An Interview with Rachel Bomar, MHR, SPHR, SHRM-SPC Tidal Health and Jan Hailey, MHL, CMOM, CMC, CMIS, CMCA E/M

David: Welcome everyone, thank you for joining me. Today is a little bit different for Jan and I. First of all Jan, I believe this is now the PMI shorts number three and today is a little bit different because I'm typically talking and asking Jan questions today Jan and I are asking the questions. We are joined by Rachel Bomar. Rachel is with Tidal Health, a Health Care system in Salisbury, Maryland and Tidal Health has just recently made the decision to bring CMOM on board in house however we want to phrase that for some of their personnel and we wanted to visit about that today, so having said that Jan welcome Rachel thanks for being here!

Jan: Thanks David, good to be here with you today, and welcome Rachel.

Rachel: Well thank you both for having me!

David: Absolutely. Rachel, I wanted to start off by having you just give a kind of a brief overview of Tidal Health and then also your role within the company.

PMI Shorts - Episode #2: a conversation with David T. Womack, Jan Hailey, MHL, CMOM, CMC, CMIS, CMCA E/M & Kem Tolliver, CMOM, FACMPE, CPC

David: My name is David Womack, and I am the President and CEO of Practice Management Institute. And today I am joined by Kem Tolliver and Jan Hailey. Kem and Jan are both trainers with PMI, both teach the CMOM curriculum. Today we are going to dive into not-really the CMOM class as much as Kem and Jan's CMOM journey, and how it all began with CMOM. Welcome Kem, welcome Jan.

Kem and Jan: Thanks for having us, David.

David: So initially for those who are not aware, I want to kind of share the CMOM story - how CMOM came about. This year, 2024, we are celebrating the 25th anniversary of CMOM. So, (yeah, exactly), so we're trying to give CMOM its props, tell the story, and to interact with a lot of people that have become CMOM graduates, and low and behold, here's two of our own. So in the early 90's - late 80's early '90s, PMI had our curriculum "How to be the Best receptionist", "how to be the best collector", "office management basics" class, and ICD-9 classes in-the-day, and a variety of things. And a certain segment of our audience reached out and asked, "What's next?" Being in the proverbial "ivory tower," we sat and looked at each other and thought, we really don't have anything for that. So we thought about it, went to the drawing board and created the CMOM curriculum to be kind of an overarching, almost like the last class you take as a college senior it's not gateway,... Is it a capstone? Capstone, that's exactly it, kind of ties all the pieces together, and that's what CMOM was for. We joked internally that CMOM course was going to be for "the person that missed the meeting" that showed up at work one day and said, guess who's the new office manager. That's who this class was designed for. Anyway, Jan and Kem, like I said, we had some fun putting this together - certainly a lot of memories.

Certainly without dating anybody here, you all received your CMOM certification many moons ago.

PMI’s New Medical Coding Bundle – a conversation with PMI President/CEO David T. Womack and PMI PMI’s Medical Coding Bundle Instructor and Lead Creator Jan Hailey, MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M

David: Jan, first of all, thank you for doing this and second talk to us about the medical coding bundle and why it exists.  

Jan: Thank you for having me David! I have taught Practice Management Institute’s Certified Medical Coder course for many years. Recently, we have seen more people enrolling in this course that have a desire to learn and get certified, but they do not have the years of experience it takes to be successful. This is why I am especially excited about the new Medical Coding Bundle! Enrolled students have access to a progressive series of basic to intermediate-level courses. Once they are done with that training, they are ready to enroll in the top-level training: the Certified Medical Coder course. 

This series is an excellent choice because it is an inclusive program for beginners who may not have any coding experience. It was designed to meet today’s needs and bring them up to the level that it takes to be successful in the certification course and gives them a better foundation to pass the exam. 

Each of these classes is comprehensive; there are five different classes, plus a self-paced medical terminology course that the student can take. This series begins with the basics: introduction to medical coding, and then ICD-10, CPT, and HCPCS coding. Then the CMC course itself. It is a progressive series that will prepare the student to pass the CMC exam. 

A career as a medical coder can be very rewarding as it offers numerous benefits, all of which contribute to a fulfilling and prosperous professional path. From offering job security in an industry characterized by high demand to offering flexible work arrangements, a career in medical coding offers several opportunities for professionals seeking growth, stability, and personal fulfillment. 

If you are interested in a proven new revenue stream while at the same time being able to provide access to courses that will lift up your providers and staff, we’d love to speak with you. We’d love to explain how a training partnership with Practice Management Institute can positively affect not only your bottom line, but enhance your role as a steward of the success of the providers and practices you serve. Here’s a testimonial from one of your peers:
 
“The Medical Society of Delaware is delighted to underscore the exceptional value and numerous benefits that our educational partnership has brought to our esteemed members and their medical practices. Since the inception of this collaboration, we have witnessed transformative outcomes that have significantly contributed to their professional growth and success.

Healthcare administrationcan be a fulfilling and stable professional path for new career-climbersthat are attracted to the business side of medicine – patient administration, medical coding, billing, auditing, office management, and compliance. Beyond the front desk there’s a whole team of professionals that support the clinicians by protecting patient privacy and enforcing compliance guidelines, reviewing medical documentation, processing insurance claims, billing, and posting payments. All these roles are vital to the health of a medical office and can be a pivotal step into a career in medical office administration. 

Obtaining a certification as a medical coder can be a pivotal step in accessing lucrative job opportunities and establishing yourself as a legitimate medical coding professional.

