Certified Professional Biller (CPB)

Certified Professional Biller (CPB) 

The Certified Professional Biller (CPB) certification exam is suitable for candidates who wish to showcase their expertise in managing all aspects of the revenue cycle, specifically patient and payer billing and collections. Candidates should have a good understanding of medical billing and understanding payer requirements is crucial for maintaining healthcare provider reimbursement integrity.

Knowledge Acquired

The candidates qualifying for the Certified Professional Biller (CPB)  exam demonstrate proficiency in -

• Submitting claims compliant with government regulations and private-payer policies
• Following up on claim statuses
• Resolving denials
• Submitting appeals
• Posting payments and adjustments
• Overseeing collections

Course Outline

The Certified Professional Biller (CPB) exam covers the following topics - 

• Introduction to Healthcare
• Understanding Health Insurance Models
• Describe Patient Registration Process/Data Capture
• Introduction to ICD-10-CM Coding
• Explain CPT®  Coding
• Learn about HCPCS Level II Coding
• Understanding Medical Necessity
• Explain Claim Forms (CMS-1500 and UB-04) Billing
• Overview of A/R and Collection Concepts
• Describe Government Carriers (Medicare, Medicaid, and TRICARE)
• Understand Blue Cross/Blue Shield
• Explain Commercial Insurance Carriers
• Describe Workers’ Compensation