Medical Billing

Test Outline

CHAMPUS
Eligibility
Electronic Claims
Positive vs negatives, government regulations
Purpose
HIPAA
Electronic Claims
Information Security
Patient Privacy
Managed Care
Capitation
Non-covered Services
PPO vs HMO
Pre-authorization
Pre-authorization & Pre-certification
Referrals
Medicaid
Basic Services
Eligibility
Managed Care
Out of State
Medical Billing
CPT Coding
HCFA Forms
ICD-9CM
Purpose
Medical Billing Basic Knowledge
CPT-4 Coding
HCPCS Codes
ICD-9-CM
Medical Billing Documents
CMS Form 1500
Insurance Contract
UB-92
Understanding the EOB
Medical Billing Process
Accounts Receivables Recovery
Claim Denials
Copays, Co-Insurance & Deductibles
Managed Care, PPO, POS, IPA, & Capitation
Verification of Benefits
Medical Terminology
ICD-9CM
Insurance Terms
Prefixes
Roots
Specialists
Suffixes
Medicare
3-Coding Level
As Secondary Payor
Eligibility
Managed Care
Medigap
Part A
Part B
UPIN#
Specialty Billing
ERISA Benefit Requirements
ERISA Eligibility
Workers' Comp Awareness
Workers' Comp Processing
TRICARE
Eligibility
Fiscal Intermediary
Plans
Workman's Comp
Definition
FECA Program

 

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