Coding, Reimbursement and Documentation for Physicians (12 hours)

Course Overview/Description

With all of the changes, HIPAA rules and regulations, and the constant possibility of audits; the physician just can't take a chance of not knowing what is needed to be compliant in the coding and billing of services. This course is designed to help determine what is needed for effective and efficient documentation, when to use modifiers, and how to not "unbundle" services.

The key to a good practice is having a compliance plan in place. Physicians will learn about the resources needed to create a successful compliance program and about the key elements needed to do so. They will also learn about the Office of Inspector General (OIG) Work Plan for 2004. This gives you a heads up on the services that could be targeted in the New Year's audits so you can be prepared.

Evaluation and Management documentation can be a doctor's worst nightmare, but this course gives detailed specifics needed when documenting multiple or single-organ-system examinations. The specialties examinations covered are listed below.
    - Cardiovascular
    - Otolaryngology
    - Ophthalmology
    - Genitourinary
    - Hematologic/Lymphatic/Immunologic
    - Musculoskeletal
    - Neurological
    - Psychiatric
    - Respiratory
    - Integumentary

For those of you who work at a teaching hospital, teaching physician guidelines, including recent changes, will be covered.

As you can see, this course is a valuable asset in preparing yourself and your staff.

Course Objectives

At the end of the course, students who are physicians will be able to document compliantly and efficiently. Students who are physician educators, office managers, consultants, etc., will be able evaluate documentation for compliance and will be able to teach physicians how to document, allowing more time to focus on patient care. They also will be able to recognize and/or provide correct documentation, allowing maximum reimbursement for the services performed.

Course Outline

• Coding
  1. Medical Necessity
  2. Bundling
  3. Modifiers
  
  
• Compliance
  1. Office of Inspector General (OIG) Compliance Plan for Physician's Offices
  2. Fraud and Abuse
  3. Services Frequently Targeted by Audits
  4. OIG Work Plan for 2003
  
  
• Documentation
  1. Why documentation is so important
  2. Documentation of Procedure Notes
  3. 1995/1997 Evaluation and Management (E&M) Documentation Guidelines (DG)
     1. Key Components
        1. History
        2. Physical Exam
           1. General Multi-System
           2. Cardiovascular
           3. Otolaryngology
           4. Ophthalmology
           5. Genitourinary
           6. Hematologic/Lymphatic/Immunologic
           7. Musculoskeletal
           8. Neurological
           9. Psychiatric
           10. Respiratory
           11. Integumentary
        3. Medical Decision Making
     2. Other Components
        1. Counseling
        2. Coordination of Care
        3. Nature of Presenting Problem
        4. Time
  
  
• "Incident To" Services
  
  
• Teaching Physician Guidelines
  
  
• Reimbursement
  1. Physician Fee Schedule
     1. Surgical Package
     2. Fee for Service

Prerequisites/Audience

This course was designed for physicians or upper-level medical-office managers. Students should have a working knowledge of medical-billing practices, medical coding, and medical terminology.

PC Requirements/Materials Included

This course is compatible with Windows Vista Operating System.

This course can be taken on either a Mac or a PC. All materials for this course are available online.

Instructor Bio

Samantha Mullins has been in the healthcare industry approximately ten years. She has a variety of skills, including managing physician practices, auditing coding and compliance issues, and coding/billing procedures and services. She currently works for VitalMed, Inc., a company that provides healthcare management and consulting services. This brings together all of her skills into a challenging career.

Ms. Mullins is also an AAPC-approved instructor for the Professional Medical Coding Curriculum (PMCC) and has a specialty certification on Anesthesia coding. In the past, she has been an instructor for various coding and medical terminology courses for Gatlin Education. Now, she and Gatlin Education Services have created a more advanced course called Advanced Coding Specialist, an online course. This will help to carry past and present students of Administrative Medical Specialist farther in their careers and will help those who already have a coding career get a better understanding. Ms. Mullins believes that you should strive for quality versus quantity.

Frequently Asked Questions (FAQs)

1. How do I register?
Click on the register button at the top of the page and follow the directions. It is important that you type all your information in the boxes, then print it out to sign.  Payment and sending instructions are in the bottom right corner of the form.

2. How much do the courses cost?
The fee is in the pink box at the top of the page.

3. Can I register for courses if I live outside the United States?
Yes you can!

4. Do I ever have go to the school I register with?
All of our courses are delivered entirely online, so you never have to go to a class or travel to the school.

5. How long does it take to complete a course?
All of our courses are self-paced and open enrollment. You can start and finish the course at your own pace. When you register for a course, you are given 180 days (6 months) to complete the course. If you need more time, extensions are available.

6. Do I have to buy additional materials?
All materials are included. The cost of materials is covered by your tuition. GES ships all materials via UPS ground service upon registration.

7. Can I get financial aid?
GES 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.

• GES provides a loan opportunity for students. Simply go to www.collegeloanapplication.com to apply for an easier qualifying loan at a slightly higher rate. Click here for more information on this loan program.

8. What happens when I complete the course?
Upon successful completion of the course, you will be awarded a certificate of completion from the school you registered with. You must obtain a final passing grade of 70% or greater to be awarded a certificate.

9. Am I guaranteed a job?
GES courses will provide you with the skills you need to obtain an entry-level position in most cases. We do not provide direct job placement services, but our instructors will help you build your resume and are available to give advice on finding your first job. Instructors will also be available to use as a professional reference upon completion of the course. Potential students should always do research on the job market in their area before registering.

10. Who will be my instructor?
Each student is paired up with a facilitator for one-on-one interaction. The facilitator will be available (via email or phone) 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.

11. What do I have to have in order to take an online course, and what are the system requirements?
In order to take our online courses, you must have access to a computer and the Internet (a normal dial-up connection is fine). You can access the course contents from any Web-enabled computer. There are no necessary plug-ins. You do not have to use the same computer to log-in to the course every time. We recommend that you have a word-processing program (Microsoft Word is best) and the latest version of Internet Explorer.

12. Can this course be taken on a Mac?
Yes.

13. How can I get more information on the course?
All of the information we have is available online under our course catalog (www.gatlineducation.com). If you have questions that are not answered online, please feel free to email us at courseinfo@gatlineducation.com or call 817-870-2870. We will answer your questions promptly.

14. When can I start the course?
Our courses are all open enrollment. You can register and start the course as soon as you are ready.