Online Training Course

Prod ID: 339
Hospital Coding and Billing Documentation

This basics course is designed for providers, managers, and staff at hospitals who need a basic understanding of coding and billing in the hospital setting.  

CEUs

6

Length

327 min

Price

$299.00

In this course, the participant will learn:

  • Hospital billing terminology
  • The difference billing inpatient versus outpatient stays
  • Reimbursement under the Prospective Payment System
  • Guidelines for completing and filing accurate the CMS 1450 claim form
  • Use of occurrence codes and modifiers

Audrey Coaxum

CHC, CPC, CEMC, CMC, CMIS, CMOM, CMCO


Audrey E. Coaxum is an influential leader with more than twenty-five years of relevant experience involving many facets of healthcare operations. She is recognized for having an exceptional ability to analyze systems and processes, create best practices, develop policy and procedures, as well as, diverse methods that are compliant, proactive and geared towards eliminating waste and revenue losses, while enhancing operational efficiencies and achieving strategic goals. Audrey has a sterling reputation across the healthcare community as a customer-service oriented strategic problem solver and trusted advisor. She has extensive knowledge and experience in leadership development, medical billing and coding, reimbursement and comprehensive clinical and business operations.

Audrey has served as a C-suite executive for many organizations where her skills as a progressive analyst afforded her the opportunity to champion initiatives involving the implementation of Value-Based Payment Models and the benchmarking of Key Performance Indicators in productivity, patient volume, budget performance and clinical quality outcomes. Motivated by her desire for change and to overcome concerns, she has overseen a range of activities directed towards the evolution and refinement of quality improvement, risk management and practice administration needed to diminish the day to day challenges facing today's medical practices.

Audrey's professional interests focus on various aspects of compliance that streamline operations and enhance profitability without compromising quality of care. As a strong advocate of hands-on, inquiry based learning, she currently spearheads activities related to compliance education and training. She conducts audits and reviews to identify trends, issues and potential areas of risk to assist her in developing technology-infused training programs geared towards educating clinicians, administrators and support staff.

This basic-level training is designed to help providers, managers, and staff at hospitals understand the nuances of coding and billing in the hospital setting.  

This basics course is designed for providers, managers, and staff at hospitals who need a basic understanding of coding and billing in the hospital setting.  

  • Define common terms related to hospital billing
  • Billing inpatient versus outpatient stays
  • State the role of ICD-10-CM Volume 3 in hospital billing
  • Identify categories in ICD-10-CM Volume 3
  • Describe the charge description master
  • State the general guidelines for completion of the CMS-1450  claim form
  • State when the CMS-1450 paper or electronic claim form may and may not be used
  • Describe the history and purpose of diagnosis-related groups.
  • Identify how payment is made based on diagnosis-related groups
  • State how payment is made under the Prospective Payment System
  • Current revenue codes and services they include
  • Name the four types of ambulatory payment classifications
  • State reimbursement methods used when paying for hospital services under managed care contracts
  • Hospital inpatient bundling
  • Pre-admission services
  • Hospital based physician services
  • Hospital re-admission review
  • The dangers of fragmenting, bundling and unbundling
  • Proper documentation for medical necessity
  • Insurance Claim Submission
  • Use of occurrence codes and modifiers
  • Edit and complete insurance claims in both hospital inpatient and outpatient settings to minimize their rejection by insurance carriers

Self-paced online program includes unlimited review of previously recorded instruction and the downloadable digital companion materials for 6 months.

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