Billing Basics for the Healthcare Professional: Coding and Reimbursement
Course Overview
Coding and reimbursement can be a challenge for many healthcare professionals to ensure proper payment. As reimbursement systems continue to evolve, staying informed about proper coding, payer policies, and compliance regulations is essential for improving financial outcomes and reducing errors in billing. It is essential for sports medicine and healthcare professionals to have a substantial base of knowledge on how to properly document and bill for services provided to a patient. Through proper documentation, the healthcare professional justifies the need for reimbursement while also providing a record to reduce the risk of future liability episodes. This course addresses the unique challenges faced by healthcare professionals in the realm of billing and reimbursement. It also targets rehabilitation professionals working in outpatient clinics or sports medicine practices who perform direct billing and coding or work closely with billing departments as well as athletic trainers employed by sports teams, schools, universities, rehabilitation centers, or health clubs who are involved in billing for services such as injury assessments, rehabilitation programs, or prevention services. The course will prioritize the understanding and application of the correct Current Procedural Terminology (CPT) and International Classification of Disease (ICD-10) codes for various therapy services; gaining insights into common payer rules, regulations, and reimbursement guidelines; and covering documentation best practices to ensure reimbursement and avoid audits. Case studies will be utilized to reinforce successful billing and coding decisions. At the completion of this course, the healthcare provider will have a stronger understanding of billing methods to ensure that compliance and regulatory standards are achieved through accurate and compliant documentation while also demonstrating value to their organization through reimbursement rates.
Learning Outcomes
Upon the completion of this course, the learner should be able to:
- Recognize the reason and importance of third-party billing and obtaining an NPI number.
- Identify types of insurance plans and common cost-sharing terminology included within plans.
- Identify common ICD-10 codes used by rehab professionals.
- Compare different subsets of CPT codes used in a rehabilitation setting.
- Connect the 8-minute rule and rule of eights to different scenarios.
About the Author/Presenter
J. D. Boudreaux received a Bachelor of Science Degree from McNeese State University in 2003 as well as a Master of Physical Therapy from LSU Health Sciences Center-Shreveport in 2005. In August 2003, he became nationally certified as an athletic trainer, and he obtained his Sports Certified Specialist certification through the American Board of Physical Therapy Specialties in 2011 and recertified in 2021. He completed his EdD Degree from the University of Louisiana Monroe in curriculum and instruction in the fall of 2018. He has over 15 years of experience as a dual credentialed sports medicine professional. He has spent seven years managing acute athletic injuries and directing the postsurgical rehabilitation of high-level athletes at the collegiate level. Furthermore, he has served as a visiting lecturer and clinical preceptor for an athletic training (AT) education program. Currently, he is employed by a sports medicine clinic as a director of sports medicine for an outreach program in southern Louisiana and works within a private outpatient sports medicine clinic delivering care in conjunction with other medical professionals to a variety of individuals, including high school and collegiate athletes. J. D. is married to the former Stephanie Mayeux and is the proud father of two daughters, Olivia and Anniston.
Audience/Accreditations and Approvals
Colibri Healthcare
This course is designed for the following healthcare professions (select your profession for details):
Occupational Therapy, Physical Therapy
If you require special accommodations, please contact Colibri Healthcare Support by clicking here: Contact Us
