Online Training Course

Jan Hailey MHL, CMC, CMCO, CMIS, CMOM

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.

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.