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Please Note: It
is assumed at all Certified RN-Auditor Institute registrants have a
basic understanding of medical coding, CPT, ICD9 and HCPCS.
The reality of the
healthcare system in the United States today is that the medical
record is no longer used only to support patient care. Today, what
is contained in the medical record is used as an audit tool to
demonstrate that services were provided, as well as reasonable and
medically necessary. More than ever before, the patient's chart will
provide the necessary information for coding and reimbursement of
hospital and physician services.
Usually working
independently under indirect supervision of the hospital CFO, the
RN-Auditor® audits medical charts and records for compliance with
federal coding regulations and guidelines. The RN-Auditor® uses
clinical knowledge of procedures and diagnoses to (1) assure
everything provided to the patient has been documented, then (2)
provides a second level review of codes assigned to medical
diagnoses and clinical procedures, ensuring that medical billing
conforms to legal and procedural requirements. The RN-Auditor®
reviews, develops and/or modifies client procedures, systems and
protocols to achieve and maintain compatibility with Medicare
billing requirements and compliance standards.
In the unique
RN-Auditor® Boot Camp, whether you are currently or working towards
becoming a provider auditor for the hospital/physician industry, or
a cost containment auditor for the health insurance industry, this
course will give you the following basic information, leading to the
certification by the
American Association of Clinical Coders & Auditors, the nation’s
only certification body for clinical coders and auditors. AACCA is
non-profit, tax-exempt 501(c)6 and is a member in good standing of
NOCA – the
National Organization of Credentialing Agencies, Washington, D.C.
RN-Auditor® Course Outline
Each day runs 8am to
5pm (and sometimes until 5:30pm). Please be on time each day, with
all your materials and homework/questions ready to go. Please bring
the required coding manuals to class each day. There is
approximately 1.5-2 hours of “homework” each evening. There are 2
15-mnute breaks AM/PM (snacks provided), and lunch is on your own
To print
the syllabus, please go to "file" on the top left of your web
browser window and select "print."
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Day 1 8am - 5pm |
Day 2 8am - 5pm |
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Introduction to the Chart Audit – Emphasis is on
Medicare Compliance, Coding, and Reimbursement. Status and
Role of the Certified RN-Auditor®. Job Descriptions. What is
Auditing vs. Monitoring? |
Coding Operative Reports – Why the Chart Must be
Complete, How CPT Must Mesh with ICD-9 for Accurate
Reimbursement. Developing Relationships with Clinical
Department Heads. |
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Day 3 8am - 5pm |
Day 4 8am - 5pm |
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Inpatient vs. Outpatient Diagnostic Coding Guidelines,
Inpatient vs. Outpatient Procedural Coding. Affects of HIPAA
on Coding and Reimbursement. Practical Resource Tools. More
Operative Report/Auditing.
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Medicare and Other Third-Party Reimbursement.
Inpatient Payment System vs. Outpatient Payment System.
Implementing an RN-Auditor® Controlled Revenue Management or
Cost Containment department. More Operative Report
Coding/Auditing. |
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Day 5 8am - 5pm |
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Fraud & Abuse – Definition, examples, OIG
Compliance Program for Hospitals. Do Other Payers
Utilize Medicare Guidelines? More Operative Report
Coding/Auditing. |
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40 CE
Contact Hours (CA BRN #13482) This is an
accelerated program for RNs and other clinical personnel. Because
of the RN-Auditor® Boot Camp’s fast-paced schedule, it is highly
recommended that all Boot Camp registrants have at least one year of
coding experience. While prior inpatient or outpatient coding
experience is helpful, this Boot Camp is also designed for clinical
individuals who are interested in developing their coding and
auditing skills for Medicare compliance and reimbursement. This
Boot Camp is also ideal for individuals either already handling cost
containment management or who would like to have a career as an
RN-Auditor® with a third-party payer.
Homework is assigned each evening for the next day's discussion. It
is important to complete all assignments before coming to class, in
order to get the most out of the lecture and assignments each day.
Please plan for 1-2 hours reading & assignments.
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Independent Study is an important part of completing this
program. Please plan to put in at least 2 hours daily to
complete the RN-Auditor®
Boot Camp assignments, Final Exam, and all readings. It is
important that you choose a Certification Exam date/location
and register for it as soon as possible. The
AACCA
requires a minimum 30 days' in advance registration,
but we recommend registering at least 45 - 60 days in
advance. If you have not heard from
AACCA
within 2 weeks after sending your Exam Application packet,
CONTACT AACCA's
Exam Office. Be sure they have received your information
& have them give you the Proctor's Name, Address, and Phone.
Often the location of the exam is not disclosed except to
those who are taking that exam. |
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