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METHOD OF INSTRUCTION

The Montes HealthCare College Hybrid program offers the same curriculum taught by the same faculty as the traditional class-room program for the Medical Coding & Billing Program, but it is delivered in a combination of classroom and online environments. This blended learning approach extends learning through the use of information and communications technology utilizing the Populi web-based learning platform.

This flexible program allows students the opportunity to receive a diploma for the Medical Coding and Billing program without weekly traditional classroom attendance. The Hybrid program is a team supported learning environment offering students the opportunity to enhance their leadership skills by building a foundation of coding theory, medical billing knowledge, and the hands-on experience to apply these skills in the business world.

The Medical Coding and Billing program is based upon a systems approach, helping students capture the hands-on learning required for the industry as well as the tactical responsibilities of medical revenue management focused around advanced medical coding skills in preparation for the national coding and/ or billing certification examination.

Medical Coding & Billing Career Outcomes

Graduates of the Medical Coding & Billing Program are prepared to fill a role in any one of the following occupations:

SOC Code Job Title
43-9041 Insurance Claims and Policy Processing Clerks
43-6013 Medical Secretaries and Administrative Assistants

Program Outline

The focus of this course is to develop an understanding and provide a practical approach to coding the language of medical billing, the basis of any healthcare reimbursement management career. Emphasis will be placed on learning about the medical coding systems available for submitting a medical bill,  including, the Current Procedural Terminology (CPT), Healthcare common Procedural Coding System (HCPCS) Level II coding system and the International Coding of Diseases, (ICD-10-CM) used to facilitate proper coding in claim submission.

The focus of this course is to develop a strong medical vocabulary, the basis of any healthcare career. You will learn medical terminology through a unique combination of anatomy and physiology, word building principles, and phonetic pronunciations. The course is perfect for non-medical professionals who want to learn medical terminology to pursue a field in the healthcare industries including medical coding and insurance billing. You will learn about body systems with strong emphasis placed on medical coding. Emphasis on medical terms associated with body systems and functions that correlate with diagnostic and procedural coding.

The focus of this course is to develop an understanding and provide a practical approach to coding the language of medical billing, the basis of any healthcare reimbursement management career. Emphasis will be placed on learning about the medical coding systems available for submitting a medical bill, including, the Current Procedural Terminology (CPT), Healthcare common Procedural Coding System (HCPCS) Level II coding system and the International Coding of Diseases, (ICD-10-CM) used to facilitate proper coding in claim submission. Unit 1 introduces the student to all aspects of procedural coding, including, coding fundamentals, specific coding guidelines for Level I and Level II procedural coding.

Unit 2 includes analysis of the diagnosis coding system and provides instruction on the applications associated with establishing medical necessity through accurate diagnosis coding to provide validation for all medical procedures billed to an insurance company. Emphasis will also be placed on the medical coding profession, including, the legal considerations in medical coding and billing.

The focus of this course is to develop an understanding and provide a practical approach to the various medical billing systems for physician practice with focus on reimbursement management and the Electronic Health Record (EHR). Emphasis will be placed on learning about the medical coding systems available for analyzing an EHR for the purpose of coding abstraction with the understanding of Healthcare Insurance policies and procedures for compliant bill submission.

Unit 1 introduces the student to various aspects of outpatient Billing and Processing, practice management software and how the EHR plays an important role in coding, billing and bill collection; including, understanding medical documentation, the SOAP note and the Electronic Medical Record (EMR). Emphasis will be placed on understanding and completion of HIPAA 5010 compliant claims.

Unit 2 will cover the Hospital billing process with emphasis placed on the Medicare reimbursement model. Through the application SIM Chart for Coders, an introduction to the inpatient billing process will be explored at the facility level, covering professional services billing and compliant collection skills.

This course will introduce the student to advanced hospital coding skills. Medical chart analysis and abstracting, Medicare reimbursement compliance and reimbursement will be evaluated from a practical standpoint. Coding from a variety of report types; professional services reports, surgical (operative) reports, and interventional radiology with hospital outpatient progress reports that include physical therapy, pharmacology, diagnostic injections and infusions. In this course, students will learn the advanced steps needed to understand hospital coding; students will receive multiple procedural handouts for manual coding. This course focuses on application of coding principles learned in CPT/ICD coding
established in module 1 – Introduction to HCPCS.

This four-week course will introduce the student to advanced coding skills through the online simulated coding internship. The initial three weeks will be spent online abstract coding through the Elsevier Buck coding program. The student will focus on abstract coding through the use of electronic coding programs such as, Encoder Pro Expert and TruCode encoders. This simulated online internship will also focus on medical chart analysis and coding abstracting, Medicare reimbursement compliance will be evaluated from a practical standpoint. Coding from a variety of report types; professional services reports, surgical (operative) reports, and interventional radiology with inpatient progress reports that include physical therapy, pharmacology, diagnostic injections and infusions. The initial module will cover Evaluation and Management (E/M) and include an advanced audit function, listed as the E/M Lecture Hall. This module will cover all aspects of the Evaluation and Management section of the CPT with each report available for coding through an E/M Audit Form based on the 1995 and 1997 Guidelines for E/M Services.

This two-week course will introduce the student to the test taking skills needed to succeed understanding the medical coding national certification examination. We will focus lecture and practical exercises on the outpatient coding examination from American Academy of Professional Coders – AAPC and the National Center for Competency Testing – NCCT.

In this module students will be placed in in operating billing environment, which could be an administrative billing center or a physician’s practice.  Students will receive hands on training in the daily operations of the department for additional learning and to apply skills and theories learned in the prior seven modules.  Externship will span 160 hours or approximately six weeks.

Click below for a complete outline of learning topics and clock hours for each module.

NEED ADDITIONAL INFORMATION?

For additional information, including module calendar, learning objectives, and additional details about the hybrid format, contact instructor, Ron Jurado, CPMA, by email at Ron.Jurado@monteshcc.com or by phone at (310) 469-4133.