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Reimbursement

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Reimbursement

This course is part of Electronic Health Record/Reimbursement Fundamentals Specialization

Instructor: Barbara Westrick

Included with

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5 modules

Gain insight into a topic and learn the fundamentals.

Beginner level

Recommended experience

1 week to complete

at 10 hours a week

Flexible schedule

Learn at your own pace

5 modules

Gain insight into a topic and learn the fundamentals.

Beginner level

Recommended experience

1 week to complete

at 10 hours a week

Flexible schedule

Learn at your own pace

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

Skills you'll gain

Details to know

Shareable certificate

Add to your LinkedIn profile

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Build your subject-matter expertise

This course is part of the Electronic Health Record/Reimbursement Fundamentals Specialization

When you enroll in this course, you'll also be enrolled in this Specialization.

Learn new concepts from industry experts
Gain a foundational understanding of a subject or tool
Develop job-relevant skills with hands-on projects
Earn a shareable career certificate

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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Instructor

Barbara Westrick

MedCerts

3 Courses 43,302 learners

Offered by

MedCerts

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Frequently asked questions

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.

To access the course materials, assignments and to earn a Certificate, you will need to purchase the Certificate experience when you enroll in a course. You can try a Free Trial instead, or apply for Financial Aid. The course may offer 'Full Course, No Certificate' instead. This option lets you see all course materials, submit required assessments, and get a final grade. This also means that you will not be able to purchase a Certificate experience.

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.