Medical Billing Certificate

School: Health Careers, Technology and Applied Learning
Academic Dept: Allied Health Careers
HEGIS: 5213.00

Important Note about Program Requirements

The requirements listed below are for students entering into this program from Fall 2023 to Summer 2024. Students who entered the program during a prior semester will find their specific requirements listed in the Catalog under which they entered. Archived Catalogs are accessible through the dropdown menu above.

Program Description

This certificate program in Medical Billing leads to credentialing as a Certified Professional Biller (CPB) through the American Academy of Professional Coders (AAPC). The program provides exposure to terminology, rules and regulations that apply to the healthcare industry. Students gain a comprehensive understanding of various insurance plans, the use of International Statistical Classification of Diseases, 10th revision (ICD-10-CM) coding guidelines and Current Procedural Terminology (CPT-4). Emphasis is placed on billing processes and procedures for filing, tracking claims and resolution of claim denials. Graduates are eligible to take the Certified Professional Biller Examination (CPB). The program can be taken alone to achieve the certificate or as a stackable credential with Medical Coding Certificate.

Note: Students must demonstrate eligibility to enroll in ENG 101 - Writing and Research.

Program Learning Outcomes

Upon completion of this program, students will be able to:

Demonstrate knowledge of policies and procedures pertaining to healthcare reimbursement including: third party payers, payment and reimbursement methodologies and Charge Description Master (CDM).
Apply healthcare terminology to the processing of medical billing documents.
Apply billing concepts and principles to the practice of health information management including Local Coverage Determinations (LCD), and National Coverage Determinations (NCD), in compliance with reimbursement regulations.
Describe the concepts and structures of various types of prospective payment systems and apply the rules of each prospective system to the appropriate healthcare setting.
Apply the concept of medical necessity to insurance claims.
Understand CPT, ICD-10-CM, and HCPCS Level 2 coding guidelines.

Program Requirements

Required Courses - 24 credits

Program Map

The program map is a recommended semester-by-semester schedule of courses based on degree requirements and serve as a general guideline to help students complete their program in two years. Although designed for full-time enrollment, these are easily adaptable for part-time study. For additional, individualized guidance, students should review Degree Works and consult an Academic Counselor or Faculty Advisor to ensure they are on track to complete their program.

Semester 1

Course	Credits
ENG 101 - Writing and Research	3
BTECH 230 - Integrated Office Applications	3
HCTAL 101 - Medical Terminology	3
HIT 120 - Introduction to Health Information Management	3
Semester Total Credits	12

Semester 2

Course	Credits
HIT 140 - Health Care Reimbursement	3
HIT 150 - Advanced Health Information	3
HIT 210 - Intro to ICD-10	3
HIT 220 - CPT-4/HCPCS	3
Semester Total Credits	12

Minimum Total Credits: 24

Gainful Employment Disclosure

For information about graduation rates, the median debt of students who have completed this program, and other important information please visit Medical Billing Certificate - GE Disclosure. For an overview of all gainful employment disclosures at Westchester Community College, visit www.sunywcc.edu/gainfulemployment.

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