Revenue Cycle Management and Medical Billing for Beginners

What You'll Learn

• Gain a deep understanding of the healthcare system: Learn how the U.S. healthcare system operates, the importance of health insurance, and why RCM is essential for smooth operations.
• Distinguish between RCM and medical billing: Discover the key differences between these two vital aspects of healthcare finance and how they work together.
• Get familiar with insurance basics: Understand how different insurance plans, including Medicare, Medicaid, and private insurance, impact the billing process.
• Verify patient eligibility and benefits: Learn the step-by-step process of verifying insurance eligibility, benefits, and understanding referral requirements.
• Grasp medical coding essentials: Master ICD-10, CPT codes, and modifiers, and understand how accurate coding ensures proper reimbursement.
• Navigate the claim creation and submission process: Learn how to complete claim forms, work with practice management systems, and submit claims through clearinghouses.
• Manage Accounts Receivable (AR): Understand the key methods for AR follow-up, including aging buckets and best practices for efficient collections.
• Master denial management and appeals: Learn the steps to handle claim denials, rejections, and how to submit effective appeal requests.
• Understand payment processing: Dive into the process of payment posting, EOBs, ERA, and EFT to ensure timely and accurate payments.