CCP
- AS Course Outline SIGN
UP NOW!
Week One & Two –
Orientation and Review
Review of Documentation Guidelines
Review of E/M Section of CPT
Review History, Exam and Medical Decision Making
When Time is considered the KEY Component in choosing a level of E/M
Critical Care
Consultations
Preventive Medicine
Week Three -
Begin the Auditing Process
Hands on Chart Auditing
Week Four –
Hands on Chart Auditing
Auditing for Medical Specialties
Week Five –
Preparing a Chart Audit Report
Present Chart Audit Findings
Week Six –
Student presentation of Sample Chart Audit, Chart Audit Report and Findings
CCP-AS Practice Exam Review
CCP-AS Practice Exam
CERTIFIED
CODING PROFESSIONAL – HOSPITAL (CCP-H) SIGN
UP NOW!
This hospital coding certification course (CCP-H) has been designed as an extension
to the CCP. Upon completion of the CCP course and successfully passing the certification
exam for medical coders, the Certified Coding Professional may take this course
to obtain an additional certification as a hospital based coder. A Certified
Coding Professional – Hospital (CCP-H) will have completed the course
materials outlined below as well as pass a certification examination specific
to hospital coding. This certification course and subsequent exam is developed
and maintained by ®PHIA - Professional Healthcare Institute of America has been here today and tomorrow.
The CCP-H course has been designed in an online format as a video lecture presentation.
Prerequisites: Must be a current certified coder in good standing
with any of the following organizations: PHIA, AHIMA or AAPC. Must also hold
a current PHIA membership.
Clock Hours – 15
Fee: $ 849.00 includes course workbook and certification exam
Additional coding books may be required and are not included in the course fee.
CERTIFIED CODING PROFESSIONAL – HOSPITAL (CCP-H) SIGN
UP NOW!
Week One - Orientation & Review
ICD-9-CM Volumes 1 & 2
Week Two - Review continued
HCPCS
CPT-4
Week Three – Outpatient Facility Coding
Modifiers
Ambulatory Payment Classifications (APC) and
Payment status indicators
UB-92 Claim Forms
How to prepare and submit
Third Party Payor Regulations
Week Four - Coding Operative Reports
CPT-4 Coding
ICD-9-CM Vol. 1, 2, 3 Coding
Week Five - DRG’s (Diagnosis Related Groups)
Examining E/M Encounters for Facilities
Charge Description Master (CDM) – How does it work?
Week Six - Certification Exam – 3 Hours Timed
Fundamentals
of Billing & Coding (FOBC) SIGN
UP NOW!
This fundamentals diploma course is designed for those individuals who want
to learn the basics of health insurance billing and coding. The student will
be introduced to basic billing guidelines, the process of completing claim forms
and follow-up procedures to receive maximum reimbursement from the major insurance
carriers. You will gain an understanding of medical procedure (CPT) and diagnostic
(ICD-9-CM) coding, as well as, compliance guidelines and how to avoid fraud
and abuse issues due to improper coding. By successfully completing this course,
the student will be eligible to take the Certified Coding Professional (CCP)
course.
This course is
only available on-line in an audio/video streamed
format.The student listens to the lecture while watching the animated full-color
format. When prompted by the instructor, the student follows along with the
written material and completes exercises as if they were sitting in a physical
classroom. Students may review a lesson. Students must complete assignments
within the week and successfully pass a quiz in order to move on to the next
lesson. Tests are graded immediately and you may view your student grade report
any time. Visit the discussion room to participate in class discussions. Each
student will be assigned to a Faculty Advisor who is certified in coding for
additional help if needed and to make sure the student is keeping up with the
class.
Prerequisites: High School Diploma or GED, Completion of the
Medical Terminology/Anatomy Diploma program or the equivalent.
Course Fee: $1195 includes Text/Workbook and the
CPT-4 Professional
edition – ICD-9-CM Expert
For Physicians Volumes 1&2 and
HCPCS Level II Expert
Medical Terminology/ Anatomy Diploma Program (MT/A) SIGN
UP NOW!
This course is designed for anyone wishing to pursue a career in the healthcare
administrative field. Taught in an easy to understand format, the student will
be guided through a series of audio/video presentations using colorful animation
and real life examples and is intended for those with little to no background
or education in Medical Terminology. The instructor lectures as if in a physical
classroom setting while the student follows along with the material provided.
