CPMA Auditing Training Course Description & Learning Objective

Ideal for Aspiring Medical Auditors and CPMA Certification Seekers:

This course is designed to be a valuable learning experience for anyone considering a career in medical auditing.  Beyond the basics, this program provides a strong foundation for those pursuing the AAPC Certified Professional Medical Auditor (CPMA) certification. Enroll in this course to gain the knowledge and confidence needed to excel on the CPMA exam.

Prerequisites: A minimum of two years of coding experience and certification are strongly recommended.

Clock Hours:

The course comprises approximately 20 hours of coursework and meets on the specified day(s) (Note: 20 clock hours account for time spent in the online course and do not include time spent outside the course or study time. Study time will vary widely per individual)

Course Length:

Option 1: This online AAPC instructor-led course prepares you to receive AAPC (American Academy of Professional Coders) CPMA Certification in 12 weeks or less.

Option 2: Self-paced to be completed at the student’s own pace within 12 months.

Class Hours: Days/Times Per Week: Online course, independent self-study.

CEUs: 20 CEUs upon completion

Course Description:

This comprehensive course equips you with the essential knowledge and skills for success in medical auditing. You’ll delve into the core principles of medical auditing, gaining a deep understanding of key areas like:

  • Regulations: We’ll explore the critical regulations that govern medical billing and coding, ensuring you’re up-to-date on compliance requirements.
  • Corporate Integrity Agreements (CIAs): Learn about CIAs and their impact on healthcare billing practices.
  • Medical Record Documentation: We’ll analyze the importance of proper medical record documentation for accurate coding and auditing.
  • Chart Abstraction: Master the skill of extracting key information from patient charts, a fundamental skill for medical auditors.

Course Objectives:

  • 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.
  • Identify the purpose of recovery audit contractors and how to prepare for potential RAC audits.
  • 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 in documentation for evaluation and management, anaesthesia, surgery, radiology, pathology and laboratory, and medicine services.
  • Explain the types of audits and the resources required for audits.
  • Define the steps of the audit process and identify statistical sampling types and factors
  • Explain aggregate analysis and when it is useful
  • Explain the importance of discussing audit findings with the provider
  • Provide practical application of auditing operative reports and evaluation and management services

Course Content:

  • Compliance and Regulatory Guidelines include:
    • Fraud and abuse
    • Federal False Claims Act
    • Anti-Kickback Law
    • Stark Law
    • Exclusion Statute
    • Civil Monetary Penalties Law
    • Office of Inspector General (OIG)
    • The Center for Medicare and Medicaid Services (CMS)
  • Medical Record Documentation Standards
    • HIPAA Privacy Regulations
    • Types and components of medical records
    • Accreditation standards
  • Evaluation and Management Coding
  • Coding and Reimbursement Concepts
    • CPT Guidelines
    • Evaluation and Management
    • Physicians at Teaching Hospital (PATH) Guidelines and much more.
  • 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 effectively

Methods of Evaluation:

The instructional methods used include reading assignments, interactive audio/video lectures with quizzes included, chapter review exams, practical application cases, and a final exam. To receive a certificate of completion, students must complete the course within 3 months or less.

Successful course completion includes:

  • A 70% or higher passing score on all chapter review exams, final exam and overall course.

Required Code Books (May not be included depending on the course package selected):

  • CPT® Professional Edition codebook (current year), AMA publisher
  • ICD-10-CM code book (current year), any publisher
  • HCPCS Level II code book (current year), any publisher

Note: Required codebooks may be purchased through your instructor, AAPC or any major bookseller.

Computer Requirements:

  • Computer with High-speed internet access
  • Adobe Acrobat Reader for downloads

Pricing Options

Pay in full or on a Bi-weekly payment plan.

When selecting the payment plan option, there is a $50.00 payment plan processing fee.

Bi-weekly payment Schedule and agreement

If the payment plan option is selected, the authorized deposit amount and an additional $50.00 will be processed. All payment plans have a non-refundable $550 deposit due the day of the signed agreement.  Three bi-weekly payments of $500 will be due until payment is complete. Non-adherence to the scheduled payment plan will immediately restrict your Blackboard access to the course until payment is made and processed.

Getting Started:

Step 1: Complete the registration agreement on the “cart” page

  • Option 1: Pay in Full
  • Option 2: Sign up for our bi-weekly payment plan here

Step 2: Blackboard Access

  • After processing your order, you will receive further email instructions on course access (user ID and Password) to Blackboard and course instructions.
  • Please allow up to 5-7 business days for online access to Blackboard.

Step 3: Start the program as soon as access is ready! *The course will begin within 5-7 business days after payment and the enrollment agreement are signed.

Exams:

In 2024, CPMA certification exams will be available electronically online from home or an AAPC testing site. Review the AAPC video on electronic exams here.

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