The CMCA-E/M is tailor-made for provider offices. Learn how to analyze medical records to determine whether the documentation supports CPT and medical necessity, and minimize risks associated with outpatient E/M claims. The curriculum places emphasis on evaluation and management coding rules, medical necessity, and proper E/M code selection.
Participants will learn how to identify documentation deficiencies, as well as consequences and penalties for improper payments for E/M services. The detailed course workbook includes audit tools for hands-on practice.
Course Outline:
Course materials include a manual with coding guidelines, reference documents from the OIG and CMS, step-by-step auditing tools, and case studies.
“A clean claim should be paid in about 15 days. If a claim is denied, it could take anywhere from 30-120 days to get it paid. It takes a team to code properly and routine audits are an essential part of a healthy revenue cycle. More of our coding positions now require auditing skills.” - Libby Purser, CHI, CMC, CMIS, CMOM, CPC, CRC HIM Supervisor for a North TX multi-specialty provider network
“The Office of the Inspector General says if you bill Medicare, your coding compliance plan should include regular auditing and monitoring. If improper payments are detected and an auditor contacts your office, your best line of defense is to have established practice standards and procedures, training and education, and transparency. Even honest mistakes can trigger an audit. If your office gets on the radar of RACs, ZPICs, UPICs and other contractors commissioned by CMS, they will request the documentation that supports the claims for reimbursement that you have submitted to the Medicare program. If it’s not yours, you’ve got to pay it back!” - Robert W. Liles Managing Member of Liles Parker, PLLC, Washington D.C.
“In 2015, it was imperative that Hendrick locate a well-established, EXPERT training partner to instruct our providers in ICD-10 E&M coding. After an extensive search and interview process, PMI was the clear choice. The training and certification opportunities with PMI allowed Hendrick Provider Network to build and implement career ladders for numerous employees. In turn, these educational and career ladder opportunities have driven greater employee confidence, increased employee and physician engagement and ultimately created superior patient confidence and satisfaction in their entire healthcare team.
As a result of our continued partnership with PMI, Hendrick has been able to provide 17 employees with CMC certification, 17 employees with CMOM certification, 8 employees with CMCA-EM certification, 35 employees with Medical Front Office Skills certification and 11 employees with CMCO certification, and we look forward to our continued partnership with PMI. Together, we can make significant strides in healthcare education which will ultimately help provide better patient care.” - Marjohn Riney, BA, CMPE, CMCO, Operations Manager, Hendrick Health Abilene, TX
The CMC online preparatory course consists of 21 hours of high-level coding instruction and practice exercises led by a PMI-approved Instructor.
Course Outline:
ICD-10-CM Coding
Procedural Coding - CPT® and HCPCS
Ancillary Services & Advanced Coding
“We hire a large number of remote coders. We recently considered a few of your credentialed coders and I have been extremely impressed. All of them scored far higher on our tests than anyone. Just as a reference, they basically outscored more than 350 other coders.” -Doug McDonald, Outcomes Health Information Solutions, Inc.
“I came into this area after working at front desk scheduling. I was not sure of the requirements for Evaluation and Management codes, proper listing of diagnosis codes, etc. After taking your class, I realized how important the billing coder really is…. learning to read the office/hospital notes, what most insurance companies require for correct billing and how to provide this within a proper time frame. Medical terminology is also a very important aspect of coding. The wrong suffix or prefix can change the diagnosis.
Your class has allowed me to understand and to better code our office billing claims, coding to the highest degree possible. This has translated into fewer questioned claims by insurance companies, faster payments and more income. It has made my job easier and encouraged me to learn more.
