Education & Outreach

RIVERS OF EMPOWERMENT
Medical Billing & Coding Course Details

Rivers of Empowerment Medical Billing and Coding courses are designed to help you prepare to sit for the American Medical Billing Specialist (AMBS) exam, and the Certified Professional Coder (CPC) exam, or the Certified Coding Associate (CCA) exam. A Virtual Work Experience with simulations related specifically to coding is also included in your program, providing career preparation that can help you find a job.

CURRICULUM

PROGRAM GOAL AND OUTCOMES

Program Goal

To prepare students for an entry-level career as a medical biller and/or coder.

Program Outcomes

Upon completion of the program, students will be able to...

• Apply CPT, ICD-10, and HCPCS coding guidelines to identify diagnoses, procedures, and patient medical records

• Identify the procedures for patient record retrieval and reimbursement

• Explain the role of a medical coder as a liaison between the health clinician and billing offices

• Apply computer and information literacy skills using electronic health records software

• Identify terms, facts, methods, procedures, concepts, theories, principles, and processes within medical billing and coding scenarios

• Classify relationships among data and items within medical billing and coding scenarios

• Recognize laws and theories, including issues relating to ethics and confidentiality

• Calculate solutions to mathematical problems related to reimbursement and medical mathematics

• Interpret information to make proper coding decisions

• Review basic written and workplace communication skills

Starting Your Program

Succeed by learning how to use your ROE, Inc program.

Objectives:

• Understand how to use your Student Portal.

• Access the ROE, Inc Community and use it to find answers.

• Connect with ROE, Inc on various social media sites.

Introduction to Allied Health

This course gives an introduction to health care, the health information management industry, and the role that health information technicians play in that industry.

Objectives:

• Describe reimbursement systems and the role health information management technicians play in reimbursement.

• Describe how technology is used in health information management.

• Discuss different professional organizations and certifications for health information management technicians.

• Explain the different roles, opportunities, and settings for health information management technicians.

Law, Ethics, and Confidentiality in Allied Health

This course examines how the law affects medical offices, the origin of law that affects medical professionals, the basics of the process of litigation and its alternatives, the common-law basis for the confidentiality of health care information, and the laws regulating health care information collected and maintained by government agencies.

Objectives:

• Describe civil and criminal law, sources of law, and the steps of litigation

• Distinguish between liability, negligence, and malpractice and explain how they relate to health care professionals

• Explain defenses against medical malpractice and against criminal charges

• Identify the various ethical issues that health care professionals face

• Discuss contemporary medical issues such as medical care access, experimentation, paternalism and autonomy, and organ transplants

• Discuss ethical issues regarding death, the right to die, and assisted suicide

• Explain the uses and content of medical records

• Describe the legal significance of confidentiality obligations

• Explain the core concepts of HIPAA’s final Privacy Rule

• Summarize the role of peer review in confidentiality issues

• Describe confidentiality and security issues related to electronic medical records

Learning Aid: Certification Test Prep

Medical Billing and Health Insurance

This course introduces the reimbursement process and the various methodologies involved, such as fee-for-service and episode-of-care methodologies. The course also covers important information regarding payment systems, fee schedules, chargemasters, coding, and the internal audit process. Finally, the course explains the fundamentals and types of health insurance.

Objectives:

• Describe the history of health care reimbursement

• Describe fee-for-service reimbursement methodologies

• Define episode-of-care reimbursement methodologies

• Outline the Medicare acute care prospective payment system

• Describe the Medicare skilled-nursing facility prospective payment system

• Discuss the different outpatient prospective payment systems

• Describe the electronic data interchange process

• Name the latest changes in health care reimbursement

• Explain the management of fee schedules, chargemasters, and coding

• Describe the internal audit process

• Outline characteristics of a coding compliance program

• Discuss your role as a health information professional in health care reimbursement

• Define prepaid health plans

• Identify characteristics of retrospective and prospective payment systems

• Describe commercial insurance plans

• Outline the history of Blue Cross/Blue Shield plans

• Discuss the different government-sponsored health care programs

• Explain how managed care works

Learning Aid: Certification Test Prep

Medical Office Procedures

This course is designed to help you develop professional relationships in the workplace and professionally administer and manage office communications and procedures. It also provides a review of basic math operations, along with a basic introduction to working with Word and Excel.

