Medical Billing Diploma
20 modules · 54 total learning hours · ~1.5-hour learning sessions · typically completed in 2–3 months · six-month completion deadline · enroll free
Completion and certificate policy: Your six-month window starts when you begin the diploma. If the deadline passes before you finish, you must re-enroll and restart from Module 1. After completing all required modules and assessments, issue your electronic ERG course-completion certificate from your dashboard; print or save it there. For a physical copy, contact hr@ergmd.com about availability and delivery details.
This course develops billing skills; job availability and location requirements vary. The ERG course-completion certificate is not CPB, CBCS, CMRS, or CPC certification. Those organizations set their own eligibility and fees; consult NHA CBCS eligibility and the other credential bodies before applying.
Part 1 · Foundations
1
Introduction to Healthcare & the U.S. Revenue Cycle
~45 min- Why medical billing - and why it matters
- The Four Ps - key players of U.S. healthcare
- Providers, facilities & specialties
- The main types of insurance (quick map)
- Worked example & a real scenario
- What is Revenue Cycle Management?
- The core documents you'll live in
- Intermediaries & how money comes back
- HIPAA in one minute
2
Health Insurance Models & Payers
~40 min- Two big buckets
- Medicare, Medicaid & friends
- Private & employer-sponsored
- HMO, PPO, EPO, POS, HDHP
- Networks, referrals & prior auth
- Who pays first?
- Where payment is heading
3
Cost Sharing & Eligibility Verification
~40 min- How the pieces stack
- The number that matters
- Before the visit, every time
- Portals, 270/271, phone
- Don't mix them up
- Prevent them up front
- CMS-0057-F — the 2026 shake-up
4
Patient Registration & Data Capture
~38 min- Why registration matters
- Demographics to capture
- Get the policy right
- Paperwork that protects the claim
- Verify before you save
- From front desk to billing
Part 2 · Billing Operations
5
Medical Coding Essentials for Billers
~42 min- Two jobs, one chain
- Diagnosis codes
- Procedure codes
- Beyond CPT
- Medical necessity & edits
- Documentation is king
- CAC, autonomous coding & the biller's QA role
6
Claim Forms — CMS-1500 & UB-04
~40 min- Professional vs. facility billing
- Where the data goes
- The part beginners miss
- What facilities add
- Forms map to the 837
7
Billing Platforms & Clearinghouses
~36 min- Where the work happens
- One pipe to every payer
- Catch errors before the payer does
- Addressing the claim
- Did it get there?
8
Claim Submission & Payment Posting
~40 min- Getting the claim out
- A crucial distinction
- How the payer decides
- What came back
- Record it accurately
- Balance to the penny
9
Accounts Receivable & Denial Management
~42 min- Money owed to the practice
- Prioritize by bucket
- Know what you're holding
- CARC, RARC & group codes
- Correct, resubmit, or appeal
- Measure what matters
- The deadline that ends claims
- Deadlines — and prediction
10
Enrollment, Credentialing & Provider Setup
~36 min- Two steps, often confused
- NPI & taxonomy
- The systems you'll use
- Why timing matters
- Re-credentialing & revalidation
11
Billing Provisions & NCCI
~38 min- The bundling rulebook
- Bill the whole, not the parts
- 59 and the X set — carefully
- How many units are too many?
- One fee, many days
- POS 02/10, modifiers & the 2026 rules
12
Invoicing & Communication
~34 min- Bill the patient the right amount
- Plain language wins
- Statements to resolution
- Apply the policy consistently to everyone.
