Medical Insurance Billing Proficiency Certificate

Description:

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's degree in Health Care Studies.

Program Learning Outcomes:

Upon successful completion of the Medical Insurance Billing proficiency certificate, students will be able to:

  • Use the correct terminology for diseases, symptoms, diagnostic studies and treatments.
  • Explain the purpose of CPT and ICD codes for reimbursement.
  • Assign CPT and ICD codes according to official guidelines.
  • Describe the importance of effective revenue cycle management in a provider's fiscal stability.
  • Define fraud and abuse issues in health care.

Program Entry Requirements:

This certificate is open to interested students. Students are required to satisfy placement at the time of admission. Students who are identified as needing developmental course work must satisfactory complete the appropriate English and mathematics course as part of the certificate.

Program of Study and Graduation Requirements:

Successful completion of the program requires a "C" grade or better in each of the courses listed. In order to receive a "C" grade or better and thus demonstrate competency, students must complete assignments, exams and participate in class activities.

Course Sequence:

Course Number and Name Prerequisites Credits
AH 103 - Medical Terminology   3 credits
ENGL 101 - English Composition   3 credits
BIOL 108 - Essentials of Human Anatomy and Physiology*   4 credits
AH 120 - Reimbursement Methodologies in Health Care   3 credits
AH 190 - Human Disease and Treatment AH 103 and  BIOL 108 or BIOL 109 3 credits
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 credits

Minimum Credits Needed to Graduate:

20

*BIOL 108, a one-semester course in Anatomy and Physiology, is the minimum requirement for this Certificate. However, students who have completed the two-semester Anatomy and Physiology sequence (BIOL 109-BIOL 110) may substitute BIOL 109-110 in place of BIOL 108, provided that they have completed both BIOL 109 and BIOL 110.

General Education Requirements:

All general education requirements necessary for graduation are met through the courses in the program as indicated above. Students who wish to take courses that differ from the general education courses indicated above must complete a course substitution request form. To access the form, login to the MyCCP portal, and in the Student tab, under Electronic Forms, click on the Records and Registration Forms link, then choose Request For Course Substitution Of Graduation Requirement link. A more detailed explanation of the College’s general education requirements is also available.

For More Information, Contact:

The Division of Math, Science and Health Careers, Room W1-1, 1700 Spring Garden Street, Philadelphia, PA 19130, Telephone (215) 751-8430.