I value the extra classes offered to keep medical professionals up to date with the current changes in medical coding, billing, and office management. I look forward to expanding my knowledge in this area.” - Carol Hicks, CMC
“I could not believe I learned so much in such a short time. The teacher was wonderful, and I received my certificate right on time!” - Missy Davis, CMC, Urology Associates of Central California
“I just wanted to take a moment and share with you how thankful I am for you guys. We honestly have been so anxious about the impending ICD10 roll out and have had a lot of anxiety with our Practice Software upgrades and changes. We’ve been trying to get prepared and I honestly can say that Pam coming here to guide us and teach us as a team and practice has been so critically necessary. We feel as though Pam had an amazing insight, great resource, and a perfect teacher for us. Thank you both for your efforts on getting "operation ICD10” underway with our practice. Couldn’t have done it without you guys!” - Chaya Burson, Office Manager, Barker Bariatric Center, Dallas, TX
“My previous job was Practice Administrator in an OBGYN practice for 17 years. PMI was responsible for my landing a fantastic job as Director of Billing at a very large Neurosurgery practice. One of the requirements was being a certified coder. I am very grateful for PMI. I have learned skills that have made me marketable and a great success in the field!” - Naomi Ziemba, CMC
“I wanted to share my comments on why it is so important to be certified in the medical field these days. I am a certified medical coder & have received my CMC thru PMI in August of 2006 with the help and hard work of my instructor Rose Moore. I recently made the move from Danville VA to Rock Hill SC. My certification played a major role in why I was hired in May 2009 with my employer here in Rock Hill SC. Also, the economy was uncertain in early 2009. I was offered a great job at Digestive Diseases Associates at their newest state of the art Endoscopy Ambulatory surgery center in Rock Hill. The physicians here told me that being certified is very important because it shows that an employee is not only qualified for the job, but also cares about the job that they are hired to do.
So, when it comes to getting that certification in your field getting there is a commitment and you also will have a great time doing it! And all of the people you meet makes it all the more fun and interesting!” - Patty Tesch, CMC Rock Hill , SC
“I found the class very helpful. It showed me how to use the coding books properly and research details. Thank you again for being a gracious host!” - Cecelia Alviderez, CMC, Biller, Fresno Nephrology Medical Group
“The instructor was great! I really liked that the curriculum was based on how the structure of the exam would be.” - Christina Soriano, CMC, Billing Supervisor, Omni Women’s Health Medical Group
Roles and Responsibilities
Compliance
Basics of Health Insurance
Medical Documentation
ICD-10-CM Diagnostic Coding
Procedural Coding
Claim form CMS-1500
Electronic Data Interchange: Transactions and Security
Receiving Payments and Insurance Problem-Solving
Office and Insurance Collection Strategies
Managed Care Plans
Medicare
Medicaid and other State Programs
Workers' Compensation
“I just wanted to share with you all the positive outcomes of our employees since we started this program. Our employee morale has increased. Our employees feel more confident in answering questions from the patients. There is a sense of pride in their work and work ethics. They all have placed their certificates up in their working areas. There has been appreciation in the quality of education they each have been receiving. We have enjoyed the program and look forward to future training with you all. On behalf of HQ Chiropractic, we want to thank you all for the time invested to better educate our employees.”
- Betty Quiroz, HQ Chiropractic, Odessa TX
"So glad we have had the opportunity to connect with PMI again. It has been a pleasure working with you and the whole team at PMI. Your team makes it so easy for us to offer quality seminars at St. Vincent Evansville. We are looking forward to continuing the relationship with PMI.”
- Julie Morrow, Physician Liaison | Strategy
"Washington County Community College (WCCC) is delighted to be working with PMI to prepare learners for exciting career opportunities in the medical field while working to meet workforce challenges here in Maine. This exciting partnership with PMI allows us to offer relevant and rigorous coursework taught by national leading experts, specifically in the field of Medical Coding and Billing. PMI shares many of the same fundamental educational beliefs and practices around a commitment to learner success, individualized learning assistance, and high standards of course content. Because of this, we are looking forward to expanded partnership around professional development and re-certification courses."
- Nichole Sawyer, Dean of Workforce and Professional Development, Washington County Community College
Five hours are allotted for the certification exam and a score of 70% or better is required to earn the CMCO certification. If a passing grade is not achieved on the first attempt, candidates may re-test for an additional fee.
