"Medicare Billing Essentials" provides a background in the elements of correct Medicare billing. This course is designed for billing professionals, from staff to management level. 

The course presents detailed instruction on completing the UB-04 billing and 1500 claim forms and provides comprehensive explanation of the inpatient and outpatient prospective payment systems. Medicare regulations concerning duration of coverage, lifetime reserve days, DRGs, outliers, APCs and calculations, late charges, and adjustment bills are also covered. The system of HCPCS codes, revenue codes, and modifiers is discussed. "Medicare Billing Essentials" describes the functions of Health Information Management (HIM), along with the HIM department’s interactions with the Patient Accounts department.

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  • Describe the UB-04 Form Locators (FL).
  • Explain how a Bill Type identifies the provider, the type of service, and the frequency of billing.
  • Identify the source of admission codes.
  • Describe the National Provider Identifier (NPI).
  • Describe the principal diagnosis assignment.
  • Explain Present on Admission indicators (POA).
  • Explain assignment of benefits.
  • Describe a benefit period or spell of illness.
  • Describe billing requirements for lifetime reserve days.
  • Describe the Outpatient Prospective Payment System.
  • Define the HCPCS/CPT4 method of coding services.
  • Explain detail level billing and when it is required.
  • Use revenue codes for ancillary services correctly.

HFMA members: $249
Non-members: $299

Course information:

  • Approximate time to complete: 12 hours
  • Designed for: Billing staff and managers
  • Level: Basic
  • Instructional method: Self-Study
  • Format: Online
  • Program prerequisite: None
  • Advance preparation: None
  • Course availability: One year from start date

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Our ironclad guarantee

HFMA stands behind the quality of our programming. If you are not satisfied, we will gladly refund your money or provide you with a credit certificate toward any future HFMA National educational programs or select products. Contact HFMA directly at 3 Westbrook Corporate Center, Suite 600, Westchester, IL 60154, Attn: Professional Development, or call (800) 252-4362, ext. 2. Please provide HFMA with your comments within two weeks of beginning the program.