Certified Professional Biller (CPB)
The Certified Professional Biller (CPB) certificate prepares medical billers with skills to maintain all aspects of the revenue cycle.
Course Information and Features
Certified Professional Billers know how to submit claims compliant with government regulations and private payer policies. They follow-up on claim status, resolve claim denials, file appeals, post payments, adjustments, and manage collections. The CPB medical billing certificate is vital to the financial success of the professional healthcare services claims process.
Certified Professional Billers have:
An understanding of various types of insurance plans
Expertise in applying payer policy, Local Coverage Determinations (LCDs), and National Coverage.
Determinations (NCDs) for successful claim submissions
Knowledge of CPT®, ICD-10-CM, and HCPCS Level II coding guidelines.
Successful navigation of healthcare industry rules and regulations, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark Law.
Understanding the medical billing claim and improving the revenue cycle.
The CPB Exam
- 200 multiple choice questions
- 5 hours and 40 minutes Exam Duration
- Open codebook (manuals)
The CPB exam thoroughly covers:
- Types of Insurance
- Billing Regulations
- HIPAA & Compliance
- Reimbursement & Collections
- Case Analysis
Authorizing billing procedures
Obtaining referrals and pre-authorizations required for systems. Checking eligibility and benefits verification for treatments and hospitalizations.
Reviewing bills for accuracy and completeness, and obtaining missing information. Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
Following up claims
Following up unpaid claims in standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance.
Keeping billing software updated
Updating billing software with changes.
Updating cash spreadsheets, and running collection reports.