Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Turn Credit Balances Into Revenue Opportunities

Resolving credit balances can bring your organization out of the red and into the green. 6-Step Checklist to Recover Revenue Adjustments are correct Patient cost-sharing amounts are correct No duplicate payment postings Payments went to correct payers No charge entry errors Corrected claims are accounted for You  may have encountered this situation: Your boss assigns […]

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AAPC Knowledge Center

CEU Opportunities this Week

Never miss another education opportunity that offers AAPC-approved continuing education units (CEUs)! Look in the Knowledge Center for weekly announcements of upcoming events. Here’s what is available this week: Setting Your Business Up for MIPS Success in 2019 DATE: Tuesday, June 18 – 10 AM PT | 1 PM ET CUE Credit: 1.0 Cost: FREE In […]

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AAPC Knowledge Center

Current Employment Opportunities @ Augusta University Health Systems In Augusta, GA

Augusta University Health System is looking for hard-working, dedicated, detailed oriented coding staff that is interested in using Computer Assisted Coding (CAC). If you want to be a part of the only teaching hospital in the CSRA, this position could be for you! You will be required to pass an entrance coding test prior to an interview.
The Coder I – Professional Services reviews provider documentation and provider assigned diagnoses and CPT codes. The Coder will accept and/or add/revise the ICD-10-CM, CPT Codes, HCPCS Codes and enters modifiers to reflect services provided and to support Professional Billing. The coder will review and accurately code CPT codes for E/M level and associated diagnoses codes, as well as minor procedures (0-10 day global periods), performed during non- intensive inpatient or outpatient encounters. Maintains knowledge of coding and billing requirements and regulatory changes. Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations. Must hold either AAPC Certified Professional Coder (CPC or CPC-A) or AHIMA Certified Coding Specialist-Physician-based (CCS-P) certifications.
The Coder II – Professional Services reviews provider notes, operative reports, and provider assigned diagnosis, procedure, and E/M codes. The Coder II will accept and/or add/revise the ICD-10-CM, CPT procedure codes, CPT E/M codes, and HCPCS Codes and enters modifiers to reflect services provided and to support Professional Billing. The coder reviews clinical and surgical documentation and accurately codes CPT codes for E/M level and associated diagnosis codes as well as operative (major procedures- 90 day global) and bedside procedures performed during intensive care inpatient or outpatient encounters. Maintains knowledge of coding and billing requirements and regulatory changes. Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations. Must hold either AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist-Physician-based (CCS-P) certifications. Must have at least 2 years coding experience for a Coder II position.

These are on-site positions.

Please apply at https://careers.peopleclick.com/care…rnal/search.do. The coding positions can be found under HIMS/Coding Category. Come join our team!
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Medical Billing and Coding Forum

CPC-A seeking entry-level opportunities!

Recent Associate Degree in Medical Billing and Coding from Ultimate Medical Academy and certification. I am seeking employment in the Carlisle, PA area or remotely. I would love to re-enter the healthcare industry with your company and begin my return to self-sufficiency. Please consider me for any open position! Thank you!
Attached Files

Medical Billing and Coding Forum

Employment Opportunities Without Healthcare Setting Experience

Hello. I’m feeling frustrated and thought I’d reach out.

I have a 2 year degree, CCA certification, and CPC-A certification. I’m located just north of the twin cities metro area (MN). I’ve applied for every coding position I come across. I don’t even get a call back for a telephone interview. Many times I get an e-mailed response stating that they require 2 years of healthcare office experience. I’ve been applying and networking and giving it my all – but I’m feeling defeated. I’ve looked into the Project Xtern opportunities, however, none of them are in my metro area. I’m not sure where to go from here. Any feedback / suggestions would be much appreciated. Thank you~

Medical Billing and Coding Forum

Challenges and opportunities in data analytics

Challenges and opportunities in data analytics

Healthcare organizations have become mass gatherers of data. But without sophisticated analytics, integrated IT tools, and processes to mine that data, they may not be able to take advantage of it.

The 33 leaders who gathered for the HealthLeaders Media Revenue Cycle Exchange, held March 23?25 at the Fairmont Grand Del Mar in San Diego, discussed some of the challenges and opportunities they’ve identified within their organizations around data analytics, as well as the tools that help them maintain an effective revenue cycle.

