Certificate in Efficient Medical Claim Management
-- ViewingNowThe Certificate in Efficient Medical Claim Management is a comprehensive course designed to enhance your expertise in managing medical claims. This program emphasizes the importance of accurate and timely claim processing, reducing claim denials, and improving revenue cycle management.
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โข Introduction to Medical Claim Management: Understanding the basics of medical claim management, its importance, and the role of efficient claim management in healthcare organizations.
โข Medical Coding and Billing: Learning medical coding systems (ICD-10, CPT, HCPCS), charge entry, and claim submission.
โข Claims Processing and Adjudication: Exploring the steps involved in claim processing, adjudication, and reimbursement.
โข Common Errors and Denials in Medical Claims: Identifying common errors leading to claim denials and how to prevent them.
โข Patient Financial Responsibility: Managing patient deductibles, co-pays, and balances, and understanding payment plans and collections.
โข Compliance and Regulations: Overview of HIPAA, False Claims Act, and state-specific regulations impacting medical claim management.
โข Medical Claim Audits: Understanding internal and external audits, the audit process, and how to prepare for an audit.
โข Medical Claim Management Technology: Familiarizing with electronic health records (EHR), practice management systems (PMS), and clearinghouses.
โข Performance Improvement in Medical Claim Management: Analyzing key performance indicators (KPIs), data-driven decision-making, and continuous improvement strategies for medical claim management.
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