What does a medical coder do?

Before diving right into the requirements to obtaining a medical coding certification, it’s important to understand what medical coders do. Medical Coders translate healthcare visits, diagnoses, and procedures into universally standardized codes for billing and data analysis. The primary role of a medical coder is to ensure the consistency and accuracy of medical records and the reimbursement processes.

 Practice Management Institute Partners with Hendrick Health Regional Services to Bring Important Web-based Programming to 139 Affiliated Regional Practice Staff

On 2/9/2024 , Hendrick Health Regional Services will host the important Patient Collections/Accounts Receivable Management and E/M Chart Auditing for Physician Services 3-hour webinars to affiliated practice staff in Abilene and 19 West-Texas Counties.

The Patient Collections/Accounts Receivable Management course covers A/R as well as compliance and practice management efforts. Students will learn to improve insurance data collection, eligibility verification, patient communication, and to reduce payment problems that can crush the bottom-line success of the practice. In our E/M Chart Auditing for Physician Services session, participants will learn to improve knowledge of level of service audits to reduce practice risk /promote accurate claim submission. The sessions will be led by PMI faculty leader Jan Hailey MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M, and moderated by Jessica Yourdon, PMI’s Social Media & Content Coordinator.

Sincere thanks to Craig Hunnicutt, Director, Regional Services, Kim Hudson, Coordinator of Provider Outreach and to Amanda Goodson, Provider Outreach, for the consistently demonstrated commitment they each have to the success of medical practices, providers, and staff served regionally by Hendrick Health. What a turnout!

Interested in a similar academic partnership with PMI?  If your organization would like more information about partnering with PMI, please contact Michael Moore at 800-259-5562, Ext. 270 or email Michael directly at mmoore@pmimd.com. 

Practice Management Institute Expands Partnership with Tyler Junior College to Bring Important Continuing Education Opportunities to Local and Regional Medical Practice Staff

PMI is pleased to announce that we are expanding our partnership with Tyler Junior College (TJC).   Working closely to offer PMI continuing educational programming covering front desk operations, patient experience, coding, billing, compliance, and reimbursement, as well as the nationally recognized PMI certifications, this new phase in our partnership will focus exclusively on the success of the local and regional healthcare industry, providers, and practice staff.

Practice Management Institute (PMI) has named Washington County Community College (WCCC) its 2023 Outstanding National Host Partner. The award, chosen nationally from among hundreds of hospital, college, medical society, physician service group and program host partners, is given to an organization who has demonstrated exceptional commitment to partnering with PMI for the purposes of advancing educational opportunities within their service area and state.

This week in Buffalo- PMI will present new instructor-led webinars with long-time PMI host Catholic Medical Partners.

PMI is a proud educational partner of Catholic Medical Partners in Buffalo, NY. For 27 years, we have joined forces to provide quality educational and credentialing programming to local and regional medical practice staff, and we’re thrilled to kick off yet another year of much needed programming to keep practice staff in the know.

Leading the 2024 Reimbursement Update: CPT© and Medicare Compliance and Mastering EM Coding sessions will be PMI faculty presenter Audrey Coaxum, CHC, CPC, CEMC, CMC, CMIS, CMOM, CMCO. Audrey is an exceptional instructor, and is known nationally for her easy to follow teaching skills and exceptional knowledge base.

New CPT® code and regulatory changes for 2024 will go into effect on January 1st. Numerous proposals include conversion factor payment increases for primary care / direct patient care, caregiver training services, and services involving community health workers, care navigators, and peer support specialists. The implementation of a separate add-on payment for HCPCS code G2211 is also proposed, which is expected to improve the accuracy of payment for primary and longitudinal care.
 
In the morning session, Audrey will help prepare attendees for the impact of coding and regulatory changes. This annual update program will help students forecast the impact on billing for their particular specialty in 2024. The training will help participants reduce denials and stay in compliance in the New Year. All proposed key changes to the procedural code set, guidelines and issues that may impact provider reimbursement are being addressed.

E/M lays the groundwork for the reimbursement process. It is also a well-known audit trigger. In the afternoon Mastering EM Coding session,  Audrey will provide the tools needed to internally monitor billing compliance. Participants will learn to relate accurate code selection to proper reimbursement, and will receive a comprehensive explanation of E/M coding and documentation guidelines, and identification of accurate and clinically useful information.
 
Huge shout out to Lea Passage, MHA, CLP, Physician’s Relations Specialist, for once again playing host, and for continually having the backs of her providers and staff.

The Catholic Medical Partners mission is to provide a high-performing health care system that continuously improves upon the delivery of health care to the populations they service, and to demonstrate improvements in the patient experience, preventative health, and the care and treatment of patients with high burden of illness with a lower the cost trend.

Pain management treatments are primarily performed by an interventional pain management specialist, physiatrist, anesthesiologist, orthopedic surgeon, or neurosurgeon, and can include physical or occupational therapy, over-the-counter or prescription medication, neurostimulators, and injections.

The rapid evolution of telehealth services has helped keep medical practice virtual doors open to meet their patients' health needs during the pandemic. But with new utilization comes cautionary areas from a billing standpoint, and it's important to stay current on updates and compliance protocols to promote revenue growth and avoid financial loss. 

The Centers for Medicare and Medicaid Services’ recently announced that Evaluation and Management (E/M) visits will soon get some relief from burdensome coding and billing requirements. These billing and documentation requirements for E/M codes were established 20 years ago and have been subject to longstanding criticism from clinicians that they do not reflect current care practices and needs.