 

Let the data do the talking

Popular wisdom says culture starts at the top?but data is another important catalyst for change. The ongoing managed Medicaid expansion is requiring organizations to collect more prior authorizations and precertifications, presenting a challenge for revenue cycle leaders. Changing the culture of the organization is often key to handling that challenge, and one way to make the change is through data, says Jane Berkebile, MA, CPAM, system vice president of revenue cycle for OhioHealth in Columbus.

One significant challenge for OhioHealth is educating physicians about the increased need for preauthorizations under managed Medicaid. In the past, many of these patient accounts were written off as charity care. However, Berkebile’s organization now needs to focus on the administrative requirements around Medicaid.

Educating OhioHealth’s 343 physician practices, as well as the employed specialists and primary care physicians, by showing them the importance of preauthorizations, has represented a change in culture.

"For communication with our physicians, clinicians, and administration, the best tool we have is to show them in the data what’s really happening," says Berkebile. Her organization’s data analytics team drills down to the information that impacts each department. Departments usually see the gross charge number and think they are doing well, she says.

However, if a department is not getting appropriate authorizations, it may not actually be getting paid that amount. Berkebile finds physicians in particular react positively to seeing data.

"If you show them the data and don’t preach to them, and let them discover the problem, you can get more positive reactions from the physician community," she says. Following the data trail can also help you avoid pitfalls, such as relying on anecdotes that may hide the actual problem.

"The tyranny of the anecdote will not be allowed in this organization," says Doug Robison, performance improvement leader for John Muir Health in Walnut Creek, California. "You have to back it up with data."

 

Turn data into information

Even data only goes so far?it needs to be turned into information, says Russ Weaver, vice president of revenue cycle/finance for Adventist Health System in Burleson, Texas, relating advice he once received.

"You will be more successful if you figure out how to turn data into information. When you’re given something, ask, ‘What does this tell me?’ "

It is important to get back to the root cause and have a sufficient level of detail to address change. As part of the transition to the Cerner Patient Accounting product, Adventist has taken the opportunity to review its processes and reporting. As part of this, Weaver is careful to avoid relying on anecdotal information.

"You can’t go to the director of patient accounts and say you think his or her department is doing something wrong without having meaningful data to back it up," he says.

Sometimes what seems like a data problem is really something else, so it’s important not to lose sight of the basics, such as whether your organization is collecting required data on the front end, according to Doug Brandt, CPA, associate chief financial officer for Truman Medical Centers in Kansas City, Missouri.

"We’re focused on capturing the data items that need to be captured. There is always some low-hanging fruit, so identify and fix that first, then move to the harder-to-fix items," he says.

For example, it is important for revenue cycle leaders to look at the root cause of things such as denials. Even if you are measuring all the right things, if something is not happening at the front end (for example, the registration department is not verifying the patient insurance), you are going to get denials. UnityPoint Health in Des Moines, Iowa, is using data to get to the root cause of denials.

"We’re using data to drive that change by having the service providers focus on getting it correct at the beginning, versus always having to do it on the back end," says Renee Rasmussen, CPA, MBA, FHFMA, vice president of revenue cycle for UnityPoint Health.

 

Ensure ‘clean’ data

Organizations that can’t trust their data might run into problems with data standardization. Alternatively, organizations can fall into the trap of having too much data, but not enough accountability. The first step to ensuring clean data is to assemble a group of stakeholders to determine what data is necessary and where it will come from, says Tammy Thomlison, chief revenue cycle officer for the University of Mississippi Medical Center in Jackson.

Her organization has set up a team to look at the data warehouse generated by Epic and agree, organizationwide, where they will pull data from.

"As an organization, we had to decide where we would pull certain information from the data warehouse, so that when we’re pulling reports we all get the same results," says Thomlison. Her team also uses the Qlik software to provide reporting options on top of the data warehouse. Having data in multiple systems and managing various interpretations of that data is a challenge for many organizations.

