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Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
AAPC provides training, certification, [9] and other services to individuals and organizations across medical coding, medical billing, auditing, compliance, and practice management. These services include networking events such as medical coding seminars and conferences. [10]
Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary Provider Programs"
An entry-level coder has completed (or nearly completed) an introductory training program in using clinical classifications. Depending on the country, this program may be in the form of a certificate, or even a degree, which has to be earned before the trainee is allowed to start coding.
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
Compliance training refers to the process of educating employees on laws, regulations and company policies that apply to their day-to-day job responsibilities. An organization that engages in compliance training typically hopes to accomplish several goals: (1) avoiding and detecting violations by employees that could lead to legal liability for the organization; (2) creating a more hospitable ...
The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits:
Initially, HFAP provided osteopathic hospitals with accreditation ensuring osteopathic residents received appropriate training. In the mid-1960s the United States Congress decided that accredited hospitals would meet conditions set for participation, and thus automatically participated in newly established Medicare and Medicaid programs.
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