Medical Insurance Billing Proficiency Certificate
Medical Insurance Billing Specialists are professionals that prepare, submit, and/or process insurance claims for doctor's offices, hospitals, extended care facilities, diagnostic centers, insurance companies and other health related facilities. Professional settings that offer career opportunities to the Medical Insurance Billing Specialist include: outpatient clinics, physicians' offices, medical laboratories, insurance companies, skilled nursing facilities, home health care agencies and independent billing agencies.
Students who complete the proficiency certificate for Medical Insurance Billing will be able to use these courses to continue their education and obtain an associate degree in Health Services Management or Liberal Studies.
Student Learning Outcomes:
Upon successful completion of the Medical Insurance Billing proficiency certificate, students will be able to:
- Know the correct terminology for diseases, symptoms, diagnostic treatment and surgical procedures.
- Gauge the susceptibility of the patient, the nature of the disease agent and the chain of infection.
- Identify and describe diagnostic tests and procedures, the normal findings, the disease indicated by the test or procedure if the results are abnormal, and common treatments recommended to treat the illness or condition.
- Identify the major sections found in the CPT manual, interpret the information contained in the Guidelines and notes, recognize symbols used and select the appropriate code which reflects type(s) of procedures performed.
- Differentiate among major types of voluntary, commercial, government-sponsored and managed care health insurance plans.
- Identify the components of the revenue cycle.
- Define revenue cycle management.
- Describe the importance of effective revenue cycle management in a provider's fiscal stability.
- Define fraud and abuse issues in health care.
- Explain health care compliance issues.
This certificate is open to interested students. New students are normally required to take the College's placement test at their time of entry. Students who are identified as needing developmental course work must satisfactory complete the appropriate English and mathematics course as part of the certificate.
Medical Insurance Billing Proficiency Certificate Course Sequence
|Course Number||Course Title||Prerequisites||Credits|
|AH 103||Medical Terminology||3|
|ENGL 101||English Composition I||3|
|Essentials of Human Anatomy and Physiology
Anatomy and Physiology I and II
|AH 190||Human Disease and Treatment||AH 103 and BIOL 108 or BIOL 109||3|
|AH 120||Reimbursement Methodologies in Health Care||ENGL 101||3|
|AH 201||Basic ICD and CPT coding||AH 103, AH 120, AH 190, BIOL 108 or BIOL 109/110 with a grade of "C" or better in each course.||4|
|Total Credits: 20|
Successful completion of the program requires a "C" grade or better in each of the courses listed above. In order to receive a "C" grade or better and thus demonstrate competency, students must complete assignments, exams and participate in class activities.
For More Information Contact:
The Division of Math, Science and Health Careers, Room W2-7, 1700 Spring Garden Street, Philadelphia, PA 19130, Telephone (215) 751-8430 or e-mail email@example.com
Gainful Employment Information
Gainful employment information is intended to provide students with better information about the effectiveness of college programs in preparing students for careers. Information provided includes estimated program costs and time needed to complete the program, financing options and related careers.