MEDICAL INSURANCE  BILLING / CODING (MIBC)

The objective of the Medical Insurance Billing/Coding Specialist Program is to prepare students to excel in the medical office administrative area of medical billing and coding. The program is designed to focus on students seeking employment in an outpatient setting (physician’s office or clinic) in a variety of administrative skills.

The competency based education will allow the student, upon completion, to "sit’ for the American academy of Professional Coders (AAPC) exam for Certified Procedural Coder-Apprentice (CPC-A).

Career Opportunities

Graduates of the program could be employed as:

• Insurance Billing Specialist
• Healthcare Reimbursement Specialist
• Electronic Claims Processor (ECP
• Medicare or Medical Billing Specialist
• Claims Assistance Professional
• Electronic Health Information Management Specialist (EHIM)
• Coding Specialist

Medical Billing and Coding is a profession that stands at the crossroads of healthcare and technology. As a medical billing or coding professional, and by collecting, maintaining, and analyzing health information, you will make an important contribution to the delivery of quality care. You will help to prevent legal difficulties and ensure that providers receive full reimbursement in a timely manner. Physicians do not have the time to handle the stacks of insurance claims; they need trained medical billing and coding specialists. Due to the aging population and the rapid growth of the healthcare industry, the demand for medical billers and coders continues to escalate.

Program Overview
The Medical Insurance Billing/Coding Specialist Program is a 960 hour program that includes 750 hours of classroom and laboratory instruction followed by a 160 hour externship. This is a modular based program and students must proceed in sequential order however, the college reserves the right to modify the sequence should the need arise. The maximum lecture and laboratory class will not exceed 20 students.

Module 110: Introduction to Insurance Healthcare Essentials

100 Clock Hours/8 Credits
Theory Hours: 60 clock hours
Laboratory Hours: 40 clock hours

This is an introductory course intended to familiarize the student with:

• Role of Insurance billing specialist
• Compliance and the E-Health initiative
• HIPPA with certification

Module 120: Introduction to Administrative Systems

100 Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

Introduction to administrative systems includes the study of:

• Basic Health Insurance
• Medical Documentation (an overview)
• Computer Application (Medical Manager)
• Bookkeeping (Peg-board)
• Preparing health insurance forms
• Introduction to filing and computerized office skills

Module 130: Introduction to Anatomy and Terminology

100 Clock Hours/8 Credits
Theory Hours: 60 Clock Hours
Laboratory Hours: 40 clock hours

Students will be introduced to the different body systems and an overview of the basic workings of the human body in health and disease with word structure and parts being emphasized. The body systems will include:

• Integumentary System
• Musculoskeletal System
• Reparatory System
• Cardiovascular System
• Digestive System
• Reproductive System
• Urinary System
• Nervous System
• Endocrine System
• Lymphatic system

Module 210: Introduction to Medical Insurance Billing

100 Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

The course will show an overview of the responsibilities, the career role and the options of a medical insurance billing specialist in the medical administrative field. The student will begin by looking at the differences between diagnostic coding and procedural coding in the medical office as well as an overview of electronic billing submissions as it pertains to claims denials and rejections.

Module 220: Medical Coding-CPT Intro to Coding Fundamentals

100 Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

The course is planned to provide a clear teaching style to a detailed subject. The student should be able to describe the difference between a CPT code and an ICD-9-CM code and be able to name the three factors and the elements needed to determine a level of Evaluation and Management code. The student will be able to understand and answer questions and code from the first three sections of the CPT manual in the work place on Evaluation and Management, Anesthesia, modifiers and the Integumentary system.

Module 230: Medical Coding-CPT Introduction to Coding Surgery

100 Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

The course is designed to enable the student to code surgery procedures and services from surgical reports and on-line surgical reports. The student will be able to answer questions and code from the surgery section of the CPT manual in the work place on the different systems of the body. The student will learn to read the guidelines and notes in the different sections of the surgery.

Module 240: Medical Coding-CPT Introduction to Radiology, Pathology/Laboratory, Medicine Sections

100Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

The course is designed to present an understandable teaching of Radiology and how it is used as a component to other types of codes in all other areas of the CPT coding manual.

Module 310: Introduction to Diagnostic Coding and HCPCS-Level II National Codes

100 Clock Hours/8 Credits
Theory Hours: 60 clock Hours
Laboratory Hours: 40 clock hours

The ICD-9-CM course is designed to give the student an overview of the diagnostic coding system. The student will be given history of the ICD-9-CM and how to use Volume I, II, and III for accurate coding in the out-patient setting. The rules on using CPT and the ICD-9-CM together will be researched for compatibility issues of medical necessity as well as developing coding skills for classroom and the work place.