Medical Auditing, Certificate (Online)

Overview

This is a new program in development. It is scheduled for 2019.

Labouré College’s Medical Auditing Certificate program is offered 100% online. The program includes five courses and one capstone project and can be completed in less than one year. The College’s program is currently the only online program that prepares students for both national exams, CMAS from AAMAS and CPMA from AAPC, to earn the credentials of Certified Medical Auditing Specialist and Certified Professional Medical Auditor.

Program Outcomes

1. Explain the reasons for and benefits of auditing medical records.
2. Discuss the role of the medical record auditor.
3. Describe the documentation requirements for inpatient and outpatient medical records.
4. Discuss the definition of the “medical necessity” concept and documentation.
5. Describe verification of charges based on documentation in several levels of healthcare services in qualitative and quantitative methods.
6. Describe the seven steps of the basic audit process.
7. Describe the differences between coding and auditing.
8. Compare internal and external audits.
9. Discuss the process and purpose of monitoring and auditing.
10. Discuss the reporting requirements for the analysis and the summary report of an audit.
11. Describe the basic components of a monitoring program and the corrective action plan.
12. Perform practice E/M and Medicine coding and complete the initial steps of an audit.
13. Describe each step in the audit process.
14. Describe risk assessment surveys and compliance audits.
15. Describe how to prepare and submit cost benefit and financial impact analysis reports.
16. Develop education and training sessions for staff.
17. Practice writing appeal letters.
18. Introduce and practice how to review and maintain charge description master (CDM).
19. Apply medical necessity rules in audit activity.
20. Prepare audit tools.
21. Develop sample compliance program.
22. Recommend/monitor disciplinary and corrective action plans.
23. Complete a practice medical audit and provide its presentation.
24. Explain the impact of the OIG Work Plan and Corporate Integrity Agreements (CIAs).
25. Identify National Correct Coding Initiative (NCCI) and Medically Unlikely Edit (MUE) risk areas.
26. Identify the purpose of recovery audit contractors and how to prepare for potential RAC audits.
27. Explain the types of audits and the resources required for audits.
28. Define steps of the audit process and identify statistical sampling types and factors.
29. Explain aggregate analysis and when it is useful.
30. Explain the importance of discussing audit findings with the provider.

Program of Study

While the College makes every effort to avoid schedule changes, the College may cancel courses or alter course schedules without prior notification.

Semester I

AUD 1000	Health Information Standards and Guidelines	3
AUD 1200	Health Information Management	3
AUD 1300	Audit Process, Work Flow, and Audit Findings	3

Semester II

AUD 1400	Medical Audit Management	3
AUD 1500	Professional Standards & Leadership	3
AUD 1600	Capstone Medical Audit with Presentation	1