“I just wanted to express my thanks to you, the staff at PMI, and the facilitators who conducted the training; Robert Liles and D. K. Everitt. They were both outstanding instructors and made our week together both informative and enjoyable. I took away a tremendous amount of information which will be extremely useful as I continue my work as a Physician Practice Advocate and Educator. I look forward to future PMI seminars and training events and will definitely recommend your sessions to my colleagues.” - Joe Maruk, CMCO
“As physicians, we are just not prepared to deal with all of the laws and regulations that the Office of the Inspector General (OIG) expects us to be compliant with. The Certified Medical Compliance Officer class teaches you how to prepare your practice for an audit by the OIG. Physicians, especially, need to be aware that each practice is responsible for the wrongful acts of its employees, and that failure to know applicable laws and statutory provisions, such as the False Claims Act, Anti-Kickback Statute, stark Laws and Fraud and False Statements, is not a defense and can lead to large monetary. Attending this class will benefit physicians who run their own practice, or who are interested in any aspect of legal compliance.” - Steven F. Crawford, M.D.; Chair, Committee on Scientific Activities; MedChi, The Maryland State Medical Society
“This was one of the most educational courses I have ever attended.” - Heather Yoo, CMOM, CMC, CMCO, Palomar Neurosurgery Center
“I wanted to take a moment and say how very much I appreciate the privilege to take the CMCO course. Wow! What a fantastic course! Robert and DK were both exceptional speakers! This course is perfect for the physician's office for compliance. The materials were well written and provided excellent explanations to the reader. I know I will refer to it often, however I know the information is subject to change. It expanded my knowledge and provided insight to things I didn't even know were important on the business side of the office.
Thank you again for the opportunity to attend this course- it truly made a difference in my career and knowledge on the business of medicine.” - Vanessa M Lankford, CPC, CMOM, AACE- CEC
“When I started in healthcare, my goal was to get a job in the front office for a year and move on to a different career path. By taking that first step into the unknown, it led me down the road of success. In my 30 year journey, I developed a passion for health care and I believe it all started in the front office.” - Ada X Gonzalez, CMCO CMOM, VP Revenue Cycle, DHR Health
Candidates will learn advanced administrative concepts and processes to become a more knowledgeable and confident leader. Improve communication with providers, staff, third-party payers, patients, and business associates. Course materials include guidelines and examples designed to improve decision-making and tactical skills.
Graduates of this program will be better prepared to manage risk, motivate employees and improve the financial outlook in a medical office.
Certified Medical Office Manager
Practice Management
Personnel Management
Financial Management
Compliance Requirements
Managed Care Delivery System
CMOM certification is a professional achievement that you can be proud of. Health systems like Sentara Health, Hendrick Health, Texas Health Resources, Houston Memorial Hermann, along with medical societies and hundreds of other health care entities across the country host CMOM and PMI continuing education training for their clinic-based managers and staff.
“I thought I knew everything I needed to perform my duties. This class was an eye-opener! I have been in my job for 10+ years and I can only wish I had taken the course back then. Incredibly valuable information no matter how much experience you have. Highly recommend.” - Jacquelyn Arzooyan, CMOM, Ann Arbor, MI
“From an employer’s perspective, it was important to set a baseline of knowledge for our managers and supervisors, and I wanted to integrate a program that was recognized in the industry. I learned about PMI and the CMOM program from a nearby university medical center that required all their office managers to be certified. The concept of having a standard baseline for competence and knowledge – something shared by peers – was an important step toward elevating manager effectiveness.” - Lindsay Usher, MA, PHR, SHRM-CP, PCC, Director of Human Resources, Northern California Medical Associates
“For over three years, South Texas College has partnered with PMI to provide training programs that directly impact the job of medical office professionals. The quality of PMI’s programs, as well as the expertise and professionalism of their instructors, is excellent. Our students are always pleased with the programs that PMI provides. We are grateful to PMI for the opportunity to partner with them and provide these services in our community.” - Olivia de la Rosa
Director- Continuing, Professional, and Workforce Education, South Texas College, McAllen, TX
“As an employer, I strongly value education and support all my staff for continued learning and updating so we can all work as a team and speak the same language! I am so grateful to PMI for really changing my life professionally as well as personally. I can work smarter not harder and have more free time with my family!” - Linda D. Parsi, MD, MBA, CPEDC, FAAP
“My experience in taking the CMOM course has not only provided me with the tools necessary to manage a practice but do it more effectively and efficiently. Before taking the course, I had a background in sales and customer service with some experience in management. Throughout the curriculum of the class, I was continuously impressed with the material covered. I have never worked for a practice or in the medical field, so it was all new, but easily adaptable.
