Certified Professional Medical Auditor (Voucher Included)

This online training course covers medical record standards and documentation guidelines allowing them to confidently communicate with providers. Coding and documentation compliance are key to a successful practice. This course arms the certified medical auditor with information to assist with improvements in the practice's documentation compliance. Coding and reimbursement concepts assist in a smooth work flow from scheduling the patient visit to the practice being paid for the visit....

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6 Months / 80 Course Hrs
Open Enrollment
Offered in partnership with your preferred school

George Mason University

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Certified Professional Medical Auditor (Voucher Included)

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Course code: GES166

What you will learn

  • 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
  • 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 found in medical documentation
  • Explain the types of audits and the resources required for audits
  • Define steps of the audit process and identify statistical sampling types and factors
  • Explain the importance of discussing audit findings with the provider

How you will benefit

  • Learn to communicate with medical professionals and assess medical documents
  • Develop the skills needed to work in medical auditing
  • Learn the legal standards necessary to perform well on the job
  • Understand best insurance and reimbursement practices so as to relay them to patients

How the course is taught

  • Self-paced, online course
  • 6 Months to complete
  • Open enrollment, begin anytime
  • 80 course hours
  1. Compliance and Regulatory Guidelines including:
    1. Fraud and Abuse
    2. Federal False Claims Act
    3. Anti-Kickback Law
    4. Stark Law
    5. Exclusion Statute
    6. Civil Monetary Penalties Law
    7. Office of Inspector General (OIG)
    8. Centers for Medicare and Medicaid Services (CMS)
  2. Medical Record Documentation Standards
    1. HIPAA Privacy Regulations
    2. Types and components of medical records
    3. Accreditation standards
  3. Coding and Reimbursement Concepts
    1. CPT® Guidelines
    2. Evaluation and Management
    3. Anesthesia
    4. Surgery
    5. Radiology
    6. Pathology and Laboratory
    7. Medicine including chemotherapy, psychotherapy, physical therapy
    8. Modifiers
    9. Diagnosis coding and medical necessity
    10. Physicians at Teaching Hospital (PATH) Guidelines
  4. Auditing
    1. Auditing process
    2. Statistical sampling, utilization review, RAT-STATs
  5. Risk Analysis and Communication
    1. Validation of audit results
    2. Analysis and report of audit findings
    3. Communicating audit results
  6. Practical Expertise
    1. Practical audit skills utilizing cases for practical application
  7. Final Exam

This is not an instructor facilitated course; however, support will be provided through email, online forms, and phone.

Prerequisites:

The Certified Professional Medical Auditor course is specifically designed to help individuals with prior coding/billing knowledge prepare for the CPMA exam.

Requirements:

Hardware Requirements:

  • This course can be taken on either a PC or Mac.

Software Requirements:

  • PC: Windows 8 or newer.
  • Mac: macOS 10.6 or later.
  • Browser: The latest version of Google Chrome or Mozilla Firefox are preferred. Microsoft Edge and Safari are also compatible.
  • Adobe Acrobat Reader.
  • Software must be installed and fully operational before the course begins.

Other:

  • Email capabilities and access to a personal email account.

Instructional Material Requirements:

The instructional materials required for this course are included in enrollment. The following textbooks will be shipped to you approximately 7-10 business days after enrollment:

  • Medical Auditing Training: CPMA® (PDF)
  • CPT® Professional Edition
  • ICD-10-CM Code Set
  • HCPCS Level II

Yes, ed2go courses are completely online. However, keep in mind that not all certifying bodies or industry-specific certifications are recognized internationally. Please review your country's regulations prior to enrolling in courses that prepare for certification.

Yes, you will be prepared to sit for the Certified Professional Medical Auditor (CPMA®) Certification Exam offered by the American Academy of Professional Coders (AAPC). You will receive an exam voucher and AAPC membership after successful completion of the course and financial obligation.

This course is open enrollment, so you can register and start the course as soon as you are ready. Access to your course can take 24-48 business hours.

This course is self-paced and open enrollment, so you can start when you want and finish at your own pace. When you register, you'll receive six (6) months to complete the course.

The time allotted for course completion has been calculated based on the number of course hours. However, if you are unable to complete the course, contact your Student Advisor to help you work out a suitable completion date. Please note that an extension fee may be charged.

You may be assigned with an instructor or team of industry experts for one-on-one course interaction. Your support will be available (via email) to answer any questions you may have and to provide feedback on your performance. All of our instructors are successful working professionals in the fields in which they teach. You will be assigned to an Advisor for academic support.

Upon successful completion of the course, you will be awarded a certificate of completion. In addition, you will receive an exam voucher for the Certified Professional Medical Auditor (CPMA®) Certification Exam, offered by the American Academy of Professional Coders (AAPC) after successful completion of the course and financial obligation.

This course will provide you with the skills you need to obtain an entry-level position in most cases. Potential students should always do research on the job market in their area before registering.

This course is non-credit, so it does not qualify for federal aid, FAFSA and Pell Grant. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses. Additionally, some students may qualify for financial assistance when they enroll, if they meet certain requirements. Financing is available from select schools. Learn more about financial assistance.

If you have questions that are not answered on our website, representatives are available via LIVE chat. You can also call us at 1-877-221-5151 during regular business hours to have your questions promptly answered. If you are visiting us during non-business hours, please send us a question using the "Contact Us" form.

American Academy of Professional Coders (AAPC)
The American Academy of Professional Coders (AAPC) is one of the world's most recognized institutions for professional medical coders, with more than 175,000 members. The AAPC offers more than 30 certifications that include medical billing and coding, compliance, and management, among other topics. These certifications are an excellent way to prove you have a working knowledge of specific aspects of healthcare, and the skills you need to practice in the field. All AAPC certifications share a common goal: help everyone from beginners to experienced professionals advance their careers and contribute positively to the industry.