This course is designed for individuals who have at least three to five years of experience as a medical coder and are interested in advancing in their current career in the health care industry.
Certification: Certified Professional Medical Auditor Certification
Certifying Body: American Association of Professional Coders
Contact Hours: 32
This course is designed to prepare an individual to become a Certified Professional Medical Auditor (CPMA®). Students will be able to use their experience with coding and documentation guidelines in order to improve their practice’s revenue cycles.
• Define the standards of a medical record
• Describe the types of documentation included in a medical record
• Describe how to format a medical record
• Describe the proper documentation requirements for consent forms, including the Advanced Beneficiary Notice
• Explain the organization and retention of medical records
• Describe how federal and state HIPAA laws apply to medical records
• Explain the purpose of a compliance plan
• Identify the seven core elements of a compliance plan
• Distinguish between Medicare fraud and abuse
• Describe the common forms of misconduct
• Determine the fines and penalties applied under the False Claims Act and the Medicare/Medicaid Civil Monetary Penalties Law
• Explain how to develop corrective action initiative for detected offenses
• Describe the regulatory guidelines set forth by the Office of the Inspector General (OIG)
• Identify the elements of a Corporate Integrity Agreement (CIA)
• Explain how the Stark Law applies to a physician and a practice
• Describe the standards developed by the Joint Commission
• Identify the types of government audits
• Explain the purpose and instructions for compliance for each type of government audit
• Explain the scope of audits
• Identify the types of audits and what gets audited
• Describe the role of statistical sampling in the auditing process
• Identify the components of evaluation and management encounters and explain how to score each component
• Explain the procedures that are audited within the medicine section of the CPT
• Analyze the proper operative note for the required elements
• Identify the appropriate indications for the performed services
• Distinguish between an interpretation of a new procedure and a review of a previously performed procedure
• Explain the proper use of the Diagnostic Interview Exam
• Analyze the scope of psychotherapy services, including reporting times, services, and types of therapy
• Identify billable services based on the intent, amount, and types of medications infused
• Describe how to validate the results of an audit
• Identify how to analyze and report an audit
• Explain how to communicate the results of an audit
• The Certified Professional Medical Auditor course includes 32 non-credit contact hours.
• This course is instructor-facilitated.
• This course prepares students to sit for the CPMA® exam administered by the AAPC.
• This course can be run fully online or in hybrid format.
• The Certified Professional Medical Auditor course is designed as part of the Pearson Workforce Education Core Health Care Curriculum, and can be included with other occupation-specific courses in conjunction with multiple certification programs.
• This course is not a CEU.
• This course can be used for professional development by incumbent workers who have at least three to five years of medical coding experience.
• This course is a complete, ready-to-deliver, customizable online course, including syllabi, lesson sequences and course objective descriptions.
• The course content is written to meet specific curriculum and course outcomes and every content item is mapped to a specific course objective.
• This course can be used in any Learning Management System (Blackboard, WebCT, Angel, Moodle, D2L, etc.).
• Interactive classroom lectures are self-contained learning objects.
• The Certified Professional Medical Auditor course includes instructor resources, optional assignments and assessments, and optional book readings, all aligned with course objectives.
• All content has been developed and created by industry leading subject matter experts and instructional designers
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