Systems must also ensure the data is clean once they have it, says Don Shaw, vice president of revenue cycle for Baton Rouge (Louisiana) General Medical Center. "Once you start pulling information, you find that sometimes you have surprises that you have to fix."

Revenue cycle leadership must hold itself to the same accountability standards it hopes to see from other departments. Data transparency is one way to increase collaboration and trust between the revenue cycle and clinical departments.

"I think it goes back to making sure our data is as accurate as possible. If other departments find differences or errors, we acknowledge that and go back and make those adjustments," says Rasmussen.

 

Measure the right things

The University of Chicago Medicine focuses more on internal benchmarks than external.

"Your benchmark is what you did last week. Now do better than that," says Charlie Brown, MBA, vice president of revenue cycle for The University of Chicago Medicine. "To really set those individual targets, you’ve got to measure against your own internal performance."

UnityPoint also focuses on internal benchmarks, but supplements them with HFMA’s MAP App, says Rasmussen. "We look at the key performance indicator of net revenue yield for our nine regions to really compare different areas."

The most important thing is to set your own benchmarks and targets, adds Berkebile. "By looking at your data and seeing where you are, you see the opportunities and continually set targets to improve your own data. We don’t try to match somebody else’s number?we continually work on improving our own performance."

Organizations need to avoid the pitfall of measuring the wrong things or being so inundated with data that they can’t make a decision.

"There are an endless number of things we can measure, and you don’t want to be playing a game of whack-a-mole where every time something pops up, you hit it and then another thing pops up," says Brandt. "It’s important to find the balance and identify where we need to drill and what we need to focus on."

HCPro.com – Briefings on APCs

Looking for Job Opportunities

I am a graduate of Eastern Florida State College Billing/Coding Program. I passed the CPC exam and earned a certificate from Certification Coaching for ICD-10 PCS coding. I am looking for an opportunity to break into the field of coding and will consider any position to get my foot in the door.
Marcianne Nichoson, CPC-A
1280 Luminary Circle, #104
Melbourne, FL 32901
352-613-0705
[email protected]
www.linkedin.com/in/marcianne-nichoson-cpc

OBJECTIVE
Utilization of my skills and experience to further the goals and mission of a healthcare organization.

SKILLS
Coding and Electronic Health Record Software: EClinicWorks, Doctors Partner, Trizetto/Gateway, ICD10Data.com, Optum Encoder.
Computer Skills: Microsoft Word, Excel, PowerPoint, Access.
Medical Proficiency: Extensive knowledge of medical terminology, anatomy, physiology, ICD-10, CPT, PCS, CMS-1500 form UB-04 form.
Workplace Skills: Familiarity with all office machines, keyboarding at 65 wpm.
Excellent analytical thinking and planning with attention to detail and accuracy.
Exceptional organizational and communication skills both written and verbal.
Strong background in customer service and problem solving.

WORK EXPERIENCE
2017 Professional Practice Experience (Internship). Dr. Vinay Kumar, Rockledge, FL
240 credit hours in Billing Department of a clinical practice.
Initiated insurance claims using correct ICD-10 -CM, CPT/HCPCS codes.
Audited physician/nurse generated claims for accuracy and completeness before submission.
Posted payments from Explanation of Benefits to patient accounts.
Researched and revised claims per rejection report for re-submission.
Audited A/R report for corrections.
Answered telephones, scheduled appointments, directed faxes to appropriate personnel for follow up.
2014 – 2016 Dillard’s Department Store. Sales Associate. Melbourne, FL
2014 – 2016 MLSBC Cruises/Carnival Cruise Line. Guest Services. Port Canaveral, FL
2006 – 2014 M*Modal Transcription Service. Franklin, TN
Level III transcriptionist of medical reports for hospitals and clinics.
Edited speech recognition software-generated medical reports.
2002-2003 Temple Sinai. Administrative Assistant. Palm Desert, CA
Transcribe sermons, lectures, letters. Preparation of weekly congregational bulletin and Torah study materials. Directed and supervised volunteer staff on daily assignments and special projects.
1999-2002 Innovative Expo, Inc. Palm Springs, CA
Owned and operated trade show services company. Developed and enforced company policies. Trained and supervised customer service agents and graphics department. Instituted computerized order processing and payroll. Performed accounting and payroll duties. Worked trade show floor interacting with employees, exhibitors, and facility personnel utilizing problem solving and communication skills to assure smooth move in and move out of exhibit materials.

