SYLLABUS – SIMPLISTIC SOLUTIONS AND MEDITECH COURSEWARE

The Final Exam – This test is necessary to receive a Certificate of Completion. Depending on your final score, certificate and/or letters are provided. The final will provide you the look and feel of a real employer exam. If you pass our final exam, you will pass almost any employer exam.

Final Exam for CD Version of the Courses – The Final Exam is included in the cost of the online courses. If you choose to do a course via the CD option, it is $89.00 to take the final exam.

BILLING COURSE

Medical billing and health insurance specialist are combined in this course. A section of the Billing Course includes an overview of coding with some coding practice. The complete Coding Course is an excellent option as well (see syllabus). Medical terminology is required to learn coding.

TIME TO COMPLETE: BILLING – 80 hours

HEALTH INSURANCE SEGMENT – 80 hours

TOTAL 160 hours

Terminology add: 150 hours

*Included in the Billing Training is Health Insurance Specialist – time to complete = 80 hours, so the combined total for Billing is 160 hours.

MEDICAL TERMINOLOGY

TIME FOR COMPLETION: 150 HOURS (130 INSTRUCTION, 20 LABORATORY)

TERMINOLOGY

SECTION I

1. LANGUAGE ORIGINS & ADAPTION (ETYMOLOGY)

2. ENGLISH 101

3. MEDICAL WORDS

4. DYNAMICS OF MEDICAL VOCABULARY & WORD STRUCTURE

5. BODY DYNAMICS

6. MEDICAL INSTRUMENTS & EQUIPMENT

7. MEDICAL SPECIALTIES

8. DIAGNOSTIC MEDICINE

9. ABBREVIATIONS

10. ANATOMY AND PHYSIOLOGY (+ILLUSTRATIONS)

11. PHARMACOLOGY

12. JUST FOR FUN

SECTION II

Section I. Introduction and Orientation

Section II – Outpatient Reports

Section III – Inpatient Reports

Section IV – Interpretation

BILLING COURSE

ONE VOLUME/SECTION PART 1

Chapter 1 – Health care History & Overview

Chapter 2 – Terminology

Chapter 3 – Provider Office

Chapter 4 – Hospital Billing

Chapter 5 – Family Relationships

Chapter 6 – Billing It Out

Chapter 7 – Practice Economics

Chapter 8 – Collections

Chapter 9 – Coding

Chapter 10- Profiles

Chapter 11- Legal Issues

Chapter 12- Just for Fun

Chapter 13 – Exploring the Possibilities

HEALTH INSURANCE SPECIALIST

TIME TO COMPLETE: HIS ONLY – 80 hours

Introduction

Chapter 1 – Health Insurance Specialist Job Description & Knowledge

Chapter 2 – Medical Care Reimbursement

Chapter 3 – Health Organizations (MCO)

Chapter 4 – Insurance Claims

Chapter 5 – Payer Processing

Chapter 6 – Laws, Rules, and Regulations

Chapter 7 – Private Insurers

Chapter 8 – Medicare

Chapter 9 – Medicaid

Chapter 10 – TriCare

Chapter 11 – Workers’ Compensation

Score Summary and Final Assignment

Appendix and Glossary (all insurance form samples and instructions)

CODING (PREREQUISITE=TERMINOLOGY)

This is a complete coding training course (includes a module on health insurance specialist).

TIME TO COMPLETE: 390 HOURS (140 instruction, 250 laboratory)

+ Terminology: 150 hours

+Health Insurance – 80 hours

TOTAL TIME: 620 hours

MEDICAL TERMINOLOGY

TIME FOR COMPLETION: 150 HOURS (130 INSTRUCTION, 20 LABORATORY)

TERMINOLOGY

SECTION I

1. LANGUAGE ORIGINS & ADAPTION (ETYMOLOGY)

2. ENGLISH 101

3. MEDICAL WORDS

4. DYNAMICS OF MEDICAL VOCABULARY & WORD STRUCTURE

5. BODY DYNAMICS

6. MEDICAL INSTRUMENTS & EQUIPMENT

7. MEDICAL SPECIALTIES

8. DIAGNOSTIC MEDICINE

9. ABBREVIATIONS

10. ANATOMY AND PHYSIOLOGY (+ILLUSTRATIONS)

11. PHARMACOLOGY

12. JUST FOR FUN

SECTION II

Section I. Introduction and Orientation

Section II – Outpatient Reports

Section III – Inpatient Reports

Section IV – Interpretation

MEDICAL CODING COURSE

(includes, ICD-9, ICD-10, CPT, HCPCS)

