Medical Billing Fundamentals
Learn the claim, block by block, from someone who has filed them.
A complete video-and-PDF course covering the full reimbursement cycle — insurance verification through appeals — plus the forms a working billing office actually runs on.
$247.00 $147.00
one-time
No subscription Free trial first One payment of $147
Course coverage map
9 topics
01Health Insurance Planspayers · HMO/PPO
02Medical Coding BasicsICD-10 · CPT · HCPCS
03Patient & Provider Infosuperbill setup
04CMS-1500 Claim Formblock by block
05Creating & Submitting Claimsclearinghouse
06Applying PaymentsERA · EOB
07Claim Problems & Patient Collectionsappeals · A/R
08Compliance, Fraud & Patient PrivacyHIPAA · HITECH
09Practice Management Softwaresoftware demos
Where most people start
- “Medical billing” and “medical coding” sound like the same job
- A claim gets refused and you would not know where to start
- You have seen ICD-10 and CPT written down but could not use either
- Insurer paperwork — EOBs, ERAs — is unreadable
What the nine topics teach
- Verify a patient's cover and spot the problems before the appointment
- Code an encounter and build a clean CMS-1500 from it
- Read an ERA, post what the insurer paid, and bill the balance
- Work a denial through appeal instead of writing it off
83Individual lessons across the core and bonus topicscounted
9 + 2Core topics, plus dental and hospital modulescurriculum
~35Billing office forms you can use as they areas listed
422Free reference pages on this site, none gatedthis build
This is the work
Every medical claim travels the same seven stages. The nine topics follow them in order, so you always know which part of the process you are learning.
The reimbursement cycle
Claim paid Refused — appeal it
All 83 lessons, listed
Open any topic to read its lesson list. They are in the order the course teaches them, which is the order a claim actually travels — so the numbering tells you where in the process you are. The last two are the dental and hospital modules, which the course lists at $200 and includes at no extra cost.
01 Health Insurance PlansWork out who is going to pay, and what they have agreed to cover, before anyone treats the patient. 9 lessons · video + PDF
- Insurance types and payers
- Indemnity, managed care and consumer plans
- Referrals and preauthorizations
- Medicare and government payers
- Medicare Administrative Contractors
- Crossover claims
- Insurance verification
- Coordination of benefits
- Provider credentialing
02 Medical Coding BasicsTurn what happened in the appointment into the codes an insurer will accept. 12 lessons · video + PDF
- ICD-10 diagnosis codes and format
- Medical treatment codes
- Coding modifiers
- Level I and II codes
- Categories of codes
- Practice management code entry
- Medical coding errors
- Bundled and unbundled codes
- Upcoding and downcoding
- Coding specificity
- Medical necessity
- Coding resources
03 Patient & Provider InfoGet the practice and the patient set up so a claim can legally be sent at all. 9 lessons · video + PDF
- Before claims can be filed
- Setting up the provider
- Credentialing and clearinghouse enrollment
- Provider fee schedule
- The superbill, and customising it
- Setting up the patient
- Verifying insurance
- Minimum patient info
- First visit patient forms
04 CMS-1500 Claim FormFill in the standard claim form correctly, box by box. 6 lessons · video + PDF
- Block-by-block description
- When paper forms are used
- Electronic claim conventions
- Patient and insured info
- Physician info
- Electronic CMS-1500 video demonstration
05 Creating & Submitting ClaimsSend the claim, track it, and fix the ones that bounce straight back. 7 lessons · video + PDF
- Claim standards
- Entering the patient encounter
- Creating claims
- Uploading claims to the clearinghouse
- Clearinghouse claim status
- Correcting rejected claims
- Claim attachments
06 Applying PaymentsRead the insurer's response, work out what they actually paid, and record it. 9 lessons · video + PDF
- ERAs and EOBs
- Copays, coinsurance and deductibles
- Interpreting remittance advice
- Explanation and reason codes
- Posting insurance payments
- Posting patient payments
- Secondary claims
- Auto-posting ERAs
- Creating patient statements
07 Claim Problems & Patient CollectionsChase the money that did not arrive, and appeal the claims that were refused. 7 lessons · video + PDF
- Why claims don't get paid
- Coding errors and error codes
- Claim appeals
- Patient collections
- Insurance aging reports
- Patient aging reports
- Tracking unpaid claims
08 Compliance, Fraud & Patient PrivacyStay on the right side of patient-privacy law and of what counts as fraud. 5 lessons · video + PDF
- HIPAA and HITECH laws
- Administrative simplification
- Physical, administrative and technical safeguards
- Business associates and covered entities
- Fraud and abuse - what's the difference
09 Practice Management SoftwareWatch all of it done in the software a real billing office uses. 3 lessons · video + PDF
- Coding in practice management software
- Electronic CMS-1500 demonstration
- Auto-posting ERAs
Dental BillingBonus A parallel track for dental practices, including its own claim form. 8 lessons · included
- Dental terminology
- Insurance
- Dental procedure codes
- Software
- Helpful coding resources
- ADA J430D dental claim form
- Medical necessity
- CMS-1500 special instructions
Hospital BillingBonus How facility billing differs from the physician side. 8 lessons · included
- Differences from physician billing
- Hospital services
- Hospital and facility coding
- Unique claim codes
- Charge master
- Reimbursement process
- Prospective payment systems
- UB-04 claim form (CMS-1450) by sections
See the material first. Pay once you know it suits you.
All 9 core topics, both bonus modules and every form.
No subscription Free trial first One payment of $147