As we went through the program, I could not imagine managing a practice without the material that is cover in the course. I truly feel it is vital for any type of practice in the medical field. As a matter of fact, the information covered can be utilized in any management role. CMOM has given me the confidence to move ahead with my goal to be in the medical field and I'm proud to be a CMOM.” - Dwayne Downs, CMOM, Newark, DE
“I can’t say enough about the professionalism from PMI during my path to excellence in becoming a CMOM. While I am happy that MultiCare Regional Cancer Center is part of a large healthcare organization, learning the components of the course has helped me to appreciate all that goes into managing a practice. I have used the education component of the program daily in my leadership role and am so appreciative to PMI for creating such an organized course. Although I will be the first in the state of Washington to obtain the CMOM-HEM/ONC certification, I am certainly talking it up to other leaders within my organization and I look to lead the way for many CMOMs to come.” - Alicia Duvall, RN, CMOM
“CMOM was a deep dive into the structure, compliance, finance, personnel, and insurance knowledge necessary to be an effective healthcare organization leader.” - Jason Buss, Bryan Health, Lincoln, NE
"The Michigan Society of Hematology & Oncology (MSHO) is thrilled to have partnered with Practice Management Institute (PMI) to help develop the Certified Medical Office Manager certification for the Business of Oncology. We chose to work with PMI because of their outstanding reputation as leaders in the industry, the rich content of the curriculum, and their expert faculty. We recognize the value it brings to our practices having their managers complete this course. Obtaining the CMOM-HEMONC certification gives managers the knowledge, skills, and experience necessary to successfully navigate today’s ever-changing physician practice/hospital. It has been a complete pleasure working with PMI and we look forward to our continued relationship." - Mary Kay Makarewicz, Executive Director, Michigan Society of Hematology & Oncology
“On behalf of the CMOM attendees and Akron General, I want to acknowledge what a fantastic job Maxine Collins has done with this week's PMI program. The attendees are having a wonderful experience and great time with Max. Her personality just lights up a room and has made this CMOM class extremely enjoyable for all the participants. A hearty thanks to PMI (and especially Max) for a job well done!!! You guys are the best!” - Dennis Nordquest, Manager, Physician Relations, Akron General Medical Center
Impacts to your reimbursement this year include a decrease in the conversion factor. The past sequester and the PAYGO rule will also have an impact on your reimbursement. Additional reimbursement considerations include the expiration of the temporary 3.75% boost provided by the Consolidation Appropriations act of 2021 (CAA). Providers could face significant cuts in payments this year and nearly all medical practices that bill Medicare should expect to feel the squeeze.
Get insight into the fate of telehealth services after the end of the public health emergency. You'll learn which codes will CMS continue to reimburse? They have retained Medicare Category 3 telehealth services, but how long will they pay for these services that appear on the list of temporary services? CMS intends for the home of a beneficiary to permanently qualify as an originating site and to lift geographic restrictions for mental health telehealth services, and even to allow the use of audio-only technology for certain mental telehealth services. What are the requirements for reimbursements for such services?
CMS plans to further delay penalties for the appropriate use criteria program for advanced diagnostic imaging services and to develop an accurate, stable payment rate for the administration of preventative vaccines under Medicare Part B. For the QPP, CMS will transition to digital quality measurement and improve the collection of social determinants of health data. Additions to the MIPS eligible clinicians list for 2022, a delay to optional MVP reporting, and continuation of the complex patient bonus will be discussed, as well as significant changes for shared services and critical care.
Highlights:
Comments from past participants:
"Excellent! The instructor was exceptionally knowledgeable and well prepared."
"The instructor did an excellent job explaining the changes and also allowed time for questions."
Changes to CPT® this year include dozens of vaccine-specific codes for efficiently reporting and tracking immunizations and administrative services against COVID-19. You will also learn about new technology services described in Category III CPT® codes and the expansion of the proprietary laboratory analyses section. The 2022 code set expands remote physiologic monitoring codes and adds new codes for principal care management services for patients with one complex chronic condition.
Summary:
Comments from past participants:
“Kem Tolliver was WONDERFUL!! She made very dry material interesting. Really good information and details!”
“I love the presenter’s style and appreciated that she did much more than read the text.”
“Kem’s background as a coder was quite evident. I would take any course she has to offer.”