CODING THEORY
(70 hrs – 70 instruction, 0 laboratory/practicum)

• Industry History and the Codes
• The Coder
• ICD Coding
• CPT Coding
• Specialty Coding
• Liability and Legal Issues
• Summary

CODING PRACTICUM 1: CODE IT!
(100 hrs – 0 instruction, 100 laboratory/practicum)

• 300+ medical charts to code
• Answer key included; shows the rationale for the coding on each chart once the learner completes the coding for a given chart.

CODING PRACTICUM 1: SPECIALTY CODING
(100 hrs – 0 instruction, 100 laboratory/practicum)

• 300 specialty medical charts to code
• Answer key included; shows the rationale for the coding on each chart once the learner completes the coding for a given chart.

HEALTH INSURANCE SPECIALIST

TIME TO COMPLETE: HIS ONLY – 80 hours

Introduction

Chapter 1 – Health Insurance Specialist Job Description & Knowledge

Chapter 2 – Medical Care Reimbursement

Chapter 3 – Health Organizations (MCO)

Chapter 4 – Insurance Claims

Chapter 5 – Payer Processing

Chapter 6 – Laws, Rules, and Regulations

Chapter 7 – Private Insurers

Chapter 8 – Medicare

Chapter 9 – Medicaid

Chapter 10 – TriCare

Chapter 11 – Workers’ Compensation

Score Summary and Final Assignment

Appendix and Glossary (all insurance form samples and instructions)

ICD-10 COURSE – Standalone Course – Pre-Requisite ICD-9

TIME FOR COMPLETION: 90 hours (20 instruction, 70 laboratory/practicum)

Introduction

A. Overview of Guidelines

B. Benefits of ICD-10-CM

C. Similarities and Differences ICD-9 and ICD-10

D. Additional changes in ICD-10

E. Section Organization

F. Conventions, General Coding Guidelines and

Chapter Specific Guidelines

G. You Code It

H. Patient Charts 1-75

Appendix:

ICD-10-CM Official Guidelines for Coding and Reporting – all sections currently available for review (from the World Health Organization).

Section Series Alpha/Numeric

Infectious and Parasitic Diseases A00-B99

Neoplasms C00-D49

Disease of Blood and Blood-Forming Organs

and Disorders Involving the Immune Mechanism D50-D

Endocrine, Nutritional and Metabolic Diseases E00-E89

Mental and Behavioral Disorders F01-F99

Diseases of Nervous System and Sense Organs G00-G99

Diseases of Eye and Adnexa H00-H59

Diseases of Ear and Mastoid Process H60-H95

Diseases of Circulatory System I00-I99

Diseases of Respiratory System J00-J99

Diseases of Digestive System K00-K94

Diseases of Skin and Subcutaneous Tissue L00-L99

Diseases of the Musculoskeletal System and

Connective Tissue M00-M99

Diseases of Genitourinary System N00-N99

Pregnancy, Childbirth, and the Puerperium O00-O9A

Newborn (Perinatal) Guidelines P00-P96

Congenital Malformations, Deformations, and

Chromosomal Abnormalities Q00-Q99

Symptoms, Signs, and Abnormal clinical and

Laboratory Findings, Not Elsewhere Classified R00-R99

Injury, Poisoning, and Certain Other Consequences of

External Causes S00-T88

External Causes of Morbidity V01-Y99

Factors Influencing Health Status and Contact with

Health Services Z00-Z99

MEDICAL OFFICE SPECIALIST COURSE

This is a complete medical office assistant-specialist training course (includes a module on health insurance specialist).

