EXECUTIVE SUMMARY
This workshop provides a result based overview of medical claim and billing processes, equipping participants with the knowledge and skills to accurately prepare and submit claims, and manage billing operations efficiently. Topics include claim forms, coding systems, payment methods, and compliance regulations.
WORKSHOP OUTLINE:
. Introduction to Medical Claim and Billing
* Overview of the revenue cycle = Importance of accurate claim submission
. Claim Forms and Requirements
. Coding Systems and Applications
* ICD-10 and CPT coding • HCPCS and modifiers
. Payment Methods and Plans
* Fee-for-service and value • Based payment
* Medicare, Medicaid, NHIS and commercial insurance.
. Compliance and Regulatory Procedures
* Corporate Governance, Fraud and abuse prevention
. Billing Operations and Management
Billing software and technology Claims submission and follow-up
. Customer Denial Management and Appeals.
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