Diploma in Medical Coding and Billing

The medical profession is essential in preserving and improving human health. Healthcare addresses various diseases and medical conditions and enhances the overall wellbeing of individuals and communities by providing public and private healthcare. Although they work independently, medical coders assign appropriate codes and medical billers submit claims to various parties. They have mutual value in providing patients and medical insurance companies with the correct data required to process claims and compensate healthcare providers.

This medical administration course defines various medical jargon terms and explores human anatomy and physiology. This information is crucial to interpreting claims and ensuring accurate decisions are made in the billing process. We go through various coding systems and describe their history and the advantages they offer. These include the Current Procedural Terminology (CPT) structure and the Healthcare Common Procedure Coding System (HCPCS), both of which were introduced and maintained by the American Medical Association (AMA). We examine the ICD-10 codes introduced by the World Health Organization (WHO), which ensure that digital health data can be compared and used across borders.

We then delve into reimbursement methodologies and their rules and regulations before examining billing and claims processing. We provide tips for filling in the forms commonly used by healthcare institutions and primary care physicians and explain how to avoid claim denials. The course examines the ethics and compliance rules of medical coding and billing.