RHC Network Billing & Coding Boot Camp

This class is specifically designed for clinical personnel (MD, DO, NP, PA, RN), coders, billers, EHR professionals, facility and financial managers that work in RHCs, and look-alikes to encourage building a shared foundation of knowledge. Though this class is designed to help facility managers and revenue cycle staff to pass the optional certification exam to become a Rural Health - Coding & Billing Specialist (RH-CBS), we urge clinical personnel to attend as well since clinical documentation is key to everything, as is building a shared foundation of knowledge. Arch-Pro will provide action items and how to “get results” by working together through hands-on practice.

The Critical Need for RHC Specialized Training

Who needs training on RHC documentation, coding, billing, and quality reporting? With the recent requirement by CMS to require RHCs to list all CPT and HCPCS-II codes, it has never been more important to make sure you are documenting and coding for 100% of what is done. If you aren’t documenting and coding correctly you may not be capturing everything that is done and some revenue may be left on the table! Your cost report is tied to your professional coding practices – don’t undervalue and underreport what you do.

Recently, RHCs had to start listing all CPT and HCPCS-II codes performed on claims to Medicare for the first time in decades. Many RHCs are still learning to balance the AIR (“per diem”) Medicare system of getting paid with the huge billing variations when billing commercial carriers or Medicaid. To ensure compliance and revenue integrity, consider these vital questions:

• Do your providers, managers, and coding/billing/quality staff have a shared foundation of knowledge?
• Do your clinical providers know the documentation rules related to capturing the valuable services they provide?
• How confident is senior management that the RHC is not under-valuing their "true costs" on the annual cost report?
• Does your RHC have a full record of each service provided (CPT/HCPCS-II codes) and why they were done (ICD-10-CM codes)?
• Are you generating all of the revenue that you are entitled to when billing non-Medicare/Medicaid payers?
• Are you reporting quality measures related to Shared Savings, Risk Adjustment, HCCs, or other Quality Improvement programs?

Curriculum and Hands-On Approach

We will focus on the guidelines that appear before and after key coding sections that are rarely accessible to providers and coders/billers in their EHRs and encoder software. We will limit the review of codes that will rarely or never be performed in your facility setting and will focus on primary care visits, behavioral health, and preventive services. We will be careful to get hands-on with over a dozen vital resources, including the CMS Benefits and Claims manuals, that outline the unique approach rural health needs to be aware of to stay compliant!

Earning the Rural Health Coding and Billing Specialist (RH-CBS) Certification

Upon completing the live class authorized attendees will be able to take the Rural Health Coding and Billing 100 question online certification examination. Following the in-person class you will have access to a practice exam plus the option to take an online examination to earn a certification as a Rural Health - Coding & Billing Specialist (RH-CBS). The exam is scored immediately and if a score of 70% is achieved, a certification will be granted by the Association for Rural & Community Health Professional Coding. Full attendance of the live training session includes a one-year membership if you pass the optional exam.