And while the course is completed entirely online, it is designed to be taken
in a disciplined fashion within 8 weeks. A Faculty Advisor is available for
questions or discussion group or online chat sessions. The Faculty Advisor makes
sure all students complete a lesson per week and are able to retain the information.
This course also includes the use of medical records, laboratory and operative
reports to achieve a level of understanding needed as a Certified Coder, Billing
Specialist or Front Office Specialist.
Prerequisite: High School Diploma or GED
Course Fee:$849.00 includes textbook
Language of Medicine,
7th edition, by Davi-Ellen Chabner
Registration Fee (non-refundable) $40 Each class is 3 clock
hours. The duration of the course is - 8 weeks.
FOBC Course Outline SIGN
UP NOW!
|
Week 6 cont'd |
Week 1 Basic ICD-9-CM
History of ICD-9
Symbols, Punctuation and Abbreviations
General Coding Tools
Official ICD-9 Guidelines
How to use the ICD-9-CM Book
Week 2 Advanced ICD-9-CM
Quiz
ICD-9 codes 001-459
Week 3 Advanced ICD-9-CM Continued
Quiz
ICD-9 codes 460-E999
Week 4 CPT-4/HCPCS/Modifiers
Quiz
HCPCS
CPT Symbols
The Index
How to Use the CPT Book
E/M Guidelines
SOAP
Purpose of a Medical Record
Charting Do’s & Don’ts
Anesthesia
Week 5 CPT-4 continued PLUS
Putting It All Together–ICD-9 and CPT-4 Coding Exercises
Surgery
Radiology
Pathology and Laboratory
Medicine
Category III Codes
ICD-9 Coding Exercises
CPT-4 Coding Exercises
Linking ICD-9 and CPT-4 Coding Exercises
Week 6 Evaluation and Management Coding
Quiz
Anatomy of an E/M Code
|
CMS Documentation Guidelines for E/M Services
Consultations
Critical CarePreventive Medicine
Medicare Definition of Fraud
Basic Chart Auditing
Week 7 Introduction to Health Insurance
Quiz
What is Health Insurance?
What is a Provider Number?
History of Health Insurance
Basic Insurance Overview
The Insurance Policy
Coordination of Benefits
Case Management
Types of Coverage
Individual
Group
Types of Third Party Payers
Managed Care
HMO, PPO, POS, EPO
Medicare A & B
Medicaid
Worker’s Compensation
Disability
Tricare
Skills required
Responsibilities of an Insurance Specialist
Encounter Form/Patient RegistrationWeek 8 Filing Insurance Claims
Quiz
HCFA 1500
UB-92
Place of Service Codes
Look at claims
Compliance
Week 9 Review
Week 10 Cumulative Final Exam
|
Click
the links above to learn more about a particular course.
PHIA offers certification courses, workshops, diploma programs, and
study guide programs. The most popular certification course is for
the CCP, Certified Coding Professional. There are also specialties in chart auditing
and in hospital coding. All certification courses require the completion of
a written timed exam in order to receive the certification. These classes
are offered online only.
Some certifications are available only as a Study Guide program. These
programs are structured so that the participant will complete the program
on schedule but at a more leisurely pace.
Diploma Programs can be prerequisite courses to our Certification courses. These
courses are designed for those who want to learn the basics of billing and coding.
Medical Terminology and Anatomy, or work in the front office of a
medical practice.
View an online coding course demonstration
Submit your CEUs
What is a PHIA Certified Healthcare Professional?
PHIA awards 6 different certifications in the healthcare field.
Click the link above to learn about each program.
They are:
CCP (Certified Coding Professional)
CCP-AS (Certified Coding Professional-Audit Specialist)
CCP-H (Certified Coding Professional-Hospital Based)
CMBS (Certified Medical Billing Specialist)
CMPM (Certified Medical Practice Manager)
CCO (Certified Compliance Officer)
What is the difference between the CPC, the CCP and the CCS-P?
