Purpose

The Billing and Coding (BC) certificate program (Plan Code 221-152-03) prepares individuals for a position in a medical office setting. Students are prepared to complete insurance and billing forms for patients and insurance companies. Upon completion of the program, students are eligible to take the National Center for Competency Testing (NCCT) for certification.

Students enrolled in the Career Studies Certificate may apply many credits earned to the college’s Certificate in Medical Assisting.

Under current guidelines, Federal financial aid cannot be used to enroll in the Medical Coding and Billing Specialist program.

Insurance and Coding Specialists provide medical billing and coding services to physician’s offices and medical specialty practices for health care providers to be paid for services rendered. Insurance and Coding Specialists prepare and submit claims to insurance companies and prepare and send statements to patients. Insurance and Coding Specialists must be knowledgeable and possess skills in the areas of medical terminology, anatomy & physiology, diagnostic and procedural coding, insurance claims processing, and medical billing procedures (NCCT, 2017).

Students will rotate through an internship. Clinical affiliates for Billing and Coding will include nursing homes, rehabilitation, the hospital, and physician’s offices. Upon completion of the program students are eligible to take the National Center for Competency Testing (NCCT) for certification as a Billing and Coder.

Program Requirements and Special Considerations

Prospective students must:

1. Complete application to Eastern Shore Community College (ESCC).
2. Have High School diploma transcript or GED certification sent to ESCC’s Registrar office.
3. Complete placement testing and master placement MTE 1-4 or completion of appropriate developmental math courses;
4. Achieve placement to ENG 111 or completion of appropriate developmental English courses;
5. Complete drug screening and criminal background check with no records of concern or pending actions.
6. Be eligible for employment with the Riverside Health System and Eastern Shore Rural Health entities.
7. Students are responsible for their own transportation to off-campus facilities for clinical experiences.
8. Students must receive a grade of “C” or better in all core courses to remain in the BC program.
9. Students must maintain an overall grade point average of 2.0 or better
10. These requirements must be fulfilled prior to the start of the second semester or entry into the clinical internship: (Students must be current, certified and or maintain standards through the end of the program for all of the continuation requirements.);
11. Students are responsible for costs necessary for program completion such as required testing fees, liability insurance, uniforms, stethoscopes, BC pins and graduation uniform, books, criminal history and sex offender crimes against minors background checks.
12. Purchase of ESCC approved Student Uniform lab coat.
13. Completion of a physical examination, two step PPD (or chest x-ray if already PPD positive). Immunizations must be up to date including tetanus, MMR or positive titers, varicella or positive titers, Hepatitis B series or positive titer, tetanus, and current flu vaccine. This will depend on location of internship and is based on the agency’s policy.
14. Potential for random drug screening.
15. Appropriate professional and social media use as defined by the college or syllabus.
16. Participation in community based activities that support student development.
17. Students must complete the program within 3 years to be eligible for national certification.

There is a limited time for the student to test for national certification following graduation.

Students must apply and send all information to National Center for Competency Testing (NCCT) in order to sit for examination.

NCCT information regarding testing and fees can be found at https://www.ncctinc.com/

Part-time students should consult their faculty advisors regarding appropriate course sequences.

Courses in this program may help students attain the following license(s) or certification(s):

National Certified Insurance and Coding Specialist, National Center for Competency Testing (NCCT)

Program Learning Outcomes

Students will be able to:

• Apply Billing and Coding skills related to ICD-10, HCPCS, and CPT.
• Apply insurance skills and knowledge related to payment and billing procedures.
• Apply the principles of law and ethics in performing office operations.
• Apply medical terminology appropriately in the workplace.