Security & Electronic Signature Standards; Implementation Specifications; Administrative Safeguards; Physical Safeguards; Technical Safeguards; Privacy & Confidentiality; Consent and Authorizations
Marketing & Fundraising; De-identification; Business Associates; Penalties for Non-Compliance; Clickable Internet Resources; Study Guide; HIPAA Examination; Certificate of Course Completion

Chapter AC2: Calculating Copayments & Deductibles
100 Copayment & Deductibles Problems & Answers

Chapter AC3: Understanding Workers’ Compensation
Introduction to Workers Compensation; Federal Workers Compensation Overview & Claim Filing; State Workers Compensation Overview & Claim Filing; First Report of Injury; CMS 1500 Completion for Workers Compensation Claims; Appeals & Adjudication; Fraud & Abuse
Tips for Successful Workers Compensation Claim Filing & Handling; Glossary of Workers Compensation Terms; Clickable Internet Resources; Study Guide

MedicalBillingCourse.com is an esteemed and reputable business which is accredited by the Better Business Bureau, and they specialize in medical billing. They have a very active forum of users that provide you with a wonderful support system. Once you have completed this medical billing training program you will be entitled to use the designation Certified Medical Billing Professional (CMBP).

There are many other medical billing training programs advertised on the Internet, some of them expensive, some of them cheap, and even some free ones, but you need to be careful that you do not fall for a scam.

Factors to Watch Out for

Factors that you need to watch out for when researching medical billing training programs are:

  • Whether they are accredited or not; what kind of reputation they have – do not just rely on their advertising, also check them out with the Better Business Bureau and do some research to see whether there are any independent reports on the internet.
  • How established the school is – generally the longer an institution has been around the better they are.
  • What the graduation rate is – a higher graduation rate is indicative of a good program.
  • How much the tuition is – expensive is not always better and be careful of hidden costs.
  • Whether textbooks are included in the price – if you have to buy textbooks it could work out to be quite a bit more expensive.
  • What their availability is – look for a physical address; if you cannot get hold of an instructor easily when necessary it will make things difficult
  • What the student/teacher ratio is – this is important in on-campus courses as too many students will spread the teacher too thinly and the quality of the teaching will be infringed upon.

Whether you are pursuing a career or want to start a medical coding business of your own, finding the right medical billing training program to suit your needs and lifestyle is of paramount importance, so make sure that you do what is right for you.