All of them are physician office based coding certifications. They are awarded
by 3 different organizations: The CPC is awarded by the AAPC (American Academy
of Professional Coders), the CCP is awarded by (PHIA-Professional Healthcare
Institute of America®) and the CCS-P is awarded by AHIMA (American Health
Information Management Association). The AAPC and AHIMA are certainly not
better or more of a "valid" certification in any way. The AAPC central
headquarters is located in Utah; PHIA is located in Kentucky and AHIMA is
located in Illinois; all certifications can be used nationwide.
Which
coding certification exam should I apply to take?
Before answering this question you should know that it will take an extensive
amount of coding experience and in different medical specialties to be able
to pass any of these exams without some education. AAPC, AHIMA, and PHIA all
require the examinee to be knowledgeable in ICD-9-CM and CPT for all of the
body systems as well as the HCPCS codes. Your medical terminology and human
anatomy should be solid and current because it is core to the coding process.
Some coders choose to take more than one exam to further their knowledge. Here
is how each exam is administered:
AAPC – 5-hour timed exam consisting of multiple choice questions. The
test is taken all at once without scheduled breaks. If you fail, you have one
complimentary retake however; you must retake the entire exam.
PHIA – 5-hour timed exam broken down into three separate sections consisting
of multiple choice, short answer and T/F. Each section is 100 minutes with a
short break before the next section. You may not go back to a previous section
after that time is finished. You must pass each section with a 75% to be awarded
your CCP. You have one complimentary retake and you only retake the section(s)
you failed.
AHIMA- 4-hour timed in two parts. The first part consists of 60 multiple choice
questions and the second part consists Part II requires you to perform diagnostic
(ICD-9-CM) and procedural (CPT and HCPCS Level II) coding for physician services.
A total of sixteen records are required to be properly coded. There are no complimentary
retakes.
| MT/A Course Description Part Two |
<<back
SIGN
UP NOW! |
| Week Five
Nervous System
General Structure of the Nervous System
Neurons, Nerves and Neuroglia
The Brain
The Spinal Cord and Meninges
Pathological Conditions
Practical Applications
Pronunciation of Terms
Cardiovascular System
Blood Vessels and the Circulation of the Blood
Anatomy of the Heart
Physiology of the Heart
Blood Pressure
Pathological Conditions
Laboratory Tests, Clinical Procedures and Abbreviations
Practical Applications
Week Six
Musculoskeletal System
Bones
Formation and Structure
Processes and Depressions in Bones
Cranial and Facial Bones
Vertebral Column and
Structure of the Vertebrae
Bones of the Thorax, Pelvis and Extremities
Pathological Conditions and Fractures
Joints:
Types of Joints, Bursae and
Pathological Conditions
|
Week Six cont'd
Muscles:
Types and Actions of Muscles
Combining Forms, Prefixes and Suffixes
Laboratory Tests, Clinical Procedures and
AbbreviationsRespiratory System
Anatomy and Physiology of Respiration
Diagnostic and Pathological Terms
Clinical Procedures and Abbreviations
Practical Applications
Skin
Structure of the Skin
Accessory Organs of the Skin
Vocabulary
Lesions, Symptoms, Abnormal Conditions and Skin Neoplasm’s
Laboratory Tests, Procedures and Abbreviations
Week 7
Cancer Medicine (Oncology)
Characteristics of Tumors
Carcinogenesis
Classification of Cancerous Tumors
Pathological Descriptions
Grading and Staging Systems
Cancer Treatment
Week 8
Review for Final Exam
Cumulative Final Exam |
| MT/A Course Description Part One |
next>>
SIGN UP NOW! |
Week One
Basic Word Structure
Objectives in Studying the
Medical Language
Word Analysis
Combining Forms, Suffixes, and Prefixes
Practical Applications
Prefixes
Combining Forms and Suffixes
Prefixes and Terminology
Practical Applications
Week Two
Terms Pertaining To the Body as a Whole
Structural Organization of the Body
Body Cavities
Abdominopelvic Regions and Quadrants
Divisions of the Back (Spinal Column)
Positional and Directional Terms
Planes of the Body
Suffixes
Combining Forms
Suffixes and Terminology
Practical Applications
Pronunciation of Terms
Week Three
Digestive System
Anatomy and Physiology
Vocabulary
Combining Forms, Suffixes and Terminology
Pathology of the Digestive System
|
Week Three cont'd
Additional Suffixes and Digestive System
Terminology
Laboratory Tests, Clinical Procedures and
AbbreviationsUrinary SystemAnatomy of the Major Organs
How the Kidneys Produce Urine
Vocabulary
Structures, Substances and Urinary Symptoms
Urinalysis
Pathological Terminology: Kidney, Bladder and Associated Conditions
Practical Applications
Week Four
Mid-Term Review
Cumulative Exam
Female Reproductive System
Organs of the Female Reproductive System
Menstruation and Pregnancy
Hormonal Interactions
Pathology: Gynecological/Breast, Pregnancy, Neonatal
Clinical Tests, Procedures and Abbreviations
Pronunciation of Terms
Male Reproductive System
Anatomy
Vocabulary
Combining Forms and Terminology
Pathological Conditions; Sexually Transmitted Diseases
Laboratory Tests, Clinical Procedures and Abbreviations
Practical Applications
|
CERTIFIED CODING PROFESSIONAL - AUDIT SPECIALIST PROGRAM
(CCP-AS) SIGN UP NOW!