- Professional and private
- No Surprises Act & Good Faith Estimates
Part 3 · Compliance & Professional Practice
13
HIPAA, PHI & Information Security
~40 min- PHI
- Two pillars
- Use only what you need
- Three kinds
- When PHI is exposed
- ERG's zero-tolerance rule
- The 2026 Security Rule overhaul — preview
14
Regulations, Fraud & Abuse, Compliance
~38 min- Intent is the line
- What you must not violate
- Red flags billers must avoid
- How organizations stay clean
- Be ready, refund fast
15
Professional Practice + Part 3 Exam
~45 min- “If you touch it, you own it”
- Measure your own work
- Continuing education & certification
- Remote professionalism
- Take the Part 3 exam
Part 4 · The Modern Revenue Cycle (2026)
16
AI & Automation in the Revenue Cycle
~45 min- The job is changing under your feet
- From manual → CAC → autonomous
- RPA vs machine learning vs generative AI
- Where AI sits in every RCM stage
- Human-in-the-loop: exceptions, QA, oversight
- What AI actually delivers (and what it doesn't)
- AI and PHI — the rule you never break
17
AI Denial Prediction, Prevention & Appeals
~45 min- Why denials are where the money dies
- Reactive management → predictive prevention
- What a denial-prediction model actually does
- Generative AI drafts, humans decide
- Read the denial like a professional
- Medicare's appeal clock (miss it and the money's gone)
- Triage by value × probability — not by age
18
Cybersecurity & AI-Era HIPAA
~45 min- Why security stopped being an IT problem
- The 2026 Security Rule overhaul — status: proposed
- Business associates — direct liability, offshore included
- PHI and AI tools — what's allowed, what's a breach
- The 8 habits that prevent most breaches
- Incident response — report fast, hide nothing
19
Hands-On Practice Lab & Portfolio
~50 min- Employers hire proof, not promises
- The clean claim — CMS-1500 from a mini-chart
- Read and post an ERA — find the underpayment
- The denial worklist — six claims, three lanes
- The appeal letter — structure that wins
- Eligibility + scenarios + flashcards
- Package the proof (zero PHI, all simulated)
20
Analytics, KPIs & the Diploma Final
~50 min- You manage what you measure
- Core KPIs and their 2026 benchmarks
- Read it like a manager
- The Pareto move: 80% of denials, 20% of causes
- MIPS, MVPs & why quality data touches you
- Leakage: the money nobody notices leaving
- The diploma final — everything, cumulatively
Reserve your free place
Course access opens after final approval. No card or fees. Your six-month completion window begins when you start the diploma; finish the required work to issue an ERG course-completion certificate from your dashboard.
Enroll free →Medical Coding Diploma Coming soon
12 modules · terminology and anatomy through ICD-10-CM, CPT, E/M, HCPCS, NCCI and specialty coding
Part 1 · Foundations
1
Medical Terminology & Body Systems
~42 min- Coding is reading
- Root + prefix + suffix
- Roots you'll see daily
- Modifiers of meaning
- The big picture
2
Anatomy & Physiology Essentials for Coders
~40 min- The reference pose
- Where is it?
- Slicing and spaces
- Mapping the abdomen
- Cell to system
- Read the op note
3
Healthcare Documentation & the Medical Record
~38 min- The source of every code
- What's in a chart
- How visits are documented
- Where surgery codes live
- …it wasn't done
- Authentication
Part 2 · The Code Sets
4
ICD-10-CM: Structure & Guidelines
~42 min- The diagnosis code set
- 3 to 7 characters
- Never code from one alone
- Don't drop a character
- The rulebook
- Includes, Excludes1/2, NEC, NOS
5
ICD-10-CM: Conventions & Specificity
~40 min- One code, two ideas
- Left, right, bilateral
- Sequencing matters
- Don't code 'rule-out' as fact
- Encounters that aren't illness
- The residual condition
6
CPT: Structure & Surgery Coding
~42 min- The procedure code set
- I, II, III
- How Category I is organized
- Read the book's signals
- What's bundled in a surgery
- Step by step
- Don't unbundle
7
Evaluation & Management (E/M) Coding
~42 min- Cognitive work, not procedures
- The 3-year rule
- MDM or time
- How complexity is scored
- Counting the day's minutes
- Beyond the office
8
CPT: Anesthesia, Radiology, Pathology & Medicine
~40 min- Base + time + modifiers
- Professional vs technical
- Panels and repeats
- A catch-all of services
- Stay current
9
HCPCS Level II & Modifiers
~36 min- Beyond CPT
- What each range covers
- Coding what's administered
- Two characters that change everything
- Pricing before informational
Part 3 · Compliance & Practice
10
Medical Necessity, NCCI & Compliance
~40 min- The Dx must justify the CPT
- Correct coding, enforced
- Bill the whole, not the parts
- The lines you never cross
- Stay clean, stay ready
11
Specialty Coding Overview
~36 min- Same rules, different terrain
- How specialties differ
- Each with its own edits
- Authoritative sources
- Your path
12
Professional Coding Practice + Final Exam
~45 min- Code it right
- Accuracy rate & productivity
- CPC, CCS and beyond
- Professional & compliant
- Take the final
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