CPB™ Medical Billing Course Syllabus
Prerequisites: Knowledge of medical terminology and anatomy required.
Clock Hours: 80 (Note: 80 clock hours account only for time spent in the online course, and does not include time spent outside the course or study time. Study time will vary widely per individual.)
Course Length: This course is a 16-week, instructor-led training. Successful completers will sit for the certification examination at the end of the course.
Class Hours: Days/Times Per Week: Students meet once per week online. Students work on the training modules outside of class and can contact their AAPC-approved instructor when they need assistance.
Certificate of Completion Issued: Yes. A certificate of completion is issued upon successful completion of the class.
Course Description: This course introduces the student to health insurance and reimbursement. In this course, the student will become familiar with the health insurance industry, legal and regulatory issues, and differences in reimbursement methodologies. The student will learn principles of medical billing related to proper claim form preparation, submission and payment processing, and the follow up process. This course is recommended for anyone who is preparing for a career in a medical billing department at a physician's office, clinic, or similar
positions. This course is strongly recommended for anyone who is preparing for AAPC’s CPB™ certification exam.
Course Objectives:
• Review an introduction to healthcare from a medical billing perspective.
• List a variety of health insurance models and how they affect medical entities.
• Understand the legal regulatory considerations involved in health care reimbursement and collections.
• Explain the process of a physician-based insurance claim including obtaining patient data, claim form completion, insurance carrier processing and payment received.
• Demonstrate the ability to use the three major coding manuals, CPT®, ICD-10-CM, and HCPCS Level II, and apply medical necessity standards.
• Explain the follow up process for A/R in a physician’s office, including the top denials by insurance carrier
along with their appeals process.
Course Content:
• Introduction to Healthcare
• Health Insurance Models
• Patient Registration Process/Data Capture
• Introduction to ICD-10-CM Coding
• Introduction to CPT® Coding
• Introduction to HCPCS Level II Coding
• Medical Necessity
• Claim Forms (CMS-1500 and UB-04)
• Billing
• A/R and Collection Concepts
• Government Carriers (Medicare, Medicaid, and TRICARE)
• Blue Cross/Blue Shield
• Commercial Insurance Carriers
• Workers’ Compensation
• Final Exam
Methods of Evaluation:
The instructional methods used include reading assignments, practice exercises, practical applications, interactive video/audio lectures, chapter review tests, and final exam. To receive a certificate of completion, students must successfully complete the course within the allotted time.
Successful course completion includes:
• An attempt of all required quizzes and practical application assignments
• A passing score of 70% or higher on all chapter review exams
• A passing score of 70% or higher on final exam
• An overall final course score of 70% or higher
Included Reading Material:
1. Medical Billing Training: CPB™ eBook AAPC; AAPC publisher
2. CPT® Professional Edition code book, AMA publisher
3. ICD-10-CM code book, any publisher
4. HCPCS Level II Professional code book, any publisher
Recommended Textbooks/Supplies (Not Included):
1. Medical dictionary, any publisher
Computer Requirements: High-speed internet connection with Blackboard supported Operating System & Web browser; Adobe Acrobat Reader. For best experience, use of a mobile device and Blackboard app is not recommended.