This auditing specialist certification course (CCP-AS) has been designed
as an extension of the CCP. Upon completion of the CCP course and successfully
passing the certification exam for medical coders, the Certified Coding Professional
may take this course to obtain an additional certification as an auditing specialist.
A Certified Coding Professional – Audit Specialist (AS) will have completed
the course materials outlined below as well as pass a certification examination
specific to chart auditing. This certification course and subsequent exam is
developed and maintained by ®PHIA – Professional Healthcare Institute
of America.
The CCP-AS course has been designed in an online format as a video lecture presentation.
Prerequisites:
Must be a current certified coder in good standing with any of the following
organizations: PHIA, AHIMA, or AAPC.
Must be a current PHIA member in good standing.
A solid understanding of the E/M Documentation Guidelines is crucial
to the successful completion of this certification course.
Fee:
$849.00 includes course workbook and certification exam–
Additional coding books may be required and are not included in the course fee.
Click
here to view the Course Outline
Certified Medical Billing Specialist (CMBS) Study Guide
BUY
NOW
Objective:
Our CMBS study guide is a collection of over 200 questions with answer
key, practical billing scenarios (filling out the CMS 1500 forms) and a Mock
certification exam with the same type of questions that will be found on the
actual certification exam. We also include the answer key and instructions for
the Mock exam. There is a free reference manual that accompanies the guide (while
supplies last).
When you successfully pass the Mock exam you will be ready to sit for the CMBS
exam which you can do in our facility or in an approved proctor facility in
your home town. Once you pass the CMBS exam, you are entitled to use the
CMBS credential behind your name. You will also be required to earn 16
CEU’s per year to keep your certification current.
Prerequisites: A minimum of two years experience in inpatient/outpatient
billing or
current certification or degree in Medical Coding or another related field.
High School Diploma or GED is required.
CEU Requirements: When you have passed the CMBS certification
exam you will be required to acquire 16 hours per year of medical billing related continuing
education. Prior approval is suggested
Reference Text:
Mastering the Reimbursement Process Third Edition:
Blout, Lamar & Waters
Fee: $295. The CMBS exam fee ($250) is not included and must
be submitted at time of exam registration. PHIA membership is required and is
$75 annually.
CMBS Study Guide Objectives
To qualify to sit for the CMBS certification exam which covers the following
areas of the Medical Billing profession:
Understanding Insurance Basics
Types of Insurance & Third Party Payers
Electronic Claims Processing
The Coding Systems
Insurance Processing
Managing Insurance & Patient Accounts
Post Submission of Claims
Insurance Accounts Receivable Management
Requests for Review & Appeals
Compliance Programs & the OIG
Privacy, Confidentiality & HIPAA
Certified
Medical Practice Manager (CMPM) Comprehensive Study Guide
BUY
NOW
Objective: The Practice Management Certification Study Guide is comprehensive
and will cover health plan functions, coding and reimbursement, financial management,
practice administration, and personnel management. This study guide will increase
the participant’s working knowledge of the most up to date medical practice
management and development techniques available today. The guidelines, suggestions
and sample forms are invaluable tools for the growth and financial success of
today’s medical practice. It is suggested that you have at least two years
of experience in medical practice management before pursuing this study guide
and certification.
