Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Frequently Asked Question How Discussion Board Grades Are Calculated: Students are expected to post: A Minimum of three posts per unit discussion thread. o one post in response to the instructor’s question by EOD Saturday o two posts in response to two classmates by EOD Tuesday, end of unit

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Frequently Asked Question Providing Substance for the Discussions and Assignments: Discussion and assignment responses should be on topic, original, and contribute to the quality of the discussion by making frequent informed references to lesson materials and seminars. Initial discussion responses should be approximately 75 words. Responses to your classmates or instructor should be around 75 words.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Frequently Asked Question Bulleting Statements: You need to create narrative statements for all the assignments and discussions. In business narrative statements are critical and bullet statements are used for presentations. It is necessary that you practice your writing skills. Using bullet statements will result in decreasing your grade. If assistance is needed, Kaplan University has a writing center that can assist you. Seminar Appreciate your participation in the seminar. I strongly recommend that every student participate in the weekly seminars to avoid completing option 2. I am not familiar with the other course’s seminar schedule. This course is not on the flexible course schedule. Please make an attempt to attend the seminars for assuring full credits.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Seminar Chapter 1 Concepts covered: Personal qualifications needed: are you adaptable, assertive, reliable and self motivated? Technical qualifications: are you good with math, data entry, following directions, and communicating? Seminar Option 2: Write a one-page summary of the seminar you missed by reviewing the seminar archive. Please click Additional Help below for directions of how to access the seminar archive. Submitting Your Work

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Discussion Pick one organization to discuss in this post. Be sure to address these main ideas: What is the organization’s mission and/or purpose? What are the associated costs (if any)? Talk about how this organization’s resources can help you in your field. Is it worth it to be a member and why? If a fellow classmate has already picked the organization you would like to discuss, find something new about the organization to bring to the conversation.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Reading In this unit, you will read Chapter 1 and visit some websites related to credentialing. The content presented in this unit will help you understand the career opportunities that are available. Be sure to check out the Extra!Extra! tab to see some more professional resources that may help you in your future job search.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Introduce Yourself Please introduce yourself and “shake hands" with your classmates. Include information about your background, current and future professional goals, your purpose for enrolling in this course, what you hope to take away from it, and any personal information you wish to share. Feel free to share a picture if you would like to (the picture must be a professional image of yourself). Read and respond to at least two classmates’ postings. These posts are designed to be substantive in nature and should ask questions, provide additional information, or promote thought. Please keep postings focused on the subject and respectful in nature.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 1 The Insurance Billing Specialist

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Careers in Health Care

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Insurance Billing Specialist Duties –Process health insurance claims –Work with other clinical and support staff –Serve as key member in financial operation of health care industry

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Insurance Billing Specialist Other titles –Billing clerk –Insurance claims processor –Medical biller –Reimbursement specialist

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Qualifications Personal –Adaptable –Detail-oriented –Ethical –Honest –Able to maintain confidentiality –Self-motivated

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Qualifications Technical –Data entry –Math skills –Oral communication skills –Written communication skills

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Qualifications Medical terminology –Read and understand medical reports –Recognize diagnostic statements and treatments –Identify discrepancies in documentation

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Qualifications Must keep current with medical coding protocols –International Classification of Diseases (ICD) –Current Procedural Terminology (CPT)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Employment Opportunities Entry-level to management Medical offices Hospitals Insurance companies Government agencies Consulting firms Medical billing services

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Employment Opportunities Claims assistance professional –Works with clients/patients Insurance collection specialist –Resolves billing and payment problems between Insurance company and health care agency Patient and health care agency

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Employment Opportunities Patient account representative –Also known as insurance counselor –Determines amount insurance pays –Determines amount patient pays –Establishes payment options before services provided

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Job Responsibilities Common tasks to all billing positions –Abstract information from patient records –Communicate via fax, , telephone, letters, and memos –Understand legal and ethical issues –Follow office policies and procedures –Participate in continuing education

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Certification Medical billing certification exams –American Medical Billing Association (AMBA) –Medical Association of Billers (MAB) –National Electronic Billers Alliance (NEBA)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medical Coding Assign codes to diagnostic and treatment statements Requires additional training and education Increases employment/career opportunities Certification exams available

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Certification Medical coding certification exams –American Academy of Professional Coders (AAPC) –American Health Information Management Association (AHIMA)