Reimbursement
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Reimbursement
This course is part of Electronic Health Record/Reimbursement Fundamentals Specialization
Instructor: Barbara Westrick
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What you'll learn
Describe the phases of the revenue cycle and gain an understanding of basic insurance terminology
Explain verification of patient financial responsibility and insurance information
Discuss capture of information and complete CMS-1500 or HIPAA 837P claims
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There are 5 modules in this course
The Reimbursement course provides an in-depth study of the medical reimbursement process, emphasizing the role of insurance specialists in managing the healthcare revenue cycle. In five lessons, students explore every stage of the patient encounter – from the initial intake and documentation of health information to claim submission, follow-up, and collections – developing a comprehensive understanding of how accurate data and communication drive financial success in healthcare organizations.
Learning outcomes include the ability to apply key principles of medical billing, coding, and reimbursement; accurately prepare and process healthcare insurance claims; and ensure compliance with privacy laws and industry regulations. The Reimbursement course integrates both administrative and practical aspects of the reimbursement cycle, bridging the gap between patient care and financial management, teaching students how each interaction and data entry impacts timely reimbursement and organizational sustainability.
This module introduces students to the stages of the patient encounter, including intake, documentation of health information, claim submission, follow-up, and collections.
What's included
6 videos1 reading1 assignment5 plugins
6 videos•Total 20 minutes
- Lesson 1 - Industry Insight and Question•2 minutes
- Lesson 1 - Introduction and Objectives•2 minutes
- Lesson 1 - Patient Registration •6 minutes
- Lesson 1 - Establishing Financial Responsibility•7 minutes
- Lesson 1 - Review•1 minute
- Lesson 1 - Industry Insight Follow up•2 minutes
1 reading•Total 15 minutes
- Course Introduction•15 minutes
1 assignment•Total 30 minutes
- Lesson 1 - The Patient Encounter•30 minutes
5 plugins•Total 75 minutes
- Lesson 1 - Key Terms•15 minutes
- Lesson 1 - The Revenue Cycle and Insurance Math•15 minutes
- Lesson 1 - Insurance Coverage and Benefit•15 minutes
- Lesson 1 - Time-of-Service Payments and Insurance Math•15 minutes
- Lesson 1 - Collecting Time-of-Service Payment•15 minutes
This module instructs students in applying the key principles of medical billing, coding, and reimbursement while also ensuring compliance with privacy laws and industry regulations.
What's included
8 videos1 assignment3 plugins
8 videos•Total 24 minutes
- Lesson 2 - Industry Insight and Question•2 minutes
- Lesson 2 - Introduction and Objectives•2 minutes
- Lesson 2 - Billing Compliance•5 minutes
- Lesson 2 - Compliance Strategies•5 minutes
- Lesson 2 - Coding and Billing Cycle Audits•3 minutes
- Lesson 2 - Fees and Reimbursement•5 minutes
- Lesson 2 - Review•1 minute
- Lesson 2 - Industry Insight Follow up•2 minutes
1 assignment•Total 30 minutes
- Lesson 2 - Encounter Charges and Billing•30 minutes
3 plugins•Total 45 minutes
- Lesson 2 - Key Terms•15 minutes
- Lesson 2 - Payment Methods and Insurance Math•15 minutes
- Lesson 2 - Insurance Claim Fraud•15 minutes
This module explores how to accurately prepare and process healthcare insurance claims.
What's included
8 videos1 assignment4 plugins
8 videos•Total 23 minutes
- Lesson 3 - Industry Insight and Question•2 minutes
- Lesson 3 - Introduction and Objectives•3 minutes
- Lesson 3 - CMS-1500 Claim Completion•4 minutes
- Lesson 3 - HIPAA 837P Claim Submission•4 minutes
- Lesson 3 - Claim Transmission•3 minutes
- Lesson 3 - Hospital Coding and Claims•3 minutes
- Lesson 3 - Review•1 minute
- Lesson 3 - Industry Insight Follow up•3 minutes
1 assignment•Total 30 minutes
- Lesson 3 - The Healthcare Insurance Claim•30 minutes
4 plugins•Total 60 minutes
- Lesson 3 - Key Terms•15 minutes
- Lesson 3 - Preparing a Correct Claim•15 minutes
- Lesson 3 - Complete a CMS-1500 Claim•15 minutes
- Lesson 3 - Capturing Insurance Information•15 minutes
This module describes the claim submission and follow-up stages of the patient encounter.
What's included
8 videos1 assignment4 plugins
8 videos•Total 22 minutes
- Lesson 4 - Industry Insight and Question•1 minute
- Lesson 4 - Introduction and Objectives•2 minutes
- Lesson 4 - Claim Adjudication•4 minutes
- Lesson 4 - Claim Status•3 minutes
- Lesson 4 - Posting and Applying Payments•5 minutes
- Lesson 4 - Secondary Payers•4 minutes
- Lesson 4 - Review•1 minute
- Lesson 4 - Industry Insight Follow up•3 minutes
1 assignment•Total 30 minutes
- Lesson 4 - Health Insurance Claim Follow-up•30 minutes
4 plugins•Total 60 minutes
- Lesson 4 - Key Terms•15 minutes
- Lesson 4 - The Remittance Advice•15 minutes
- Lesson 4 - Denials and Appeals•15 minutes
- Lesson 4 - Claim Status•15 minutes
This module describes the collection stage of the patient encounter.
What's included
7 videos1 reading1 assignment1 peer review4 plugins
7 videos•Total 20 minutes
- Lesson 5 - Industry Insight and Question•2 minutes
- Lesson 5 - Introduction and Objectives•2 minutes
- Lesson 5 - Patient Financial Responsibility•5 minutes
- Lesson 5 - Collections•6 minutes
- Lesson 5 - Collections cont.•3 minutes
- Lesson 5 - Review•1 minute
- Lesson 5 - Industry Insight Follow up•1 minute
1 reading•Total 10 minutes
- Project Instructions•10 minutes
1 assignment•Total 30 minutes
- Lesson 5 - Billing and Collections•30 minutes
1 peer review•Total 60 minutes
- Document the Lifecycle of a Patient Encounter and Develop a Training Plan for a New Employee•60 minutes
4 plugins•Total 60 minutes
- Lesson 5 - Key Terms•15 minutes
- Lesson 5 - Account Write-offs and Bad Debt Math•15 minutes
- Lesson 5 - Other Collection Considerations•15 minutes
- Lesson 5 - Account Billing and Collection•15 minutes
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No. This course is considered an introduction to MedCerts career and certification training. It does not fully prepare students to test for national certification. To prepare for a national certification, students have the option to enroll in a more comprehensive program at MedCerts, where certification and job-readiness is the intent.
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When you enroll in the course, you get access to all of the courses in the Specialization, and you earn a certificate when you complete the work. Your electronic Certificate will be added to your Accomplishments page - from there, you can print your Certificate or add it to your LinkedIn profile.
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