TIME TO COMPLETE: 190 HOURS (100 instruction, 90 hours laboratory)

PLUS TERMINOLOGY: 150 hours

– Detailed Outline:

MODULE I – Medical Office Assistant

Chapter 1 – Introduction

Chapter 2 – Personal Assets & Skills

Chapter 3 – Employment

Chapter 4 – The Provider

Chapter 5 – Policies and Procedures

Chapter 6 – Interacting With the Patient

Chapter 7 – Tools, Software & Equipment

Chapter 8 – Legal Aspects of Confidential Information

Chapter 9 – Laboratory Data

Chapter 10 – Pharmacy

Chapter 11 – Coding

Chapter 12 – Medical Records, Patient Charts

MODULE II – BILLING

Chapter 1. Health Care History & Overview

Chapter 2. Terminology

Chapter 3. Provider Structure & Protocols

Chapter 4. Hospital Billing

Chapter 5. Family Relationships

Chapter 6. Billing the Encounter

Chapter 7. Practice Economics

Chapter 8. Collections

Chapter 9. Coding

Chapter 10. Profiles

Chapter 11. Medicaid and Medicare

Chapter 12. Legal Issues

Chapter 13. Certification

Chapter 14. Just for Fun

MODULE III – HEALTH INSURANCE SPECIALIST MODULE

Every type of insurance is included in each chapter, together with co-payments, rules, regulations, samples, and each is interactive requiring full understanding before moving on.

Chapter 1 – Health Insurance Specialist Jobs

Chapter 2 – Medical Care Reimbursement

Chapter 3 – Health Care Organization Plans

Chapter 4 – Insurance Claims

Chapter 5 – Payer Processing

Chapter 6 – Laws, Rules, and Regulations

Chapter 7 – Private Insurers

Chapter 8 – Medicare

Chapter 9 – Medicaid

Chapter 10 – Tricare

Chapter 11 – Workers’ Compensation

Included are all of the insurance forms used in the industry with complete exercises to fully understand how to fill them out

MEDICAL TERMINOLOGY

SECTION I

1. LANGUAGE ORIGINS & ADAPTION (ETYMOLOGY)

2. ENGLISH 101

3. MEDICAL WORDS

4. DYNAMICS OF MEDICAL VOCABULARY & WORD STRUCTURE

5. BODY DYNAMICS

8. MEDICAL INSTRUMENTS & EQUIPMENT

7. MEDICAL SPECIALTIES

8. DIAGNOSTIC MEDICINE

9. ABBREVIATIONS

10. ANATOMY AND PHYSIOLOGY (+ILLUSTRATIONS)

11. PHARMACOLOGY

12. JUST FOR FUN

SECTION II

Section I. Introduction and Orientation

Section II – Outpatient Reports

Section III – Inpatient Reports

Section IV – Interpretation

MEDICAL OFFICE MANAGER

Medical Office Administration includes Medical Terminology, Coding, Health Insurance Specialist, and Complete Medical Office Management

TIME TO COMPLETE: 800 HOURS (352 instruction, 448 laboratory)

MODULE I – Medical Terminology Course

SECTION I – LANGUAGE ORIGINS AND ADAPTATIONS

Chapter 1 – Etymology
Chapter 2 – Grammar, Spelling & Punctuation
Chapter 3 – Medical Words

SECTION II – DYNAMICS OF MEDICAL VOCABULARY AND WORD STRUCTURE

Chapter 1 – Word Dynamics
Chapter 2 – Body Dynamics
Chapter 3 – Medical Instruments & Equipment
Chapter 4 – Medical Specialties & Specialists
Chapter 5 – Diagnostic Medicine
Chapter 6 – Abbreviations
Chapter 7 – Anatomy and Physiology
Chapter 11 – Just for Fun

GLOSSARY AND REFERENCES (INCLUDED NO EXTRA CHARGE)

Anatomical Words, Drug References & Instruments (on-line access)

DRUG LISTING – generic alpha, name brand cross-reference, plus 200 of the most commonly prescribed drugs.

MODULE II

INTRODUCTION AND ORIENTATION

A. Report Types
B. OUTPATIENT REPORTS
C. INPATIENT REPORTS

PHARMACOLOGICAL COMPENDIUM
Pharmacology is the study of drugs and their interactions with living organisms. It is one of the oldest branches of medicine.

MODULE III – CODING

SECTION I – CODING THEORY

I. INDUSTRY HISTORY & THE CODES
II. THE CODER
III. ICD CODING
IV. CPT CODING
V. LIABILITY & LEGAL ISSUES
VI. SUMMARY

SECTION II – CODE IT!

