The eLearning Center for Gatlin Education Services

The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, which includes billing and coding, processing insurance forms, and using medical software. According to the American Medical Association, there are more than 1.2 million Medical Specialists in the United States. This profession is listed as one of the fastest growing professions in allied health. The Administrative Medical Specialist with Medical Billing and Coding will give you the skills you need to find the job YOU are looking for as an Administrative Medical Specialist (AMS), Medical Billing Specialist, and/or Medical Coder. In addition to the extensive Medical Billing information, you will be taught every aspect of the Medical Receptionist/Front Desk position. This includes scheduling appointments, industry- specific techniques for filing, proper protocol for patient interaction, and hands-on training with a Practice Management system used in many doctor’s offices around the country. This program also provides preparation for the Certified Coding Associate (CCA) national certification exam. Upon successful completion of the Administrative Medical Specialist with Medical Billing and Coding course, students will be prepared for an entry-level position doing medical billing or coding in a medical office setting and will be prepared to sit for the CCA national certification exam.

Some typical tasks for the AMS include:

1. Receiving, making and documenting telephone calls.
2. Scheduling appointments and registering of patient information.
3. Performing insurance verification, pre-authorization and referral tasks.
4. Preparing patient charts and maintaining medical records.
5. Preparing and posting transactions on day sheets, charge tickets and patient accounts.
6. Coding and billing insurance claims.
7. Collecting patient payments and performing collection activities.

The career of an administrative medical specialist is a challenging one with new opportunities arising continuously. Job security is high for an individual who understands claims processing and billing regulations, possesses sharp coding skills, and is successful in appealing under-paid or denied insurance claims. Recent surveys of medical office personnel Help Wanted advertisements indicate the need for individuals with these skills. With this online AMS program, students will learn the job skills they need to be successful candidates in the workforce.

Please Note: This course prepares you for the CCA certification. You must also meet the Professional Association's Eligibility Requirements for the examination. The American Health Information Management Association's (AHIMA) eligibility requirement is a high school diploma or equivalent.

Upon registering, you are given an initial six months to complete the program. Should you need more time, you may request a 6-month extension at no additional charge.

Course Objectives

Upon successful completion of the Administrative Medical Specialist with Medical Billing and Coding program, students will:

• Be proficient in skills such as medical terminology, communication, telephone techniques, organization and time management.
• Have knowledge of Medical Practice Settings and Specialties, as well as the differences in Traditional and Managed Care. Students also learn about Commercial, HMO/PPO, Federal and State insurance plans, including eligibility and coverage, as well as reimbursement methodologies.
• Have knowledge of the legal and ethical responsibilities of an administrative medical specialist, including the HIPAA mandates, the rules for maintaining privacy of medical records and protected health information, and the types of consents and disclosures that are required in a medical office environment.
• Be able to perform tasks associated with the entire Accounts Receivable and Revenue cycle, including scheduling and registration of patients; posting of accounting transactions; completion of insurance claim forms, and collections.
• Be able to perform the day-to-day tasks associated with medical coding, medical billing and completing insurance forms.
• Be able to effectively input patient information, run office reports, and process insurance claims using medical software.
• Be prepared to take an Advanced Coding course to prepare for more advanced national certifications.

Module 1 - Introduction to Healthcare

• Various professions and opportunities
• Medical Specialties
• AMS job descriptions and duties (medical asst/reception/billing & collecting)

Module 2 - Compliance, Law, & Ethics

• HIPAA
• CMS Regulations
• Medical Ethics

Module 3 - Medical Terminology

• Essential Information for Learning by This Quick and Easy Method
• Writing Terms with Suffixes and Combing Forms
• Writing Terms with Prefixes, Suffixes, and Combining Forms
• Diagnostic Procedures and Therapeutic Interventions
• Organization of the Body
• The Musculoskeletal System
• The Circulatory System
• The Respiratory System
• The Digestive System
• The Urinary System
• The Reproductive System
• The Integumentary System
• The Nervous System and Psychologic Disorders
• The Endocrine System

Module 4 – Administrative Module I: Front Desk/Reception

• Roles & duties
• Description of administrative responsibilities
• Appointment Scheduling and tracking
• Medical Records management
• Perform associated tasks using Medical Office Simulation Software (MOSS©)

Module 5 – Administrative Module II: Patient Registration/Billing & Collections

• Processes
• Rules & regulations
• Transaction Entries
• Claims Management
• Reports Generation
• Perform associated tasks using Medical Office Simulation Software (MOSS©)

Module 6 - Diagnostic Coding

• The ICD-9-CM Manual
  • Federal Law Regarding Use
  • Primary Diagnosis vs. Principal Diagnosis
  • Organization
    • Volume I: Tabular Index
    • Volume II: Alphabetic Index to Disease
  • Conventions
  • Main Terms
  • Notes
  • Tables
  • 4th and 5th Digit Modifiers
  • V Codes
  • E Codes
• Chapter Descriptions
  • Infectious and Parasitic Diseases (001-139)
  • Neoplasms (140-239)
  • Endocrine, Nutritional and Metabolic Diseases, and Immunity Diseases (240-279)
  • Diseases of the Blood and Blood-Forming Organs (280-289)
  • Mental Disorders (290-319)
  • Diseases of the Nervous System and Sense Organs (320-389)
  • Circulatory System (390-459)
  • Respiratory System (450-519)
  • Digestive System (520-579)
  • Genitourinary System (580-629)
  • Complications of Pregnancy, Childbirth, and the Puerperium (630-677)
  • Diseases of the Skin and Subcutaneous Tissue (680-709)
  • Diseases of the Mucoskeletal System and Connective Tissue (710-739)
  • Congenital Anomalies (740-759)
  • Conditions in the Perinatal Period (760-779)
  • Symptoms, Signs and Ill-Defined Conditions (780-799)
  • Injury and Poisoning (800-999)

Module 7 - Procedural Coding

• What is Coding?
• The CPT Manual Layout
  • CPT Main Index
  • CPT Main Index Format and Conventions
  • CPT Appendices & Addendums
  • CPT Alphabetical Index
• Steps for Procedural Coding
  • Using the Alpha Index to Search
  • Coding Steps
  • Code Modifiers
• CPT Main Index Sections
  • Evaluation and Management
    • Anesthesia
    • Surgery
      • Surgery - Integumentary
      • Multiple Laceration Repair
      • Surgery - Musculoskeletal System
      • Surgery - Respiratory System
      • Surgery - Cardiovascular System
      • Surgery - Hemic: Lymphatic, Mediastimum and Diaphragm
      • Surgery - Digestive System
      • Surgery - Urinary System
      • Surgery - Male Genital System
      • Surgery - Intersex, Laparoscopy, Femal Genital and Maternity
      • Surgery - Endocrine and Nervous Systems
      • Surgery - Eye and Ocular Adnexa
      • Surgery - Auditory System
  • Radiology Section
  • Pathology and Laboratory
  • Medicine
  • HCPCS Level II
    • HCPCS Sections
    • HCPCS Modifiers

Module 8 – Administrative Module III: Insurance Billing

• Industry basics
• CMS-1500 Claim Form
• UB-92 Claim Form
• Electronic Filing & Remittance
• Reimbursement
• Perform associated tasks using Medical Office Simulation Software (MOSS©)

Module 9 – Certified Coding Associate Prep