Certified Professional Medical Auditor – CPMA

Pre-requisites:

Strong background in Anatomy and Medical Terminology Highly Recommended

Skill Level:

Advanced

Course Hours:

40 Course Hours

Target Audience:

Medical Coders, Auditors, Billers

Summary:

In this course you will obtain skills required for conducting medical auditing and abstraction of coding and billing for medical claims in connection with fraud, abuse, risk analysis and governmental and payer guidelines.

Course Outline:

• Review of Compliance and Regulatory Guidelines
• Fraud and Abuse
• False Claims Act
• Anti-kick back and Stark Law
• OIG and CMS regulatory requirements
• Medical Record Documentation Standards
• HIPAA Privacy Regulations
• Coding and Reimbursement Concepts
• Auditing Processes
• Statistical Sampling Methods
• Risk Analysis and Communication
• Validating Audit Results
• Practical Application Exercises