Jan Hailey CMC, CMIS, CMOM, CMCO

Jan Hailey has more than 20 years of experience in healthcare with proficiency in administration, coding, and billing roles. She joined Saint Joseph Physician Network located in Mishawaka, IN as the Director of Quality in November 2015. In 2019, her role transitioned into Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. This transition allowed for her expertise to expand beyond the physician network to lead a comprehensive interdisciplinary team across the health system and work closely with providers, management, staff, community and payers to develop strategies on process improvement, gap closures and patient experience.  

Jan also developed a documentation improvement program and is currently implementing an education program for Hierarchical Condition Category (HCC) coding in order to improve risk scores. She holds four professional certifications in office management, coding, and compliance. She is a member of WPS Medicare’s Provider Outreach and Advisory Group, Indiana Association for Healthcare Quality.

Jan has a passion for teaching and facilitates educational programs nationwide. Prior to joining Saint Joseph, Jan was the Director of Quality, Coding and Compliance for one of the largest health systems in Northern Indiana.

 This course provides the knowledge and tools needed to internally monitor billing compliance. 

This content covered in this course assumes a basic level understanding of E/M coding and documentation.

Highlights:

• Step-by-step explanation of documentation guidelines
• The down side of using EMR templates for E/M code selection
• Select proper E/M code for location and type of service provided to the patient
• Explanation of proper add-on code usage
• Look at appropriate codes for work performed by ancillary providers
• Instruction of diagnosis codes indicating level of necessity
• E/M coding grids to aid in accurate level of service selection
• Documentation necessity in the medical record
• Correct use of Level II CPT® modifiers
• How documentation is used to record the complexity of medical decision making
• The role of history and exam
• Review examples of chart notes to identify potential problem areas