As a physician reimbursement specialist, the CPRP National Certification will enhance your knowledge and add the credibility you deserve, whether you are seeking to enter or progress in a billing career.
 
National certification of a medical biller through the Medical Business Institute is a process that recognizes competency that has met our high standards of proficiency through course attendance and certification testing.  Certified Physician Reimbursement Professionals (CPRP) are skilled in facilitating the claims paying  process from the time a service is rendered by a health care provider until the balance is paid. Through our course, you become knowledgeable in ICD-9, CPT-4 and HCPCS coding, utilizing medical technology resources, an insurance claim's billing cycle, winning appeals and overcoming denials, negotiating  contracts and  credentialing, fraud and abuse, HIPAA, OIG compliance, information and web technology, Medicare and other Federal payers' rules for reimbursement, billing preventative services, and much more. Upon successful testing you will become one of the elite nationally recognized CPRP specialists who play a critical role in a health care provider's daily business operations.
  

This course will benefit anyone who already has a good working knowledge of coding, either through education or work experience, and would like to take their expertise to a higher level of proficiency. Attendees without an understanding of the coding fundamentals should also take the Beginning Coding session. 

- Coders
- Billers
- Collectors
- Office Managers
- Practice Managers
- Nurses
- Residents
- Non-Physician Practitioners
- Physicians
 
CHART VERIFICATION
Apply your skills! The Office of the Inspector General suggests performing internal medical record audits on a regular schedule. This prevents fraud and abuse, and promotes compliance in your office. When it's time to perform an audit on your medical records, you must have a well-rounded knowledge base of information. In this course, we'll walk through the steps of coding by utilizing the following resources:

- AMA CPT Guidelines
- Evaluation and Management
- CMS Documentation Guidelines
- "Key Components"
- Time-Based Visits
- Consultations
- "Incident-to" Services
- Preventive Services
- Surgical Codes
- Modifier Usage
- ICD-9 Guidelines
- Utilizing Local and National Coverage Determinations
- Understanding the Importance of ICD-9 codes for Medical Necessity 
- Screening or Problem Visit?
- NCCI Edits
- Component Edits
- Mutually Exclusive Edits
- Overrides

ESSENTIAL RESOURCES
We will not only teach you valuable information during the seminar, but will also provide you with the industry resources that you will need to perform your own research on coding, as well as keep up-to-date with the ongoing changes within this fast-paced industry!

BRING YOUR CODING BOOKS
This will be a hands-on class. CPT and ICD-9 books are required.

CPT/ICD-9 Beginning Coding

This interactive seminar will benefit anyone who has minimal or no formal coding education or coding experience:
- Entry level medical office personnel
- Entry level medical office personnel
- Billers
- Collectors
- Office Managers
- Nurses
- Residents
- Non-Physician Practitioners

CODING vs BILLING - The Complete Cycle

THE CMS HIERARCHY

CPT CODING
- Book Design and Structure
- Locating Your Code
- Linkage with ICD-9 Codes
- Building an Evaluation and Management Code
- Unspecified Codes; Use With Caution
- A Modifiers intent

HCPCS CODES
- How Do They Fit Into the Picture?
-Their Benefits and Usage

ICD-9-CM CODING
- Medical Necessity; Your Key to Payment
- Specificity - It's Mandated
- Book Design and Structure
- Official Guidelines for Diagnostic Coding
- Application and Benefits of Volume I and II
- E-Codes and V-Codes
- NOS and NEC Codes

COMPLIANCE
Improper coding can result in serious penalties and irreversible damage to a physician practice. In this seminar, you will gain understanding on how to prevent improper coding and the importance of having a comprehensive knowledge of coding as related to compliance.

HANDS-ON WORKSHOP
Don't forget your CPT and ICD-9 books! We'll perform hands-on coding scenarios to kick-start your new coding knowledge!

This seminar is important to you because:
- Private practice is a business that requires a rational response to outside influence. 
- Healthcare organizations of all sizes are dealing with unexpected change. 
- Quality care and service can best be accomplished by defining who you are, where you want to go and what you hope  to accomplish. 
- Strategic planning helps you identify your course of action to achieve success. 
- Coding compliance for new Growth is essential. Adding new services is not enough to increase revenue. You must  learn to use CPT and ICD-9 codes properly to bill appropriately for those added services.
 
   
Success in your practice depends on having a strategic plan that works.  Start out with a firm plan to accommodate your practice�s competitive and changing marketplace.   Regardless of practice size or specialty, a strategic plan is essential in guiding a practice to achieve objectives and maintain quality, growth and profits.  Physicians, practice administrators, office managers and business managers must have tools to fulfill the vision of the practice.  A strategic plan is vital for circumventing the �false starts� that can take years and considerable expense to correct.  A strategic plan � designed to work in conjunction with your marketing plan, your financial plan and your operational/management plan � is a valuable component of a comprehensive business plan that will lend stability and intentionality to the direction of your practice.  You will be taught the proper way to code new services such as bone density studies and waived lab codes for the physician office using both CPT and the very important ICD-9 codes that will allow claims to be properly filed and paid. Coding compliance is imperative to any strategic planning you want to achieve. We will show you how hiring CPC coders should be part of your overall plan.
This course covers the key elements required in developing and structuring a strategic plan, coding compliance for any planned growth � and how to get everyone on board � so you can guide your organization in this time of change.

The Deficit Reduction Act of 2005 (DRA) takes effect in 2007, which means health care compliance programs will be required to educate employees about the federal False Claims Act. We are here to help with a program designed to get your practice into compliance.

The Act requires that any employer who receives Medicare/Medicaid payments must provide information in written policies, employee handbooks, and employee training that covers:

- E&M Coding Basics
- 3 Key Component of E&M code selection
- Selecting the correct level of E&M codes using the Documentation Guidelines
- the federal False Claims Act
- any applicable state False Claims Act
- the right of employees for whistle-blower protections
- the employer's policies and procedures for detecting and preventing billing and coding fraud, waste and abuse.

Ethics and Compliance covers the False Claims as well as other applicable acts while also covering the basics in ethical billing practices.  The E&M coding basics as well as the documentation guidelines will be covered; we will cover the coding and false claim connection.

Be sure to send all of your staff members who are responsible for coding, writing and implementing rules for these important compliance areas.

Where can the busy professional turn for up to date information on compliance with OSHA standards for the healthcare industry? Attend this intensive two-hour seminar that covers a broad range of OSHA compliance issues.

TOPICS INCLUDE:
- Choosing and using personal protection equipment
- Needle stick safety law device requirements
- Housekeeping schedules and disinfectants
- Other rules required by the Federal Bloodborne Pathogens Standard

Also covered are reporting, record keeping and procedural requirements that you must follow. You will learn to develop written Hazard Communication programs, i.e. Bloodborne Pathogen Exposure Control Plans, TB Respiratory Protection Plan and much more. You will also master the ins-and-outs of meeting OSHA training standards, which according to JCAHO is one of the most common sources of non-compliance fines. Materials include a sample Exposure Control plan for you to follow as well as an assessment tool to assess your facility's OSHA compliance. This seminar is targeted to first time training needs and for the yearly retraining needs of the healthcare professional.

Ample time will be provided for Q & A.

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