Certification Training

Deborah McNeilance and Jan Hailey

Deborah McNeilance, MBA-HCA, CMC, CMIS, CMOM, CPC

Deborah McNeilance is an enthusiastic and knowledgeable professional with more than 35 years in the healthcare field. She holds a Masters of Business Administration with a focus in Healthcare Administration and currently serves as the CEO/Administrator for a large Gastroenterology practice. In her recent past, she was a director for a large healthcare network of physicians specializing in hematology-oncology and surgical oncology.

She has served as an administrator for several medical group practices in Cardiology and Medical Oncology where she was responsible for business operations, financial management, risk management, and marketing. She has gained insight into hospital operations working with the billing department, human resource department and managing the medical records/transcription department.

Deborah was the president and CEO of Med-Line Transcription where she began a medical transcription service offering support to over 400 physicians. Her main responsibilities included business development, project management, consulting, and implementation. She is an implementation specialist who is able to assess practice needs and provide support and follow-up to improve practice efficiencies and operations.

Deborah believes in the importance of mentoring team members to think big and broaden the limitless impact one can have on society and within a healthcare organization one patient at a time. She enjoys sharing her knowledge with others in the healthcare field who are interested in achieving their dreams and goals.

Jan Hailey, MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M

WorkForce Initiatives

Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.

Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.

Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.

Phase one of the training:

Certified Medical Office Manager

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.

Practice Administration

• Review of practice administration role and responsibilities
• Facility, operational, and time management
• Review of practice administration roles and responsibilities
• Facility, operational and time management
• Employee relations, laws and guidelines
• Employee handbook and business policies
• Administration of medical records and patient relations
• Labor regulations and reporting requirements
• Terminating the patient/provider relationship
• Risk Management and Quality Assurance
• Sexual harassment, discrimination, and substance abuse

Personnel Management

• Creating effective job descriptions, interviewing, and hiring tips
• Team building and managing conflicts
• Handling staff grievances, evaluations and performance issues
• Compensation and benefits packages attract talent and minimize turnover
• Proper maintenance of employee personnel files (e.g. Form I-9)
• Goal setting and conducting effective staff meetings
• Termination procedures and the exit interview
• Physician and staff retention and motivation
• Coping strategies for difficult employees
• Leadership vs Management

Financial Management

• Financial planning, calculations, and controls
• Examining contracts and fee schedule
• Patient education, verification, and collections procedures
• Accounts receivable, status and activity reporting
• Developing and maintaining a budget
• Revenue and cost accounting
• Maximizing cash flow and controlling overhead
• Cost analysis, forecasting, and new revenue streams

Compliance Requirements

• MACRA and the Quality Payment Program
• HIPAA and OSHA compliance
• Implementing the OIG's recommended compliance program
• Policies and procedures that inhibit fraud/abuse
• Identifying and controlling the risk of medical identity theft
• Legal protections, risk management, and compliance checklists

Payment Models

• Physician credentialing and privileging
• Payer contract evaluation, negotiation, and termination
• Calculating the right patient-payer mix for your office
• Physician Utilization Committee review process
• Utilization control techniques
• HMO, IPA, MSO, PPO definition, purpose, and analysis
• Assigning an internal managed care coordinator
• Health insurance exchanges
• Value-based care and quality metrics
• Coordination of benefits
• ACOs and Patient-Centered Medical Homes

Phase two of the training:

The Business of Oncology

Managing an oncology practice is extremely complex and requires extensive knowledge in the areas of finance, leadership, regulations, purchasing, physician recruitment and revenue cycle management. The constant changes in healthcare can make it challenging to provide a quality patient-centered focused practice. In this world of value-based reimbursement, new and emerging therapies, precision medicine, and even Artificial Intelligence, it is imperative that we move to a more standardized, yet comprehensive approach in managing an oncology practice so as to ensure we are treating every patient with the best quality of care while staying current with advances in technology as well as advances in treatment. This portion of the certification will cover:

• Dealing with physician burnout
• Physician contracting
• From Volume to Value
• Precision medicine
• Telehealth
• Oral Oncolytics and patient monitoring
• Pharmaceutical contracting
• A 340b drug program
• Provider-Based Billing (PBB)
• Clinical trials
• Avoiding financial toxicity
• Revenue cycle management and reimbursement challenges
• The role of a Nurse Navigator
• Palliative care
• Survivorship clinics in the Oncology practice
• USP 797, 800 and 825 requirements
• The role of advocacy
• The patient experience

“The knowledge gained from the CMOM-HEM/ONC certification course has instilled a new and greater confidence in our team. This investment to enhance our practice managers has increased their value and improved team morale. They have bonded as a cohort and work better together to solve challenges. In addition, over the course of the training series, practice managers have become more effective in their roles, and the overall performance of each of our clinics has improved, with many stars shining among them.”