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Saudi Arabia Certification Programmes

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Introduction

Clinical coding is critical for public health reporting. It helps in the assessment of the quality of care, leading to improved health services planning, education, research, and performance monitoring.

The widely used code set for diagnoses is the International Classification of Diseases (ICD), of which the latest implemented version is the 10th edition (ICD-10). The code sets currently used in the Kingdom of Saudi Arabia are ICD-10-AM (Australian modification) for diagnosis reporting in all healthcare settings and the Australian Classification of Health Interventions (ACHI) for inpatient procedure reporting.

A comprehensive team of experts from ACCUMED Practice Management and the American Health Information Management Association (AHIMA), came together to develop the Kingdom of Saudi Arabia Billing System (KBS) in response to the requirements and compliance by the regulator that led to the development of this program.

This Outpatient Coder Certificate Program focuses on training healthcare professionals for coding in the ambulatory setting using ICD-10-AM and the Council of Cooperative Health Insurance - Billing System(CCHI-BS).

Program Overview

The Outpatient Coder Certificate Program consists of total 12 modules beginning with an introduction to each of the classifications of the Council of Cooperative Health Insurance - Billing System (CCHI-BS). then moving on to specialty-specific coding, and culminating with a practicum involving application of codes to ambulatory cases.

Those who successfully complete all 12 modules in addition to fulfilling the pre-requisite requirements of other three courses; are eligible to take the Outpatient Coder Certificate exam, administered by AHIMA.

Program Objectives

By the end of this certificate program, you will be able to:
  • Identify the structure and organization of the International Statistical Classification of Diseases and Related Health Problems – Tenth Revision – Australian Modification (ICD-10-AM), Council of Cooperative Health Insurance - Billing System (CCHI-BS)
  • Apply the conventions and instructions found in ICD-10-AM, CCHI-BS
  • Determine diagnosis and procedure codes for ambulatory cases

Program Learning Outcomes

Top 5 learning outcomes you will achieve by attending this program
  • Successfully demonstrate the important role of the coding profession within the healthcare delivery system
  • Evaluate the compliance of health record content within the health organization
  • Determine diagnosis and procedure codes according to official coding guidelines
  • Adhere to workplace policies, procedures, and professional requirements
  • Ensure compliance with KSA regulatory requirements


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Introduction

Clinical documentation is at the core of every patient encounter. This documentation must be clear, consistent, complete, reliable, timely, and legible to accurately reflect the patient’s disease burden and scope of services provided.

The purpose of Clinical documentation integrity (CDI) programs facilitates the accurate representation of a patient’s clinical status that translates into coded data. Coded data is then translated into quality reporting, physician report cards, reimbursement, public health data, disease tracking and trending, and medical research.

The convergence of clinical care, documentation, and coding processes is critical to appropriate reimbursement, accurate quality scores, and informed decision-making to support high-quality patient care. Hence; CDI has a direct impact on patient care by providing information to all members of the care team.

CDI Program Objectives

The goal of clinical documentation improvement is accuracy, clinical soundness and final coding of a record after the discharge and helps to:
  • Improve quality of care by correctly capturing the patient SOI, ROM and ALOS, so that the hospitals can report the appropriate level of care
  • Standardize medical data for research and track analysis (W.H.O)
  • Augment the case mix index of the hospitals
  • Minimize claims rejections by the insurance
  • Apply suitable hospitals reimbursements for the level of care they provide
  • Maximize the DRG assignment and optimize payments for the services rendered to the patient

Learning Objectives

By attending the CDI courses; you should be able to:
  • Understand the importance of Clinical Documentation improvement and the Diagnosis Specificity impact on the patient quality care
  • Manage the coding and diagnostic elements that should be identified to support high quality clinical documentation and coding
  • Differentiate between clinical vs diagnostic terms
  • Identify common ICD-10-AM Documentation Requirements for the procedures
  • Pin-point the common severity drivers for effective treatment and results


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Introduction

Certificate In Healthcare Revenue Cycle Management (CHRCM) is an online course to help you understand the basics of healthcare RCM. It navigates the learner from “What is RCM to Healthcare RCM, global trends and best practice to regional insights and the scope of CDI (Clinical Documentation Improvement) in RCM.

Introduction to CHRCM provides a complete overview of different departments or units of RCM and the RCM process flow from patient registration to end billing. This modular course covers RCM learning from an international perspective and is not confined to any one country standards. We have included various roles of RCM in our course; that serve as a source of knowledge and also helps you identify a suitable RCM model for improved revenues and financial outcomes.

This course will benefit

Healthcare professionals keen to understand the Revenue Cycle Management; including but not limited to:
  • Physicians
  • Nurses, allied health professionals
  • Administrative and billing professionals
  • Managers, team leaders, supervisors and heads from insurance and coding departments
  • Senior executives who are keen to gain a macro-overview and understanding of RCM function

Course Objectives

By the end of the entire course; you will be able to:
  • Comprehend different versions of codes available in any RCM practice and recognize the differences in various versions of coding in respect to the country’s Healthcare Billing System
  • Gain 360 degrees understanding of RCM concepts and principles ranging from coding to insurance protocols to billing regulations and compliance; in addition to claim submissions, insurance denials, and reconciliations
  • Become aware of Revenue Cycle Management (RCM) concepts to maximize the billing potential leading to increased revenues and improved financial results


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