Prerequisites:
A minimum of two years experience in the role of physician office practice management,
High School Diploma or GED.
CEU Requirements:
Sixteen hours of qualifying CEU’s will be required annually. These sixteen
hours can be from any substantive area addressed below. Prior approval is suggested.
Fee: $395 - Includes 400+ page Reference Book with over 50
sample forms, Job descriptions, Questions, Answers to those questions and a
Mock Certification Exam. Study questions and mock exam questions are derived
from the reference text included as well as other resources named in the guide.
It is suggested that you read the textbook first then proceed with the questions.
Once you have mastered the Mock CMPM exam in the specified time allowance, you
will be ready to sit for the CMPM exam, fee of $250 will be do at time of exam
registration. Exam may be taken at any approved proctor facility. PHIA membership
is required to sit for the CMPM exam, fee is $75 annually.
Click
here for the Study Guide Outline
Certified
Compliance Officer (CCO)
Comprehensive Study Guide
the CCO Study Guide is currently unavailable however the
Compliance Officer certification exam is available
Mastering the ICD-9 Coding Process
Up to 21 PHIA CEU’s approved
Up to 21 AAPC CEU’s approved
You may participate in any or all of these workshops. At the completion of the
series those who wish may take the ICD-9 Mastery exam. This exam is complimentary
to those who completed the series (all 7) and $75.00 for those who completed
6 or fewer of the sessions.
Participants who successfully pass the exam will be awarded a Certificate of
Mastery – ICD-9-CM Coding.
Cost - $ 99 each (Mastery Exam $75)
$249 any 3 (Mastery Exam $75)
$499 all 7 (Mastery Exam FREE)
Certified
Coding Professional (CCP) Study Guide VOL 1- TABLE OF CONTENTS
Introduction:
Preparing for the Coding Certification Examination - How to use this guide
|
| About PHIA |
Examination Requirements:
CCP Exam Breakdown/Requirements and Registration Form |
SECTION ONE – Coding Rules
PART I:
|
PART II: HCPCS 69
|
| Coding Principles |
1 |
PART III: ICD-9-CM 73 |
| SECTION TWO - Coding Review Exercises |
| Evaluation and Management |
3 |
| Anesthesia |
16 |
Evaluation & Management |
1 |
| Surgery Guidelines |
20 |
Anesthesia |
3 |
| Coding From the Operative Report |
21 |
How to Code from the
Operative Report |
4 |
| Integumentary System |
22 |
Integumentary System |
7 |
| Musculoskeletal System |
27 |
Musculoskeletal System |
8 |
| Respiratory System |
32 |
Respiratory System |
9 |
| Cardiovascular System |
34 |
Cardiovascular System |
10 |
| Interventional Radiology |
37 |
Digestive System |
11 |
| Digestive System |
40 |
Urinary, Male/Female Systems |
12 |
| Urinary, Male/Female Systems |
43 |
Endocrine System |
14 |
| Nervous |
45 |
Nervous System |
14 |
| Eye and Ocular Adnexa/Auditory System |
47 |
Eye, Ocular Adnexa, Auditory System |
16 |
| Radiology |
48 |
Radiology System |
17 |
| Pathology and Laboratory |
56 |
Pathology and Laboratory |
19 |
| Medicine |
53 |
Medicine |
20 |
| Category II & III Codes |
65 |
SECTION THREE –
Mock Certification Exam 1 - 10 |
| Modifiers |
65 |
Certified Coding Professional (CCP)
Study Guide VOL II - TABLE OF CONTENTS
|
SECTION ONE -
Study Guide - Answers 1 – 65 |
SECTION THREE –
Mock Certification Exam – Answers 1 - 9 |
SECTION TWO –
Coding Review Exercises – Answers 1 - 4
|
|
Certified
Coding Professional (CCP) Study Guide
See
the table of Contents | BUY
STUDY GUIDE NOW
The CCP study guide is designed to provide a clear understanding of
the knowledge needed to successfully complete the CCP exam as well as coding
certification exams from other institutions. The experienced Medical Coder or
Medical Coding student will use this tool for review and to time-test themselves
in all areas of coding. This study guide includes over 400 questions and answers
regarding the rules and regulations of coding, as well as coding exercises and
a mock certification examination.