The second section consists of over 600 medical charts requiring coding. The answers to the questions, insertion of the procedure and diagnosis codes must be done. This begins with general outpatient and inpatient coding exercises, then moves to specialty coding and chart abstraction to build coding expertise. They are rated from simple to very complicated. The answers and the rationale for the correct codes is provided at the end of each coding exercise. These exercises are the equivalent of several months’ of experience.

MODULE IV – HEALTH INSURANCE SPECIALIST

A. Medical Care Reimbursement
B. Health Organization Plans
C. Insurance Claim Form Analysis
D. Payer Processing
E. Laws, Rules and Regulations
F. Private Insurance
G. Medicare, Medicaid, and Tricare
H. Workers’ Compensation

MODULE V – MEDICAL OFFICE MANAGER

A. Health Care Overview

B. Leadership Training

C. Medical Office Organization

D. Financial Management

E. Formal Policies (Policies & Procedures and Compliance Planning)

F. Managed Care Contracts

G. Medical Marketing

H. Human Resource, Government-Required Documentation

MEDICAL SCRIBE TRAINING COURSE

MODULE 1 – Medical Terminology

Chapter 1. Language Origins, Etymology

Chapter 2. English Grammar101

Chapter 3. Medical Words, Blueprints, Nuts and Bolts

Chapter 4. Dynamics of Medical Vocabulary & Word Structure

Chapter 5. Body Dynamics

Chapter 6. Medical Instruments and Equipment

Chapter 7. Medical Specialties and Specialists

Chapter 8. Diagnostic Medicine

Chapter 9. Abbreviations

Chapter 10. Anatomy and Physiology

Chapter 11. Pharmacology

Chapter 12. Just For Fun

MODULE 2 – Medical Records

Chapter 1 Medical Records

A. Electronic Medical Records

B. Electronic File Transfer

C. Confidentiality

D. Data Entry
Chapter 2 Medical Reports, Formats and Types

A. Medical Dictation

B. Report Types

C. Outpatient Reports

D. Correspondence

E. Inpatient Reports

F. Operative Report

G. Discharge Summaries

H. Consultations

I. Autopsies

J. Interpreting Medical Records & Dictation

MODULE 3 – MEDICAL CODING

PART I

Introduction

Chapter 1 – Industry History and Codes

A. ICD Codes

B. CPT Codes

C. HCPCS Codes

D. Evolution of Coding

Chapter 2. The Coder

A. Private Practice

B. Hospital Services

C. Coder Responsibility

D. Ethical Standards

E. Understanding What is Coded

F. Documentation

G. Medical Necessity

Chapter 3. ICD-9 Coding

A. ICD-10 Coding

B. Using Reference Books

C. General Coding Guidelines

Chapter 4. CPT Coding

A. Types of Services

B. CPT Coding Book Guidelines

C. Modifiers

D. CPT Book Sections

E. Symbols

F. Unlisted Procedures

G. Evaluation and Management

Chapter 5. Software

Chapter 6. Legal Issues

PART II

Applied Coding Practicum

A. ICD-9 and ICD-10 Coding

B. CPT Coding

C. Reports 2 through 63

D. Evaluation and Management Reports

E. Supply Codes, APC, PCS

F. Appendix

MEDICAL RECORDS TECHNICIAN

TIME FOR COMPLETION: 220 hours

Chapter 1 – Medical Record Technician

Chapter 2 – Medical Records

A. Rationale and Application

B. Record Number and Forms

C. Medical Reports

(1) History and Physical

(2) Clinical and Laboratory

(3) Autopsy

(4) Operation

(5) Discharge Summaries

Chapter 3 – Departmental Responsibilities

A. The Department

B. Step by Step Process

C. Filing Systems

(1) Straight Numeric Filing

(2) Terminal Digital Filing

D. Data and Statistics

Chapter 4 – Electronic Medical Records

A. EMR

B. Differences in EMR/EHR

C. Benefits of EHR

D. Paper Medical Records

E. Computerization of Medical Records

Chapter 5 – Policies and Procedures

A. Policies and Procedures

B. Confidential Information Management

C. Public Law – HIPAA

Chapter 6 – Workplace Assets

Chapter 7 – Medical Professionals

Chapter 9 – Coding

A. Disease Classifications and Coding

B. ICD9-10 Codes

C. CPT Codes

D. HCPCS

E. APC Codes

F. Coding Software

G. Coding Practice

Appendix