Certification Training - Medical Coders, Billers Auditors

Need for CHRP –

• To understand the basic terminologies in Medical Billing, steps involved in a claim cycle, all that is required to submit a claim.
• It helps in understanding the basic difference between the process handled in Abu Dhabi and Dubai in a claim cycle
• It educates on the various methods of Insurance Payment Methods both Medical & Dental with Respect to Abu Dhabi and Dubai.
• Explains in detail the various billing adjudication rules of each Section of CPT as per the regulators (DOH/ DHA).
• To introduce the learner to the world of codes which is used to interpret various diseases and procedures.
• To educate about the navigation of CPT 4, ICD 10 CM, HCPCS codes and how to decide on Principal and Secondary diagnosis.
• In detail the different methods of Submissions in Abu Dhabi (Shafafiya) and Dubai (eClaim).
• Based on Insurance denials, how to analyze and decide on Resubmission. To identify when a claim should be moved to Reconciliation.
• The violations standards of DHA & DOH and application of compliance rules to different Specialties

Eligibility – Any Bachelor’s / Master’s degree approved by the respective country
Contents –
Introduction
Module 1 – Introduction of RCM
Module 2 – Coding Concepts
Module 3 – Insurance Protocols
Module 4 – Billing Regulations & Compliance
Module 5 – RCM Operations (Submissions, Denials, Re submissions, Reconciliations)

Need for CHRS –

• To revise and to have an overall understanding of the RCM Audit Process.
• To redefine career as an Auditor in RCM Healthcare.

Eligibility - Any Master’s degree approved by the respective country or must have completed CHRP or have minimum 2 years experience in RCM healthcare in UAE or any country. With qualifying an aptitude test.

Contents –
Module (1 - 5) - Refer 5 Modules of CHRP
Module 6 - Audit Methodologies / Medical Records / Compliance/ Risk Assessment
Module 7 - Jawda indicators & Audit Tools

Need for CHRE –

• To shift from one vertical to another being a Manager.
• To get oriented with various functions or verticals of RCM if from another vertical.
• To launch a career as an Executive – either a Manager or any equivalent state.

Eligibility – Any Master’s degree / CHRP course + 3 years of RCM experience or one who Completed CHRS Course + 2 years of experience or minimum 5 years of RCM experience.

Contents -

• Modules 1- 5 of CHRP
• Modules 6,7 of CHRS
• Module 8- Stabilization & Sustaining Revenue in the Organization – Methods/ Obstacles with Case studies.
• Module 9 - Leadership in RCM /Attributes (Soft Skills) of an efficient Manage

Need for ICD 10 AM –

• Job Opportunity for a fresher in the respective Nation or a migrant looking for a job abroad in ICD 10AM practicing countries.
• To gain knowledge on ICD 10 AM for proper claim submission by a current coder
• To add a feather to the cap as certification for a coder of any nation.

Eligibility –

• Fresher looking for a job
• Coder who wishes to migrate
• Need for a Coding Certification

Content –

CC1 - Introductory course consists of Clinical Coding for the following subjects:

• Endoscopy
• Oncology
• Accidents and incidents
• Endocrine
• Ophthalmology and ENT
• Digestive (including dental)
• Urinary and male reproductive
• Gynaecology
• Bones muscles skin and nerves
• Cardiovascular

• Psychiatry
• Infectious
• Respiratory
• Oncology haematology and immunology
• Accidents and incidents
• Endocrine
• Digestive
• Genitourinary
• Gynaecology
• Bones muscles skin and nerves
• Cardiovascular
• Obstetrics
• Paediatrics

To get educated on ICD 10AM analyzing the differences between CM and AM. To convert CM certification to AM one.
Eligibility-
CPC / CCS/ CPMA or any equivalent Coding Certification

Need for Conversion Course -

• To get Certified in ICD 10 AM/ ACHI/ ACS.
• To gain a suitable job in Hospitals and Clinics using ICD 10AM

CPC / CCS/ CPMA or any equivalent Coding Certification Content- Conversion from CM to AM +Intermediate Course (CC2)
1. Conversion Course (CM to AM) Topics

• Introduction to AM, ACHI &Clinical Documentation for AM
• Coding Essentials
• Digestive
• Endocrinology
• Oncology, Haematology, Infections
• Cardiovascular
• Psychiatry
• Obstetrics & Gynecology
• Injury, Poisoning & External Causes
• Other Specified Standards
• Paediatrics

2. Intermediate Course – CC2 Topics-

• Psychiatry
• Infectious
• Respiratory
• Oncology, Haematology & immunology
• Accidents and incidents
• Endocrine
• Digestive
• Genitourinary
• Non acute care
• Bones muscles and nerves
• Cardiovascular - Heart
• Obstetrics
• Paediatrics
• Neurology
• Vascular 

Need –
To educate nations adopting a new Healthcare System
To participate in the mission of WHO in introducing a new Coding System

Eligibility-
Job Seekers, Experienced Coders who would want to update their Coding Knowledge
Coders of the Country where ICD 11 is decided to be implemented.

Contents- ICD 11/ ICHI/ ICF
ICHI-

• 1 - Interventions on Body Systems and Functions
• 2 - Interventions on Activities and Participation Domains
• 3 - Interventions on the Environment
• 4 - Interventions on Health-related Behavior

ICD 11 Topics-

• Certain infectious or parasitic diseases
• Neoplasms
• Diseases of the blood or blood-forming organs
• Diseases of the immune system
• Endocrine, nutritional or metabolic diseases
• Mental, behavioral or neurodevelopmental disorders
• Sleep-wake disorders
• Diseases of the nervous system
• Diseases of the visual system
• Diseases of the ear or mastoid process
• Diseases of the circulatory system
• Diseases of the respiratory system
• Diseases of the digestive system
• Diseases of the skin
• Diseases of the musculoskeletal system or connective tissue
• Diseases of the genitourinary system
• Conditions related to sexual health
• Pregnancy, childbirth or the puerperium
• Certain conditions originating in the perinatal period
• Developmental anomalies
• Symptoms, signs or clinical findings, not elsewhere classified
• Injury, poisoning or certain other consequences of external causes
• External causes of morbidity or mortality
• Factors influencing health status or contact with health services
• Codes for special purposes
• Supplementary Chapter Traditional Medicine Conditions - Module I
  • V Supplementary section for functioning assessment
  • X Extension Codes

ICF –

• Musculoskeletal Conditions
• Neurological Conditions
• Mental Health
• Other Health Conditions
• Diverse Situations
• Cardiovascular & Respiratory Conditions
• Cancer

Need –

• To become a RCM Healthcare Auditor in UAE
• To learn the various Auditing methods across the Nation
• To efficiently apply Auditing techniques based on Regulatory guidelines and Coding Guidelines

Eligibility –

• Any one interested in becoming an Auditor with minimum 2 years of experience in any vertical of RCM.

Contents –

• Compliance & Regulatory Guidelines
• Medical Record Standards & Documentation Guidelines
• EM Coding Guidelines +DSL codes
• Coding & Reimbursement
• Audit, Scope & Statistical Sampling Methods
• Risk Analysis & Communication
• Case Studies