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Course Descriptions
The Medical Insurance Billing Certificate Program consists of 8 required courses, offered annually from September to May. This schedule allows students to complete the program in as little as nine months.
There are no prerequisites to begin the program. Students can register in any course that doesn’t require prior coursework (NBMB 111, 112, 113, 114, 115), which can be taken at any point within the program. In the latter half of the program (NBMB 116, 117, 118), courses build on earlier material, with NBMB 115 serving as the first prerequisite.
NBMB 111 | Insurance and Third Party Payers
Noncredit
This course includes detailed reviews of Medicare, Medicaid, 3rd Party Insurance, Worker’s Compensation, Blue Cross and Managed Care. Emphasis includes providing payers with “clean claims” and techniques to employ to minimize claims denials.
NBMB 112 | Office & Insurance Problem Solving
Noncredit
This course provides details concerning the Operations within a Medical Practice. This course will cover topics such as: Job Descriptions, Human Resources Office Operations, and Best Practices. Topics will also include follow-up procedures, collections and utilization of electronic media to improve cash flow and minimize errors.
NBMB 113 | Regulatory Requirements – HIPAA, Compliance & Ethics
Noncredit
This course will focus on the regulatory requirements impacting the operation of healthcare/physician practice. Major topics include:
• Regulatory Agencies
• Fraud & Abuse
• False Claims Act
• Medical Necessity Denials
• Compliance programs for Physician Offices
• Compliance Programs for 3rd party billing companies
• Healthcare Insurance Portability & Accountability Act (HIPAA)
• Ethics.
NBMB 114 | Inpatient / Outpatient Facility Billing
Noncredit
This course will focus on entitles that bill for facility charges using the UB04. Specialized billing requirements for Ambulatory Surgery Centers, Hospital Inpatients, Outpatients, Therapies, and Home Health will be covered. Reimbursement systems such as Diagnostic-Related Groups (DRGs) and Outpatient Prospective Payment System (OPPS or APCs) will be reviewed.
NBMB 115 | Medical Terminology
Noncredit
Provides an overview of medical terminology, including prefixes, suffixes, roots and combining forms. Students will learn about the various body systems as they relate to medical terminology. Also covered will be medical abbreviations and exercises on how to read medical reports. This course is a good foundation for anyone working in a medical environment. Students should bring the required textbook to class: Medical Terminology: A Short Course.
NBMB 116 | ICD-10 Diagnosis Coding
Noncredit
Prerequisite: NBMB 115
This course will provide a basic understanding of Diagnosis Coding Principles. The basic steps in coding will be reviewed and students will be able to practice with actual coding exercises. Students should bring the required textbooks to class: ICD-10-CM Coding Book—latest edition & Insurance Handbook for the Medical Office with Student Workbook.
NBMB 117 | CPT Procedure Coding
Noncredit
Prerequisite: NBMB 115 and 116
Students will develop a firm foundation for medical insurance billing with a thorough knowledge of CPT coding. This course is specifically designed and taught for people with little or no experience in the medical field. Begin with the basics and develop a clear and concise understanding of the procedure coding systems to help formulate an accurate insurance claim that will maximize reimbursement. Students should bring the required text to class: CPT-4 Coding Book—latest edition & Insurance Handbook for the Medical Office with Student Workbook.
NBMB 118 | Medical Insurance Computer Billing and Applied Billing Techniques
Noncredit
Prerequisite: NBMB 115, 116, and 117
Learn the basics of using a computer in medical insurance billing. Learn how to build a patient information database, how to input patient and insurance information, and the ins and outs of electronic claims submissions that will produce third-party insurance claim forms and patient billing statements. A review of the information needed to set up a computerized medical insurance billing practice is included. Focus will include collecting data, charges and coding to create “clean” claims. Students should bring all required textbooks to class.
Books & Materials
Books and materials should be available in the CSUDH University Bookstore and other retailers. Students will use the following textbooks for the entire program:
NBMB 111, NBMB 112, NBMB 113, NBMB 114, NBMB 116, NBMB 117, NBMB 118
Required: Fordney's Medical Insurance and Billing, Smith, 16th Edition
Required: Workbook for Fordney’s Medical Insurance and Billing, Smith, 16th Edition
NBMB 115
Required: Medical Terminology: A Short Course, Chabner, 9th Edition
NBMB 116
Required: ICD-10-CM 2025: The Complete Official Codebook, AMA -- Available September 2024
NBMB 117
Required: CPT 2025 Professional Edition, AMA -- Available September 2024
Students should bring the required text(s) to each class.