.png/:/cr=t:0%25,l:0%25,w:100%25,h:100%25/rs=w:1209,h:909)
Medical Billing & Revenue Cycle Management (RCM)
From Patient Registration to AR Calling. Learn the complete financial backbone of US Healthcare.
THE RCM CYCLE
Complete RCM Cycle Training
Medical Billing is not just data entry; it is a complex cycle. Our course covers the entire Revenue Cycle Management (RCM) lifespan. You will understand how a patient appointment turns into a paid claim, ensuring you can work in any department of a healthcare organization.
Patient Registration & Insurance Verification
The cycle begins here. Learn how to:
- Demographic Entry: Accurately capturing patient details.
- Eligibility Verification: Checking active insurance coverage, copays, and deductibles before the doctor sees the patient.
- Authorization: Understanding Prior Authorizations (Pre-Auth) to prevent front-end denials.
Charge Entry (Charge Posting)
Learn the critical skill of entering medical codes into billing software.
- Superbills: Reading and interpreting provider superbills.
- Linking: Correctly linking CPT codes to ICD-10 codes to prove medical necessity.
- Accuracy: Ensuring dates of service and provider details match perfectly to avoid rejections.
Claims Submission & Clearinghouse
Understand how claims travel from the doctor to the insurance company.
- CMS-1500 vs. UB-04: Learn the difference between Professional (Physician) and Institutional (Hospital) claim forms.
- Clearinghouse Rejections: How to scrub claims and fix errors before they even reach the insurance payer.
Payment Posting (Cash Posting)
Learn to handle the money.
- EOB Analysis: Reading complex Explanation of Benefits (EOB) documents.
- Posting: Entering insurance payments, patient payments, and adjustments (write-offs) into the system.
- ERA: Handling Electronic Remittance Advice files.
AR CALLING (Accounts Receivable)
Learn how to follow up on unpaid claims.
- Aging Reports: Analyzing claims that are 30, 60, or 90 days old.
- Communication: Training on exactly what to say to US Insurance representatives to check claim status.
- Action Plans: Deciding whether to rebill, appeal, or write off a claim.
Denial Management Specialist
Become an expert problem solver. Learn to fix the most common denials:
- Medical Necessity Denials: When the diagnosis doesn't match the procedure.
- COB Denials: Coordination of Benefits issues.
- Duplicate Claims: Handling accidental double billing.
- Timely Filing: Understanding submission deadlines.