OVERVIEW
Designed for the experienced coder, AAPC's CPMA online training course provides training for the multifaceted components of medical auditing. This online training course covers medical record standards and documentation guidelines, coding and documentation compliance, coding and reimbursement concepts, audit scope and statistical sampling methods, medical record audit abstraction, and category risk analysis and communication. A minimum of two years coding experience is strongly suggested prior to taking this course.
The registration fee for this program includes AAPC membership, CPMA practice exams, and the AAPC Certified Professional Medical Auditor (CPMA®) exam.
Prepares You For...
Careers
- Medical Auditor for physicians
- Medical Auditor for payers
- Practice consultant
Certification Exam
- Certified Professional Medical Auditor (CPMA®)
OBJECTIVE
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
DETAILS
This online training course covers medical record standards and documentation guidelines allowing them to confidently communicate with providers. Coding and documentation compliance are key to a successful practice. This course arms the certified medical auditor with information to assist in improvements for documentation compliance within the practice.
Coding and reimbursement concepts assist in a smooth work flow from scheduling the patient visit to the practice being paid for the visit. Understanding these concepts reduce overhead and reduce turnaround time for payment of services, thereby increasing the financial well-being of a practice.
Medical record abstraction helps identify risk areas to a practice. Understanding what a provider documents and what will improve the provider’s documentation are key to compliance. Learning how to communicate information back to a provider improves this process. Understanding audit scope and statistical sampling methods and category risk analysis help identify where a compliance office can focus and receive the most benefit from audits.
This course prepares an experienced coder to improve the financial well-being as well as the compliance of provider practices.
Upon completion of this program you will be prepared for the AAPC Certified Professional Medical Auditor (CPMA®) exam. The registration fee for the exam, AAPC membership, and CPMA practice exams are included with this program.
This program is entirely online and is completed at your own pace. When you register, you receive six (6) months to complete this program.
OUTLINE
- Compliance and Regulatory Guidelines including:
- Fraud and Abuse
- Federal False Claims Act
- Anti-Kickback Law
- Stark Law
- Exclusion Statute
- Civil Monetary Penalties Law
- Office of Inspector General (OIG)
- Centers for Medicare and Medicaid Services (CMS)
- Medical Record Documentation Standards
- HIPAA Privacy Regulations
- Types and components of medical records
- Accreditation standards
- Coding and Reimbursement Concepts
- CPT® Guidelines
- Evaluation and Management
- Anesthesia
- Surgery
- Radiology
- Pathology and Laboratory
- Medicine including chemotherapy, psychotherapy, physical therapy
- Modifiers
- Diagnosis coding and medical necessity
- Physicians at Teaching Hospital (PATH) Guidelines
- Auditing
- Auditing process
- Statistical sampling, utilization review, RAT-STATs
- Risk Analysis and Communication
- Validation of audit results
- Analysis and report of audit findings
- Communicating audit results
- Practical Expertise
- Practical audit skills utilizing cases for practical application
- Final Exam
REQUIREMENTS
This program can be taken from either a Mac or a PC. It is compatible with the Windows XP and later operating systems, Firefox, Chrome, or IE 7 and later browsers. There are no specific computer requirements other than an Internet connection and e-mail account.
Adobe Flash Player and Adobe Acrobat Reader are required for this program.
Click here to download the Acrobat Reader.
Click here to download the Flash Player.
ed2go will provide the required textbooks for this program:
- Medical Auditing Training: CPMA® (PDF)
- CPT® Professional Edition (current year)
- ICD-10-CM Code Set (current year)
- HCPCS Level II (current year)
PREREQUISITES
Knowledge of medical terminology and anatomy (or AAPC courses) strongly recommended.
FAQS
1. Can I register for programs if I am an international student?
Yes, because ed2go programs are online you never have to actually travel to the school. Most schools offer telephone or online registration.
2. How long does it take to complete a program?
All of our programs are self-paced and open enrollment, so you can start them when you want and finish them at your own pace. When you register, you’ll receive six (6) months to complete the program.
3. What if I don't have enough time to complete my program within the time frame provided?
The time allotted to complete your program has been calculated based on the number of hours for each program, so don't worry too much about not completing in time. If, after a concerted effort, you are still unable to complete, your Student Advisor will help you work out a suitable completion date. Please note that a fee may be charged for an extension.
4. Do I have to buy additional materials?
No
5. Can I get financial assistance?
ed2go courses are non-credit courses, so they do not qualify for federal aid. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses. Additionally, some students may qualify for financial assistance when they enroll, if they meet certain requirements.
6. What happens when I complete the program?
Upon successful completion of the program, you will be awarded a certificate of completion. In addition, you will receive an exam voucher for the Certified Professional Medical Auditor (CPMA®) Certification Exam, offered by the American Academy of Professional Coders (AAPC) after successful completion of the program and financial obligation.
7. Am I guaranteed a job?
ed2go programs will provide you with the skills you need to obtain an entry-level position in most cases. We don’t provide direct job placement services, but our facilitators and career counselors will help you build your resume and are available to give advice on finding your first job. Facilitators will also be available to use as a professional reference upon completion of the program. Potential students should always do research on the job market in their area before registering.
8. Who will be my instructor?
Each student is paired with a facilitator for one-on-one interaction. The facilitator will be available (via e-mail) to answer any questions you may have and to provide feedback on your performance. All of our facilitators are successful working professionals in the fields in which they teach.
9. What software or hardware do I need in order to take online programs and what are the system requirements?
In order to take our online programs, you must have access to a computer and the Internet. You can access the program contents from any Web-enabled computer. You don’t have to use the same computer to log-in to the program every time. We recommend that you have a word-processing program (Microsoft Word is the best) and the latest version of Internet Explorer.
10. Can I use a Mac?
Yes
11. How can I get more information about this program?
If you have questions that are not answered on our website, please feel free to contact us via LIVE chat (click the button above). If you are visiting us during non-business hours, please feel free to send us a question using the “Contact Us” form to the right. You may also call us at 1-877-221-5151. We will answer your questions promptly.
12. When can I start the program?
Our programs are all open enrollment. You can register and start the program as soon as you are ready.
Please note: Once the program curriculum is accessed online or through submission of a material shipment confirmation, refunds cannot be issued.
13. Does this program prepare for a certification?
Yes, you will be prepared to sit for the Certified Professional Medical Auditor (CPMA®) Certification Exam offered by the American Academy of Professional Coders (AAPC). You will receive an exam voucher and AAPC membership after successful completion of the program and financial obligation.