What You'll Learn...
The student will learn principles of medical auditing. In addition, there will be discussion of key areas of regulations, CIAs, medical record documentation and chart abstraction. This course is recommended for anyone who is preparing for a career in medical auditing and strongly recommended for anyone who is preparing for the AAPC CPMA certification examination.
Upon completion of this program you will:
• Define fraud and abuse and explain regulatory guidelines for key regulations
• Explain the impact of the OIG Work Plan and Corporate Integrity Agreements (CIAs)
• List the elements of compliance plans and identify potential compliance risk areas
• Identify National Correct Coding Initiative (NCCI) and Medically Unlikely Edit (MUE) risk areas
• Explain the HIPAA privacy rule, including details on protected health information, minimum necessary, sharing of information, and enforcement
• Identify medical record documentation standards and record retention standards
• Identify common errors found in documentation for evaluation and management, anesthesia, surgery, radiology, pathology and laboratory, and medicine services
• Explain the types of audits and the resources required for audits
• Define steps of the audit process and identify statistical sampling types and factors
• Explain the importance of discussing audit findings with the provider