Objectives:

• Identify and name decimal place values

• Convert measurements in the metric system and in foreign currencies

• Identify prefixes of the metric system

• Use percent to calculate percent increase or decrease, interest rate, sales tax, discounts, shipping charges, and the base price

• Identify the six steps for problem-solving

• Calculate the following values: three types of averages, deductions from a paycheck, and simple and compound interest

• Identify and use parts of speech

• Demonstrate knowledge of the elements of sentence structure

• Explain and identify subject-verb agreement

• Identify and correct grammatical errors in sentences

• Use end marks, commas, and other common punctuation marks

• Use capitalization correctly  

• Identify the correct way to answer and place interoffice, long-distance, and

• conference calls

• List and describe at least six components of effective oral communication

• Identify the correct way to process incoming and outgoing mail

• Process routine information requests and correspondence

• Assist in writing well-structured letters that are professional in appearance

• Correctly format, compose and address business letters

• Describe the purpose and format of memos

• Identify the correct way to organize an email message

• Explain safe and effective uses of email

• Create new Word documents and Excel spreadsheets

• Edit and format existing documents and spreadsheets

• Add graphics and tables to Word documents

• Create charts

• Use formulas and functions

Body Systems and Medical Terminology 1

In this course, you’ll become familiar with the medical terms that you'll hear on a daily basis in your new career, and you’ll examine the organization of body systems. More specifically, you’ll study terms related to the following body systems: integumentary, musculoskeletal, hematic, lymphatic and immune, and cardiovascular.

Objectives:

• Explain how root words (and their combining forms), prefixes, and suffixes function in medical terms

• Define many of the most common roots, prefixes, and suffixes

• Determine the meaning of a given medical term by analyzing its parts

• Identify the anatomical position and directional terms, as well as the three planes, four quadrants, and nine regions of the body

• Describe the body science of nutrition

• Explain the anatomy and function of the integumentary and musculoskeletal systems

• List diseases of the integumentary and musculoskeletal systems

• Identify tests and procedures to diagnose and treat diseases of the integumentary

• and musculoskeletal systems

• Use combining forms to build and analyze terms related to cellular anatomy, the integumentary system, and the musculoskeletal system

• Explain the anatomy and function of the hematic, lymphatic, immune, and cardiovascular systems

• List diseases of the hematic, lymphatic, immune, and cardiovascular systems

• Identify tests and procedures to diagnose and treat diseases of the hematic,

• lymphatic, immune, and cardiovascular systems

• Use combining forms to build and analyze terms related to the of the hematic,

• lymphatic, immune, and cardiovascular  systems

Learning Aid: Certification Test Prep

Body Systems and Medical Terminology 2

In this course, you’ll become familiar with the medical terms that relate to the following body systems: respiratory, digestive, nervous, endocrine, reproductive, and excretory. You’ll also examine terms related to the sensory organs, with a concentration on the organs for hearing, sight, and smell. Finally, you’ll examine the medical specialties of oncology, radiology, nuclear medicine, genetics, surgery, and pathology.

Objectives:

• Explain the anatomy and function of the respiratory, digestive, and nervous

• systems

• List the diseases of the respiratory, digestive, and nervous systems

• Identify tests and procedures to diagnose and treat diseases of the respiratory, digestive, and nervous systems

• Use combining forms to build and analyze terms related to the respiratory, digestive, and nervous systems

• Explain the anatomy and function of the endocrine, reproductive and excretory systems

• List diseases of the endocrine, reproductive, and excretory systems Identify tests and procedures to diagnose and treat diseases of the endocrine, reproductive, and excretory systems

• Use combining forms to build and analyze terms related to the endocrine, reproductive,

• and excretory systems

• Explain the anatomy and function of the sensory organs

• List diseases of the sensory organs

• Identify tests and procedures to diagnose and treat diseases of the sensory organs and the nervous system

• Use combining forms to build and analyze terms related to the sensory organs

• Differentiate between tumor types and explain how cancer develops

• Classify cancers and describe the major methods of cancer treatment

• Identify radiographic procedures and outline the types and uses of nuclear medicine tests

• Summarize surgical methods and pathological processes

• Describe the application of genetics to the study of diseases

Learning Aid: Certification Test Prep

Electronic Medical Records

This course is designed to help you understand the reimbursement process and the various methodologies involved. You’ll be introduced to billing cycles and how health information technology is used in medical offices, and learn about basic accounting transaction terminology and apply this information to enter patient charges and payments.

