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Medical Billing and Coding Certification





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Why Get Certified?

Certification can lead to better visibility, opportunities and jobs. In today's increasingly complex and highly-specialized economy, credentials are everything. Sure you may have the skills to do the job, but how do you convince potential clients or employers? Certification!

Certification may open doors you don't expect. Certification is likely to increase self-esteem as well as job potential and income.

What is the Certified Medical Billing Specialist® Exam?

The Medical Association of Billers CMBSTM Program is a challenging series of interesting and practical courses. It is aimed at individuals employed in a provider's office, health insurance company, or an independent billing center.

A candidate for certification is an individual who is motivated to improve their medical billing and coding knowledge and to develop new skills to assist providers in maximizing their reimbursement through proper coding and documentation.

How Long Does it Take to Get Certified?

Certification can take anywhere from a single weekend to as much as 6 months. To achieve certification, an individual must successfully complete a series of six online courses, take a PowerWeekend™, or test out at a proctor site. There are no classroom prerequisites required to sit for the CMBSTM certification.

NEWS!

For the past 20 years the Medical Association of Billers has brought you reliable training in medical billing and coding as well as the world renowned Certified Medical Billing Specialist® (CMBSTM) certification.  Some of our proctor sites have asked for a certification encompassing medical billing alone.  For this reason we have created the Certified Medical Records TechnicianTM (CMRTTM) certification which started in January 2015. 


Certified medical billers are vital to the success of healthcare practices. Their vigilant work preparing, submitting, and following up on claims keeps physician’s practices, hospitals, third party billing centers and federal and state government clinics running smoothly.

 

Certified medical billers review patient records, calculate charges, submit claims and answer patient and insurance payer questions regarding claims. A certified medical biller is knowledgeable in payer rules and regulations as well as privacy and confidentiality concerns related to Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA). Certified medical billers must pass the rigorous Certified Medical Billing Specialist® or Certified Medical Records TechnicianTM exam, and are more highly sought after than those without certification.

The new CMRTTM examination covers: medical terminology, the billing process, commercial medical plans, government medical plans, insurance terminology, medical records documentation, insurance claims, fraud and abuse, and the anatomy of an Explanation of Benefits (EOB).  It covers front office tasks such as: answering phones and scheduling, obtaining insurance and patient information (demographics), verifying patient coverage, pre-authorizing non-routine services, entering claim information into the practice management software, transmitting claims, following-up on claims, posting payments, billing patients for co-pays, resubmitting denied or partially paid claims, generating and sending secondary insurance claims.

The CMBSTM examination covers everything in the CMRTTM exam with the exception of medical terminology and adds ICD-9, ICD-10, CPT-4, medical necessity, and the proper use of modifiers.  A Certified Medical Billing Specialist®, although not a certified coder, is capable of reviewing claims related to coding or medical necessity problems found on an EOB or assisting the provider in coding the initial claim.

According to the Bureau of Labor Statistics, jobs for billing and health information technicians are expected to increase by 22% through the year 2022.  Due to the administrative changes in healthcare, patient records are being scrutinized by payers more than ever.  Certified Medical Billing Specialist® and Certified Medical Records Technicians are extremely important to the health of a medical practice.  Claims must be submitted correctly the first time to keep practices running efficiently.


What is on the Exam?
Each examination consists of 100 questions in the following areas:

Introduction to Medical Office Insurance
  • Billing Process - From the time the patient calls for an appointment through claim payment
  • The importance of a provider's financial policy
  • Sample forms evaluation - superbill, patient intake sheet...
  • Place of Service Codes
     CMBS and CMRT Exam
Medical Terminology
  • Medical Terminology Basics - Prefix, Root, Suffix
  • Ways to memorize and conquer medical terminology
CMRT Exan
Introduction to ICD-9 Coding
  • History
  • Purpose
  • Format
  • Volume 1
  • Volume 2
  • Volume 3
  • Conversions
  • The Coding Process
  • Tables: Hypertension, Neoplasm, Drugs and Chemicals
  • "Rule Out": Chronic Conditions, Late Effects, V and E Codes
  • Importance of ICD/CPT Linkages
  • Basics of ICD-10
CMBS Exam
Introduction to ICD-10 Code Set
Introduction to:
  • ICD-9 Vs ICD-10
  • Impact of ICD-10
  • Format of ICD-10
  • Placeholders
  • Laterality
  • Excludes changes
CMBS Exam
Introduction to CPT Coding
  • Brief History
  • Sections of CPT Manual
  • HCPCS
  • Format and Conventions
  • Symbols
  • Guidelines
  • Appendix
  • Index
  • Modifiers
  • E/M Codes
CMBS Exam
Insurance Carriers
  • Definitions
  • Commercial Plans
  • Government Plans
  • HMO
  • PPO
  • Workers Compensation

CMBS and CMRT Exam
Proper Billing and Coding of Medicare Claims
  • Guidelines
  • Par Vs Non Par
  • Parts of Medicare
  • CCI Edits
  • Medicare Appeals Process

CMBS and CMRT Exam
How to Complete a CMS-1500
  • Required Fields
  • Establishing Medical Necessity

CMBS and CMRT Exam
Claim Resolution
  • Reading and Evaluating an EOB or RA
  • Writing successful letters of appeal

CMBS and CMRT Exam

Please note
: Medical Terminology may be on the re-test for the CMBS Exam

If you would like to view a mock test Click here .


Put your career into high gear
~ Get Certified Now ~

To find out how to register for the CMBSTM exam visit our Test Out Procedures page. 

How do I stay certified?

To maintain your CMBSTM certification, graduates must complete 12 continuing education units (CEUs) per calendar year. This may be accomplished by successfully completing one MAB on-line class, one PowerWeekend™, one or by taking approved vendor classes. Students must be a current member of the Medical Association of Billers to remain certified. Many schools throughout the country offer CMBSTM CEUs. If schools have requested pre-approval of their CEUs 1 CEU will be awarded per hour of classroom study. If CEUs are not pre-approved they will receive 50% - or a 4 hour class would be awarded 2 CEUs. Please check the Pre-approved CEUs page.


Intermediate Level Instructor Certification

Certified Medical Billing Specialist® Instructor - CMBS-I The Medical Association of Billers offers a training class for instructors. We will demonstrate how to conduct a refresher class and provide tips and assessment tools. Instructors will have an opportunity to present topics to the class and be evaluated on presentation as well as question answering skills. Upon successful completion instructors will receive their CMBS-I. This class is given once a year in Las Vegas. For more information please go to: CMBS-I Train-the-Trainer.