Online Training Course

Jan Hailey MHL, 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.

Participants will learn the value of an internal self-audit protocol and be in a position to discover missed revenue opportunities when auditing charts based on fact.

This is a basic-level course. Content assumes basic knowledge of medical charts and coding of E/M claims. Self-provided, current year coding books are required: CPT® and ICD-10-CM to participate in audit practice exercises.

This program will demonstrate a step-by-step process to implement an internal audit program. Adopting a systematic approach to cross-checking records ensures that you always know where you stand and improves communication with providers and staff.

• Verify that chart documentation supports claims submitted
• Determine whether appropriate levels of service are billed
• Review levels of history, exam, and medical decision-making
• Identify how to properly evaluate the nature of the presenting problem
• Check billing for prolonged services plus other E/M services
• Uncover revenue holes and improve the practice’s bottom line
• Expert guidance on key components and potential problem areas

Self-paced online program includes unlimited review of previously recorded instruction for 6 months and a downloadable e-manual.