Objectives:

• Discuss the history of electronic health records

• Perform administrative health information management functions

• Build an electronic health record

• Enter information into an electronic health record

• Utilize templates to increase productivity

Textbook: TBD

Simulation: TBD

Learning Aid: Certification Test Prep

Pathology and Pharmacology

This course describes health-care professionals who are licensed to prescribe medications for the treatment of disease and illness, reference material most often used by pharmacists and pharmacy technicians, and pharmaceuticals that are designed to alleviate or repair any sort of malfunction in the body.

Objectives:

• Define the basic elements of pharmacology

• Identify common drugs, drug names, drug references, routes and forms of drug administration, and drug classification related to body systems

• Understand the basics of drug regulatory agencies and enforcement

• Define drug action and effect according to specific classifications

• List common diseases of body systems

• Identify tests and procedures to diagnose and treat diseases of body systems

• Identify basic surgical procedures

Learning Aid: Certification Test Prep

Basic Medical Coding

Your first course begins with an overview of coding concepts, terms, and procedures. You’ll explore the history of the ICD-10 coding system. You’ll code diagnoses in the ICD-10-CM and use the chapter-specific coding guidelines to code diseases and conditions with specific and unique rules. You’ll finish your course by learning how to code procedures in the ICD-10-PCS, rounding out your training in the basics of coding with ICD-10.

Objectives:

• Describe the purpose of coding and the documentation used in coding

• Assign ICD-10-CM codes using the ICD-10-CM coding manual

• Correctly apply coding guidelines for ICD-10

• Assign procedure codes using ICD-10-PCS

Textbooks:

• Step-By-Step Medical Coding 2019

• ICD-10-CM 2019

Learning Aid: Certification Test Prep

Intermediate Medical Coding

In this course, students will concentrate on the diagnoses or procedures that don’t seem to fit into any specific coding category. Students will also learn about general coding guidelines for inpatient and outpatient procedures and physician office coding using ICD-10-CM, HCPCS Level I, and HCPCS Level II procedure coding.

Objectives:

• Assign codes for services and procedures using CPT and HCPCS Level II

• Outline the procedure for assigning codes from the E/M and Anesthesia sections of the CPT

• Outline the types of services and procedures described in the CPT

• Explain the types of procedures coded in the hemic, lymphatic, digestive, reproductive, and urogenital systems

• Describe the procedures coded in the endocrine, nervous, ocular, auditory, radiology, pathology, and medicine sections of CPT

Textbooks:

• CPT 2019

• HCPCS Level II 2019

Learning Aid: Certification Test Prep

Advanced Medical Coding

In this course, you’ll assign codes using ICD-10, CPT, and HCPCS in advanced medical coding scenarios. You’ll build off what you learned in your Basic and Intermediate Medical Coding courses, using the skills from those courses to interpret complex medical data. You’ll fine-tune your coding skills through several practice coding scenarios to prepare to take the CPC coding exam and become a professionally certified coder.

Objectives:

• Locate and accurately assign diagnosis codes for complex coding scenarios using ICD-10-CM

• Locate and accurately assign procedure codes for complex coding scenarios using ICD-10-PCS

• Add characters to expand ICD-10-PCS codes for complex coding scenarios

• Assign codes using CPT

• Assign codes using HCPCS Level II

Textbooks:

• The Next Step 2017/2018

• Virtual Medical Office

Learning Aid: Certification Test Prep

ADDITIONAL DETAILS

• PROFESSIONAL LICENSING/CERTIFICATION INFORMATION

Licensing and/or certification requirements for jobs in this field are not the same in every state and may include educational, testing, and/or experiential requirements beyond those offered in the Penn Foster Program. Prospective students should contact the state professional licensing board or similar regulatory body in the state(s) where they plan to work to determine their requirements before enrolling in this Program. for contact us for more information for state licensing/regulatory boards and certain industry licensing information.

​

• STATE REQUIREMENTS

Please review your state board requirements that are applicable to your field of study. State boards may impose a variety of different requirements, which vary from state to state.