Comprehensive Medical Billing and Coding Course – Part 3

Comprehensive Medical Billing and Coding Course – Part 3: Syllabus

Course Overview:

In this advanced section of the program, learners will gain expertise in collections, patient account management, billing statements, and the ethical and legal responsibilities of a medical billing professional. The focus is on real-world skills, professionalism, and regulatory compliance.

Module 8: Collections and Delinquent Accounts

Duration: 1 Week
Objectives:

• Understand the collections process and its role in revenue cycle management.

• Learn effective and compliant communication strategies for collections.

• Explore legal limitations and protections related to debt collection.

Topics Covered:

• Internal collections process

• External collections agencies

• Aging reports and follow-up timelines

• Telephone etiquette and written communication for collections

• Fair Debt Collection Practices Act (FDCPA)

Activities:

• Create a sample collections policy

• Review and analyze an aged accounts report

• Collections call role-play

End-of-Module Assessment:

• Scenario-based role-play: Respond to a delinquent patient account

• Written quiz on FDCPA compliance and collections workflow

Module 9: Patient Account Management and Billing Statements (Enhanced Detail)

Duration: 1 Week
Objectives:

• Master patient account setup and maintenance.

• Interpret and generate patient billing statements accurately.

• Understand payment posting, adjustments, and account reconciliation.

Topics Covered:

• Patient account creation and verification

• Payment posting: co-pays, deductibles, and insurance payments

• Adjustments, write-offs, and refunds

• Generating and interpreting billing statements

• Reconciling patient accounts and balancing reports

Activities:

• Hands-on walkthrough: Creating a patient account

• Statement generation from sample data

• Payment posting exercises

End-of-Module Assessment:

• Practical task: Generate and explain a patient billing statement

• Short quiz on account reconciliation and adjustments

Module 10: Compliance and Ethics in Medical Billing (Refined)

Duration: 1 Week
Objectives:

• Understand the ethical and legal framework of medical billing.

• Identify fraudulent billing practices and how to avoid them.

• Learn documentation, confidentiality, and HIPAA best practices.

Topics Covered:

• Overview of fraud, waste, and abuse in healthcare

• HIPAA Privacy and Security Rules

• Stark Law and Anti-Kickback Statute

• OIG compliance guidelines for billing professionals

• Ethical case studies and dilemmas

Activities:

• Ethics scenario analysis

• HIPAA compliance checklist creation

• Review of real-world fraud cases

End-of-Module Assessment:

• Case study: Identify ethical and legal violations in a billing scenario

• Multiple-choice quiz on HIPAA, fraud prevention, and compliance guidelines

Completion Criteria:

To complete Part 3 and receive the Certificate of Completion, learners must successfully complete all end-of-module assessments from Modules 8–10.