Volume I
Contains important questions pertaining to the rules
and regulations as they relate to the ICD-9, CPT and HCPCS coding books. Completing
these questions will not only give you the opportunity to review the specific
rules of coding but will also provide you with the information needed to make
additional notes in your coding books. Ample space has been provided for detailed
answers. A Mock Certification Exam is also provided at the end of this guide.
This mock exam provides you with a good sampling of the types of questions you
will find on the CCP exam. The exam portion of the study guide should be completed
prior to sitting for the actual certification exam and should take approximately
1 hour and 45 minutes to complete. Be sure to find a quiet place to take your
exam and don’t forget to time yourself! The current year edition of the
ICD-9-CM, CPT-4 and HCPCS books are used during the actual certification exam
therefore, we recommend that you use the same books while taking the mock certification
exam.
Volume II
Contains the answers to all of the questions in
Volume I, as well as the answers to the Mock Exam.
.
Want to Succeed the First Time?
All coders will excel in their specific area of expertise but will find they
may have a weakness in one or more area(s) of coding. Therefore, in order
to truly test your coding knowledge, it is recommended that you complete all
of the questions provided for you in Volume I prior to looking up the answers
in Volume II. This will give you an idea as to where your particular weakness
lies, if one exists, and what subject(s) you need to study prior to sitting
for the actual certification exam. Good Luck!
Certified
Coding Professional (CCP) SIGN UP
NOW! | BUY
STUDY GUIDE NOW
Objective:
This comprehensive 17 week certification course will prepare the student for
the
Certified Coding Professional (CCP) exam. The course will
increase the experienced coder’s knowledge of medical insurance coding
as well as educate the non-experienced coder. A
Certified Coding Professional
(CCP) is directly involved in the correct assignment and coding of
all procedures and services performed by the physician/provider. This certification
is a most valued tool in complying with correct coding, auditing and Fraud and
Abuse issues.
This course is only offered online in an audio/video streamed
format. Here is how it works: The student listens to the lecture while watching
the animated full-color format. When prompted by the instructor, the student
follows along with the written material and completes exercises as if they were
sitting in a physical classroom.Students may go back and review a lesson if
further understanding is needed. Students must complete assignments within the
week and successfully pass a quiz in order to move on to the next week’s
lesson. Tests are graded immediately and you may view your student grade report
any time. Visit the discussion room to participate in class discussions or to
just see what everyone is talking about. Each student will be assigned to a
Faculty Advisor who is certified in coding for additional help if needed and
to make sure the student is keeping up with the class. The certification exam
will be taken at a licensed proctoring facility in your area.
Prerequisites: High School Diploma or GED, a minimum of two
years actual medical coding experience OR completion of the Medical Terminology/Anatomy
and Fundamentals of Billing & Coding courses. “Experienced”
students must” test out” of the Medical Terminology/Anatomy and
Fundamentals of Billing & Coding courses with a score of 75% or greater.
Annual CEU Requirements: 16 hours of qualifying CEU’s
will be required annually. Prior approval is suggested.
Course Fee* – $2495 Includes PHIA membership (1 year),
CCP certification exam and the following textbooks:
CCP Text/Workbook – 700 pages tabbed and spiral bound
CCP Study Guide
CPT-4 Professional edition
ICD-9-CM Expert for Physicians Volumes 1 & 2
HCPCS Level II Expert
*Course Fee - $2295.00 for those who have recently completed the
Fundamentals of Billing and Coding course and will be using the same year CPT,
ICD-9 and HCPCS books.
| CCP Course Outline |
SIGN UP NOW! |
Medical Record Documentation &
ComplianceICD-9-CM
HCPCS
CPT-4, Modifiers, and Index
Medicine
Evaluation and Management Services
Evaluation and Management Documentation Guidelines
Evaluation and Management Auditing
Anesthesia and Pain Management
Radiology
Pathology and Laboratory
Surgery:
Global Package
Integumentary System
Musculoskeletal System
Respiratory System
Cardiovascular System
Digestive System
Urinary Systems
Genitourinary System – Male
Surgery (continued)
Genitourinary System – Female
Endocrine and Nervous Systems
Eye and Ocular Adnexa
Certified Coding Professional Exam:
The CCP Exam consists of 3 sections
Each section is timed at 1 hour and 45 minutes each
After each section we break for 15 minutes
You must pass each section with a 75% or better to receive your CCP designation.