EDUCATION
Eastern Florida State College, Cocoa, FL, Medical Coder/Biller Program-37 credits.
Certification Coaching Organization, 30 Continuing Credit Units, ICD-10-PCS.
College of the Desert, Palm Desert, CA. Course work in Microsoft Word, Excel, business law, accounting.
University of Wisconsin-Milwaukee, Bachelor of Arts.

PROFESSIONAL MEMBERSHIPS
American Academy of Professional Coders (AAPC).

Medical Billing and Coding Forum

Medical Coding Job Opportunities

Tazin Ahmed
Somerville, MA 02145, P: 617-642-0990, [email protected]
Objective:

Summary:
• ICD-10 CM Coding/CPT-4 Surgical/CPT-4 Nonsurgical/HCPCS/HIPAA Regulations Medical Billing
• Anatomy/Pharmacology/Medical Terminology, ICD-10 CM and ICD-10 PCS from AAPC
• Microsoft Office Suite 2010, i.e. Word, Excel, PowerPoint, Outlook, Access, internet research
• Administrative: File management, data input, letter composition, client inquires, and customer service
• Multilingual: Urdu/Hindi/Bengali; Medical/DCF/Court/Insurance com/three way line phone interpreting
• Accounting: Accounts payable, Accounts receivable, Income Tax, Payroll, and Auditing

Professional Experience:
Bay State Interpreters Inc., Gardner, MA
Interpreter, 2009-Present
• Work with hospitals patients, courts, insurance companies, three-way line phone settings
• Knowledge of medical vocabulary’s interpreting at professional level
• Discuss key issues of cultures of the patients with staff

Bulfinch Temporary Service, Boston, MA
On-Site at MGH, Charlestown NY, MA
Senior Customer Service, 2013
• Handled all communications, which include correspondence, telephone and email, from patient and other departments within the PBO
• Utilized customer service, self pay collection, refund process and billing experience to gather and interpret relevant information to resolve patient account issues and complaints
• Ensure accurate patient billing through review of account history, third party billing activity and analysis of payments and adjustments at Massachusetts’s Physician’s Organization-MGPO

Randstad Staffing, Charlestown, MA
On-Site at Partners Healthcare
Cash/Remittance Processor, 2013
• Break down the lock box, use Soarian software, create an Insurance and verification, Account Transfer
• Balance, add batch, enter batch entry, post batch, Print out balance report, process patients credit card

Asian American Civic Association, Boston, MA
Accountant, 2013
• Allocate bank charge, class income item, bank reconciliation
• Find out total Sick leave and Vacation hour by using Excel for Payroll period ending day
• Matched Credit Card transaction with sales receipt
• Filling, labels option by using mail merge

Cambridge Health Alliance, Somerville, MA
Practice Medical Receptionist 2012
• Checked in patients as they arrive in a courteous customer service manner
• Scheduled, cancel & no show office appointments both internal and external to the practice
• Collected co-pays from patients and process co-pays for deposit; reconciled cash collection

MDP Inc., Boston, MA
Medical Billing/Coding, 2011
• Entered transaction entry, completed daily work reports
• Managed claims, obtained patient information, printed out explanation of benefits
• Handled sensitive and confidential material according to HIPAA regulations

H & R Block, Medford, MA
Income Tax Specialist, 1999-2004
• Experience preparing income tax; responsible for quality customer service and applied interpreter skills for non-English speaking customers.

Harvard Student Agencies, Cambridge, MA
Assistant Accountant, 1996-2001
• Experience in accounting field, responsible for accounts payable and receivable, and payroll.

Education:
American Carrier Institute, Cambridge, MA, Medical Coding/Insurance Billing/Auditing, & Certification 2014
Operation A.B.L.E. of Greater Boston, Inc. Skills2Work (Certified) 2013
University of Dhaka, Dhaka, Bangladesh, Bachelor’s Degree & Accounting 1981

Medical Billing and Coding Forum