Reach your personal and professional goals! Certification can lead to better visibility, opportunities, and jobs. In today's increasingly complex and highly-specialized economy, credentials are fundamental. Sure you may have the skills to do the job, but how do you convince potential clients or employers? Certification!
Certified medical billers are vital to the success of health care practices. Their vigilant work preparing, submitting, and following up on claims keeps physician’s practices, hospitals, third-party billing centers, and federal and state government clinics operating smoothly. Certified medical billers review patient records, calculate charges, submit claims, and answer patient and insurance payer questions regarding claims. A certified medical biller is knowledgeable in payer rules and regulations, privacy and confidentiality concerns, Medicare, Medicaid, and various fraud and privacy laws. Certified medical billers must pass the rigorous Certified Medical Billing Specialist® exam.
Due to the administrative changes in health care, patient records are being scrutinized by payers more than ever. According to the Bureau of Labor Statistics, jobs for billing and health information technicians are expected to increase by 22% through the year 2022.
Certified Medical Billing Specialist® (CMBS™)
The Medical Association of Billers CMBS program is aimed at individuals employed in a provider's office, health insurance company, or independent billing center. A candidate for certification is an individual who is motivated to improve their medical billing and coding knowledge and to develop new skills to assist providers in maximizing their reimbursement through proper coding and documentation. A Certified Medical Billing Specialist®, although not a certified coder, is capable of reviewing claims related to coding or medical necessity problems and assisting the provider in coding the initial claim.
To maintain the CMBS certification, members must complete 12 continuing education units (CEUs) per year after the date of certification. Current membership with MAB is required to remain certified.
The annual CEU requirements are:
CMBS: 12 CEUs or 36 teaching hours
CMBS-H: 12 CEUs
CMBS-I: 20 CEUs plus 100 teaching hours
CMBS-INT: 12 CEUs
If you hold a CMBS certification and are teacher, you may submit evidence of 36 teaching hours of medical billing/coding topics instead of the 12 CEUs. This must be on a letter from your director and must include supporting material, such as pages from the course catalog documenting hours and class descriptions.
If you hold a CMBS-I certification, you must submit evidence of 100 teaching hours of medical billing/coding topics in addition to the 20 CEUs . This must be on a letter from your director and must include supporting material, such as pages from the course catalog documenting hours and class descriptions.
MAB grants prior approval for CEUs required to maintain the CMBS certification, in which case we award 100% of the CEU amount or contact hours. For contact hours, we grant one CEU per contact hour, and we do prorate (e.g., a 90-minute class would be worth 1.5 CEUs). We also accept at 100% certificates from Medicare University, medical societies, and local chapter meetings. MAB also accepts college courses submitted on transcripts for the CEU period. The courses must be medical billing/coding related. We grant 1.5 CEUs for each college credit (e.g., if the course grants 3 college credits, MAB will grant 4.5 CEUs).
If you submit CEU certificates for classes not on MAB’s pre-approved list, we will consider them at a maximum of 50% of the stated CEUs or contact hours. Members may request credit for other CEUs by sending the class curriculum and grade to MAB, although MAB offers no guarantee for classes that are not pre-approved.
Many schools throughout the country offer CMBS™ CEUs. If MAB has pre-approved the school's CEUs, MAB will award 1 CEU per hour of classroom study. If MAB has not pre-approved the schools CEUs, MAB may award 50% (for example, a 4-hour class would be awarded 2 CEUs). Please check the Pre-Approved CEU Vendor List (below) for a list of schools and vendors who have pre-approved CEUs.
A few key points:
You must submit a certificate of attendance, certificate of completion, or transcript to show participation / attendance.
The certificate must have your name on it.
The date on the CEUs must be within your current CEU cycle (e.g., if your revalidation date is March 31, 2018, then your CEUs must be dated from April 1, 2017 to March 31, 2018).
Prior approval is recommended for all learning institutions. The Pre-Approval form must be submitted with the application fee, agenda, dates, and presenter information at least 30 days prior to the class.
A single application is valid for a 12-month period beginning with the date of the approval.
Multiple programs at a learning institution must submit multiple forms.
One CEU is awarded for each hour of instruction.
MAB will only approve billing and coding program content.
MAB will not approve reading and responding to publications.
Institutions may use the following statement for pre-approved curriculum: "This program is granted prior approval of ___ CEUs by the Medical Association of Billers. Granting of prior approval does not constitute MAB's endorsement of the program content or sponsor."
You can test out on the Certified Medical Billing Specialist® Examination by taking the exam at a proctor site. There are two types of proctor sites:
A facility or college who has signed an agreement with MAB to protect the confidentiality of the CMBS™ exam.
MAB will consider any nonprofit location who agrees to monitor the exam. Many libraries, schools, churches, and synagogues are willing to proctor exams. The site must provide MAB a written request on their letterhead stating that they will proctor the exam on a particular date. The letter must include the proctor's name and email address. MAB must receive the letter and exam fee at least two weeks prior to the exam date.
Proctors will verify that the person taking the exam is the person who is registered and will monitor that the only resources used during the exam are the appropriate ICD-10-CM and CPT® coding manuals. Upon completion of the exam, the proctor site returns the examination to MAB.
Please visit our Proctor Sites page for a list of current proctor locations.
Billing Process - from the time the patient calls for an appointment through claim payment
The importance of a provider's financial policy
Sample Forms Evaluation - superbill, patient intake
Place of Service codes
Medical Terminology Basics - prefix, root, suffix
Proper billing and coding
Participating versus Non-Participating
Parts of Medicare
Correct Coding Initiative (CCI) Edits
Medicare appeals process
CMS-1500 Claim Form
How to complete
Establishing medical necessity
Reading and evaluation a Remittance Advice (RA)
Writing successful appeal letters
Introduction to ICD-10-CM
Benefits of ICD-10-CM
Indexes and Tables
Introduction to CPT® Coding
Sections of CPT® manual
Format and Conventions
Evaluation & Management (E/M) codes
Examination Refund Policy
All exams must be taken within 90 days of purchase, after which time there is no refund. There is no refund for any examination no show with subsequent cancellation, a $75 cancellation fee if cancelled within one week of the test date, and a $50 cancellation fee for any exam cancellation that occurs at least one week prior to the scheduled test date. There is a $50 rescheduling fee for any examination no show with subsequent rescheduling or a rescheduling within one week of the test date.