If you do not pass one or more sections, you only retake the section(s)
you failed.
One complimentary retake is included if needed.
|
CCO
Certification Study Program Outline
I. Reference Text Required Reading:
Introduction: Healthcare Fraud & Abuse
Examples of Fraud & Abuse
Fraud & Abuse Statutes
Anti-kickback Legislation
Stark Self-Referral Legislation
Entities Involved in Fraud & Abuse Investigations
Medicare Claims Review and Audits
Medical Necessity Denials
How to Minimize Risk of an Audit
CPT Coding
ICD-9 Diagnosis Coding
Compliance Programs: A Way to Minimize Fraud and Abuse Liability
Developing a Compliance Program
Compliance Efforts in Smaller Medical Practices
Actions of the Office of Inspector General
How to Request an Advisory Opinion
OIG Compliance Program Guidance for Individual and Small Group Physician Practices
II. Supplement: Other Laws Relating to Compliance i.e. Policies & Procedures,
Employee Issues
Employee Handbook
Employee Law: FMLA, ADA, FLSA, ADEA, etc.
OSHA - Safety and BBB's
III. HIPAA
Privacy Regulations
Data Standards
Security Standards
Standard Forms and How to Use Them
CMPM Certification Study Guide Program Outline
Section I PRACTICE ADMINISTRATION
Chapter 1 Personnel Recruitment, Selection, Training & Management
Chapter 2 Office Policy & Procedures
Chapter 3 Personnel Law & Record Keeping
Chapter 4 Facility Management
Chapter 5 Patient Management
Chapter 6 Medical Records Management
Section II FINANCIAL MANAGEMENT
Chapter 7 Financial Operations
Chapter 8 Financial Calculations, Accounts Receivables & Collections
Section III REIMBURSEMENT & CODING
Chapter 9 ICD-9-CM Diagnosis Coding
Chapter 10 CPT Procedural Coding
Chapter 11 Modifiers
Chapter 12 Medical Record Documentation & E/M Documentation
Section IV THIRD PARTY PAYERS & MEDICAL INSURANCE FILING
Chapter 13 Health Plan Functions and Organization
Chapter 14 Evaluating Managed Care Contracts
Chapter 15 Patient Education
Section V COMPLIANCE (OIG & HIPAA)
Chapter 16 Fraud & Abuse/Auditing
Chapter 17 OIG Compliance
Chapter 18 HIPAA Compliance
The
TOP 5 ICD-9-CM Coding Mistakes – 3 CEU’s
DID YOU KNOW that most of the ICD-9 codes submitted by physician practices are
INCORRECT? Even if you are a seasoned coder, you may be making one or more of
these common coding mistakes. You will learn how to choose which diagnosis to
report, the order in which to report them, how to link the diagnosis with the
procedures and how chronic conditions should be reported.
Learn how to properly link ICD-9 to CPT codes
Rules-What Rules? – Yup, 20 of them! – 3 CEU’s
We’ll tell you what they are, how to use them correctly and what happens
if you don’t!
Diabetes – Complications – Manifestations 3 CEU’s
There are over 100 diabetes codes available in ICD-9. Learn how to correctly
report these diabetes codes with their corresponding manifestations- check out
the rules of medical and surgical complication coding that many forget about!
Hypertension – 3 CEU’s
Did you know that there are SEVERAL HUNDRED different codes for Hypertension?
We’ll teach you how to read the Hypertension table!
Burns – 3 CEU’s
The “Rule of Nines” and calculating the extent of burns
What is TBSA? The 3 degrees or depth of burns defined – late effects
Why is accuracy so important?
Neoplasms – 3 CEU’s
A Step by Step Approach to coding Neoplasms –
How to look, where to look and the EXCEPTIONS to the rules -
learn the terminology commonly used in diagnosing & treatment
Poisonings – Adverse Reactions – Late Effects – Pregnancy
3 CEU’s
These 4 areas are a mystery to most – learn how to unravel the puzzle
and pick out the clues for accurate billing
$ 99 each 3 for $249 or all 7 for $499
