BankOfMedicare University
Free Medical Billing and Reimbursement University
Learn the rules behind clean claims, coding systems, remittance, denials, appeals, Medicare compliance, and DME reimbursement from reviewed official sources.
Billing Fundamentals
Claims, code sets, eligibility, privacy, clean-claim controls, and payment basics.
New billers and cross-functional teams
Professional Claims
CMS-1500, 837P, place of service, provider roles, and professional claim logic.
Practices, suppliers, and professional billers
Institutional Claims
CMS-1450, 837I, type of bill, revenue lines, and institutional data relationships.
Hospitals and facility billing teams
Coding Rules
NCCI PTP, MUE, distinct-service modifiers, units, and code-set discipline.
Coders, auditors, and denial teams
Denials and Appeals
Remittance interpretation, root-cause triage, correction, reopening, and appeal workflow.
Denial and payment integrity teams
Medicare Compliance
Timely filing, prior authorization, MSP, ABNs, enrollment, and documentation.
Medicare operations and compliance staff
DME Reimbursement
HCPCS, DME MACs, coverage, orders, delivery, rental, replacement, and fee research.
DME suppliers and reimbursement teams
8 lessons
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DME Audits Explained: SMRC, CERT, TPE, RAC & UPIC
Compare Medicare review contractors, prepayment and postpayment audits, the complete SMRC timeline, recurring DME documentation failures, appeal timing, and an audit-prevention system.
Medicare Timely Filing: The One-Year Rule
Calculate the general Original Medicare filing deadline and distinguish a late original claim from an adjustment or reopening.
Prior Authorization Workflow and Denial Prevention
Match the authorized service, provider, setting, units, and dates to the final claim and retain the clinical decision trail.
Medicare Secondary Payer and Coordination of Benefits
Determine payer order, collect other-insurance facts, and submit primary adjudication data correctly when Medicare pays second.
ABNs and GA, GY, GZ, GX Modifiers
Separate expected medical-necessity denial, statutory exclusion, voluntary notice, and no-notice scenarios.
Medical Necessity and Documentation That Supports Payment
Learn how to document medical necessity by connecting contemporaneous records to the billed service, level, quantity, frequency, order, and coverage criteria.
Medicare Common Working File (CWF)
Understand how Medicare's Common Working File supports beneficiary eligibility, deductible, utilization, coordination-of-benefits, and prepayment claim validation processes.
NPI, Taxonomy, and Medicare Enrollment
Keep identity, specialty, location, reassignment, ordering, and billing enrollment facts aligned with the claim.