1. Introduction to Medical Billing

• Overview of the Healthcare Industry: Understanding the structure and functions of healthcare systems, including private and public sectors.
• Roles and Responsibilities of a Medical Biller: Exploring the duties of a medical biller, including patient data management, billing processes, and communication with insurance companies.
• Legal and Ethical Considerations: Discussing the importance of compliance with healthcare laws, including HIPAA (Health Insurance Portability and Accountability Act), and understanding patient confidentiality.

2. Medical Terminology

• Understanding Medical Terms: Introduction to common medical terminology, including prefixes, suffixes, and root words used in billing and coding.
• Anatomy and Physiology: Basic overview of human anatomy and physiology relevant to medical billing.
• Medical Abbreviations: Familiarization with common abbreviations used in medical records and billing documents.

3. Healthcare Insurance

• Types of Health Insurance: Exploration of different types of health insurance plans, including HMOs, PPOs, Medicaid, Medicare, and private insurance.
• Insurance Policies and Procedures: Understanding the policy requirements, claim submission processes, and the role of medical billers in managing insurance claims.
• Insurance Terms and Definitions: Key terms related to insurance billing, such as deductibles, co-pays, premiums, and coverage limits.

4. Medical Billing Process

• Patient Registration and Data Management: Gathering and verifying patient information, including demographic and insurance details.
• Charge Entry and Claim Preparation: Accurately entering charges for services rendered and preparing claims for submission to insurance companies.
• Claim Submission and Follow-up: Understanding the electronic and paper claim submission processes, and the importance of following up on denied or unpaid claims.
• Accounts Receivable Management: Techniques for managing accounts receivable, including handling patient payments, setting up payment plans, and managing overdue accounts.