CERTIFICATIONS: AAPC & AHIMA

 The Certified Professional Coder (CPC) is the gold standard for medical coding in a physician office setting. The CPC certification exam tests the competencies required to perform the job of a professional coder who specializes in coding for services performed by physicians and non-physician providers (eg, nurse practitioners and physician assistants). Individuals who earn the CPC credential have proven expertise in physician/non-physician provider documentation review, abstract professional provider encounters, coding proficiency with CPT®, HCPCS Level II, ICD-10-CM, and compliance and regulatory requirements for physician services. 

Medical auditing is a critical piece to compliant and profitable physician practices. Whether the audit purpose is Recovery Audit Contractor (RAC) audits, private payer denials, or just peace of mind, physicians have audits conducted regularly. The risks of being non-compliant with documentation and coding are too costly. As a CPMA, you will use your proven knowledge of coding and documentation guidelines to improve the revenue cycle of nearly all types of healthcare practices.

With tighter regulation on reporting medical services, there is a growing demand for CPMAs. They have a clear understanding of when and where an organization is at risk for non-compliance. CPMAs help providers avert liability and secure proper reimbursement for their patient care.

Experienced evaluation and management (E/M) coders are encouraged to sit for the CEMC exam. CEMC certification demonstrates proficiency applying correct ICD-10-CM, CPT®, HCPCS Level II, and modifier assignment when reporting evaluation and management services. The CEMC certification validates command of E/M medical decision making (MDM) and time guidelines, which pertain to multiple specialties.

An additional certification like this is a smart career move. Year after year, our salary surveys show that the more credentials you have, the higher your salary potential.

 The Certified Professional Biller (CPB) credential demonstrates skills related to maintaining all aspects of the revenue cycle, particularly patient and payer billing and collections. Without expertise in medical billing and the nuances of payer requirements, healthcare provider reimbursement may be compromised.

Through rigorous examination and experience, CPBs have proven knowledge of how to submit claims compliant with government regulations and private payer policies. They follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. The CPB medical billing credential is vital to the financial success of the professional healthcare services claims process.

 With some physicians choosing to join hospital groups over private practices, the need for certified outpatient coders continues to escalate, making COC certification a smart career move. A COC certification demonstrates your mastery of outpatient hospital coding, including working knowledge of ambulatory payment classifications (APCs), payment status indicators, and Medicare severity-diagnosis-related groups (MS-DRGs). Coders who earn their COC credential go on to report outpatient services in a variety of settings, such as:

• Hospital emergency departments
• Outpatient hospital clinics
• Outpatient therapy departments
• Outpatient cancer centers
• Dialysis services
• Outpatient radiology departments
• Ambulatory surgery centers

Managing a physician's office requires a wide range of skills. The responsibilities are broad and require detailed management of multiple processes, including the revenue cycle, compliance regulations, human resources, health information, and general business processes. Practice management can be a challenging yet rewarding profession.

The Certified Physician Practice Manager (CPPM) credential is a logical next step for individuals with a lot of experience in many areas of healthcare and who are ready to advance their careers into a physician practice management position. Experienced practice managers will benefit from the broadened skillset and validation of their knowledge and expertise in this profession.

 Coding specialists are skilled in classifying medical data from patient records, often in a hospital setting but also in a variety of other healthcare settings. The CCS credential demonstrates a practitioner's tested skills in data quality and accuracy as well as mastery of coding proficiency.

The CCS certification is a natural progression for professionals experienced in coding inpatient and outpatient records. Coding specialists create coded data used by hospitals and medical providers to obtain reimbursement from insurance companies or government programs such as Medicare and Medicaid. Researchers and public health officials also use this data to monitor patterns and explore new interventions.

 Coding professionals who hold the CCA credential have demonstrated coding competency across all settings, including hospitals and physician practices. Since 2002, the CCA designation has been a nationally recognized standard of achievement in the health information management (HIM) field. 

 Coding specialist – physician-based professionals perform coding in physician offices, group practices, multi-specialty clinics, or specialty centers. The CCS-P certification exam assesses mastery-level proficiency in coding of health services delivery beyond the hospital setting.