What you’ll learn

Gain a clear understanding of the US healthcare system, revenue cycle management (RCM), and its critical role in healthcare administration.
Learn the complete medical billing process, from patient registration to final payment posting, ensuring accuracy and efficiency at every step.
Acquire detailed knowledge of insurance types, including Medicare, Medicaid, Tricare, HMO, PPO, and POS plans, and understand their impact on billing and claims
Develop the skills to process claims, manage denials, and apply best practices to maximize reimbursements and minimize delays.
Build a solid foundation to launch or advance your career in medical billing, RCM, or healthcare operations with confidence and competence.

Requirements

No Prior Experience Needed: This course is designed for beginners, so no prior knowledge of medical billing or healthcare revenue cycle management is required.
Basic Computer Skills: Learners should have a basic understanding of how to use a computer and navigate the internet.
Access to a Computer and Internet: You’ll need a computer or device with internet access to complete the course.
A Willingness to Learn: Bring a positive attitude and the determination to explore a rewarding career in healthcare RCM.

Description

Are you looking to build a solid foundation in Medical billing and revenue cycle management (RCM)? This course is your comprehensive guide to mastering the essentials of RCM and medical billing, even if you’re starting from scratch.In this beginner-friendly course, you’ll:Gain a deep understanding of the healthcare system: Learn how the U.S. healthcare system operates, the importance of health insurance, and why RCM is essential for smooth operations.Distinguish between RCM and medical billing: Discover the key differences between these two vital aspects of healthcare finance and how they work together.Get familiar with insurance basics: Understand how different insurance plans, including Medicare, Medicaid, and private insurance, impact the billing process.Verify patient eligibility and benefits: Learn the step-by-step process of verifying insurance eligibility, benefits, and understanding referral

Requirements

.Grasp medical coding essentials: Master ICD-10, CPT codes, and modifiers, and understand how accurate coding ensures proper reimbursement.Navigate the claim creation and submission process: Learn how to complete claim forms, work with practice management systems, and submit claims through clearinghouses.Manage Accounts Receivable (AR): Understand the key methods for AR follow-up, including aging buckets and best practices for efficient collections.Master denial management and appeals: Learn the steps to handle claim denials, rejections, and how to submit effective appeal requests.Understand payment processing: Dive into the process of payment posting, EOBs, ERA, and EFT to ensure timely and accurate payments.By the end of this course, you’ll be equipped with the knowledge and skills needed to confidently manage the revenue cycle in any healthcare setting.

Overview

Section 1: Introduction to Revenue Cycle Management and USA Healthcare System
Lecture 1 What is Revenue Cycle Management (RCM)?
Lecture 2 Understanding the US Healthcare System and Health Insurance
Lecture 3 Understanding RCM, Medical Billing, and Medical Coding
Lecture 4 4 Key Players in Revenue Cycle Management
Section 2: Medical Billing Cycle

Overview

Lecture 5 The Comprehensive Medical Billing Cycle – 12 key steps
Section 3: Insurance Basics in Medical Billing
Lecture 6 Understanding How Insurances Work in US Medical Billing
Lecture 7 What is Centers for Medicare & Medicaid Services (CMS)?
Lecture 8 Types of Insurance in Medical Billing
Lecture 9 Who is Eligible for Medicare, Medicaid, TRICARE, CHAMPUS, Railroad, & Black Lung
Lecture 10 Understanding Healthcare Insurance Plans: HMO, PPO, and POS
Lecture 11 Healthcare Plans, Providers, and Referral

Requirements

Section 4: Insurance Eligibility and Benefits
Lecture 12 Understanding Patient Demographics in Medical Billing
Lecture 13 Insurance Eligibility and Benefits Verification
Lecture 14 Patient Appointment Scheduling
Lecture 15 Benefits Verification Process
Lecture 16 Understanding Benefits Terminologies in Healthcare
Lecture 17 Referrals and Prior Authorizations
Section 5: Medical Coding Essentials
Lecture 18 Introduction to ICD-10 Codes
Lecture 19 Introduction to CPT Codes
Lecture 20 Modifiers in CPT Codes
Lecture 21 Units of CPT Codes
Lecture 22 Understanding NCCI, LCD, and NCD in Medical Billing
Section 6: Providers and Facilities
Lecture 23 Who Are Healthcare Providers?
Lecture 24 Types of Healthcare Providers in Medical Billing
Lecture 25 What Are Healthcare Facilities?
Lecture 26 Understanding Place of Service and Type of Service Codes
Section 7: Claim Creation and Practice Management Systems
Lecture 27 What Is the HCFA 1500 / CMS 1500 Form?
Lecture 28 Understanding the 837P Format for Professional Claims
Lecture 29 Major Boxes in CMS 1500 Form and the Purpose of Box 12 and Box 13
Lecture 30 What Is a Practice Management System?
Section 8: Claim Submission Process
Lecture 31 Understanding Clearinghouses in Medical Billing
Lecture 32 Batch Claim Submissions: Streamlining Medical Billing
Lecture 33 Timely Filing Limits for Insurance Claim Submission
Lecture 34 5 Key Rules for Successful Claim Submission
Lecture 35 Understanding Rejections and Their Levels in Medical Billing
Section 9: Accounts Receivables (AR) and Follow-Up
Lecture 36 Understanding Accounts Receivables in Revenue Cycle Management
Lecture 37 Methods for AR Follow-Up: Tools and Techniques
Lecture 38 Understanding Aging Buckets in Medical Billing
Lecture 39 Industry Standards and Best Practices for AR Management
Lecture 40 Automation and AI in Accounts Receivables Management
Section 10: Denial Management and Appeals
Lecture 41 Understanding Denial Management: Impact on Practice Revenue
Lecture 42 Denial vs. Rejection in Medical Billing
Lecture 43 Reconsideration and Appeal Requests in Medical Billing
Lecture 44 Appeal Writing Process in Medical Billing
Section 11: Payment Processing in RCM
Lecture 45 Understanding Payment Posting in Revenue Cycle Management (RCM)
Lecture 46 Understanding EOB and ERA in Medical Billing
Lecture 47 What Is EFT Setup in Medical Billing?
Lecture 48 Manual vs. Automatic Payment Posting in Medical Billing
Aspiring medical billers and coders: Individuals aiming to start a career in medical billing, coding, or healthcare RCM.,Healthcare professionals: Doctors, nurses, or administrators who want to enhance their understanding of billing and revenue processes.,Students and graduates: Those studying or recently graduated in healthcare, business, or IT fields interested in RCM career opportunities.,Small healthcare practice owners: Entrepreneurs seeking to improve their practice’s revenue cycle and billing efficiency.,Career changers: Professionals from other industries looking to transition into the growing field of healthcare administration.,Tech and data enthusiasts: Individuals skilled in data analysis, MS Excel, or healthcare analytics wanting to apply their expertise to RCM.

Homepage:

www.udemy.com/course/revenue-cycle-management-medical-billing-course/

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