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Course Catalog
 
IMA Consulting no longer offers Annual CEU Coding Scenarios, Nuts & Bolts of Evaluation,
or Management Coding Courses. Please visit CodingWebU to purchase.
They will be available shortly.
For our existing customers, please log in with your user name and password. Access to the courses that you have previously purchased is still available to you.
Using the Benchmarking Process to Enhance Performance Improvement
Benchmarking is defined as a process to measure, evaluate, and compare results to improve performance. Benchmarking is data driven. It is a continuous process to achieve best practices.
There are several types of benchmarking, but the most frequently used in healthcare facilities are:
- Operational benchmarking
- Clinical benchmarking
This course will discuss operational benchmarking and its application to the daily operations of the hospital.
Operational benchmarking, as its name implies, focuses on the measurement, evaluation, and comparison of key operational processes with results of best performances. For purposes of this course, we will focus on financial performance – specifically, the labor and non-labor elements of the operating budget.
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Service Excellence: Principles and Concepts for Healthcare
Service Excellence is a broad term used to describe the interactions and communications that take place between members of an organization and their customers.
Some functions of Service Excellence may be found in distinct hospital departments with names, such as, Customer Service, Customer Relations, Guest Relations, and/or Consumer Affairs, but Service Excellence is not limited to a specific department.
Service Excellence represents an overall organizational goal for the entire staff – the delivery of services that exceed the expectations of its customers.
In this course, you will learn:
The importance of Service Excellence in the delivery of healthcare services,
Why superior Service Excellence is essential for the successful operations of healthcare organizations,
Who are the various customers in a healthcare organization,
How customer perceptions can positively or negatively influence the delivery of Service Excellence, and
Different methods and tools you can use to enhance the delivery of Service Excellence.
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Patient Access: Medicare and Medical Necessity
This course focuses on Medicare’s medical necessity and Advance Beneficiary Notice (ABN) regulations and processes, as they relate to patient access functions and activities. The course answers questions such as:
What is medical necessity, an LMRP, NCD or LCD?
When should a facility verify that a test or procedure meets Medicare’s medical necessity criteria?
When should an ABN be obtained?
What if the patient refuses to sign an ABN?
Where to begin?
- Educating facility staff
- Educating the physicians and their staffs
- Informing the patients
The course initially defines the medical necessity “alphabet soup;” CMS, FI, NCD, LMRP LCD, ABN… As the reader progresses, he or she will learn how to execute a valid ABN and the benefits of a successful Medicare medical necessity program.
2 Educational Contact Hours
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Patient Access: How Registration Fits into the Revenue Cycle
How Registration Fits into the Revenue Cycle identifies and defines Patient Access functional areas – scheduling, pre-registration, registration, insurance verification and financial counseling. The contributions of Patient Access functions (particularly Registration), to the overall success of a hospital’s Revenue Cycle are presented. Lastly, the internal and external customers to Patient Access department is discussed.
1 Educational Contact Hour
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Patient Access: Customer Relations
The Patient Access: Customer Relations course begins by covering proper telephone etiquette. This is important to anyone, not just the Patient Access department. The course concludes by direct patient contact. The first interaction the patient has with the hospital is through their registration, so it is important to understand their needs and make their stay as comfortable as it can be.
1 Educational Contact Hour
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Patient Access: Patient Information Gathering
Patient Access: Patient Information Gathering course covers the importance of gathering correct and accurate patient information in Patient Access is discussed. Topics covered include patient identification techniques, methods of obtaining patient demographic and insurance information, and methods of obtaining financial data related to medical services. The course concludes with a discussion of the impact of incorrect and inaccurate patient information within a healthcare facility.
1 Educational Contact Hour
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Patient Access: Account Coding
Patient Access: Account Coding begins with an overview of account coding and how coding effects the revenue cycle. It emphasizes on the importance of accurately and correctly coding, providing reasons to code and bill appropriately. It then concludes by describing major non-clinical and clinical codes used for patient accounts.
1 Educational Contact Hour
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Patient Access: Legislation and Regulations Impacting Patient Access
Patient Access: Legislation and Regulations Impacting Patient Access are presented in this course. Patient treatment regulations, compliance, fraud and abuse regulations; and other regulations are identified and described. Regulatory agencies overseeing healthcare are then identified, with emphasis on JCAHO.
1 Educational Contact Hour
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Patient Access: Insurance Guidelines
Patient Access: Insurance Guidelines begins by defining key insurance terms, including service approval terms, patient payment responsibility terms, and miscellaneous insurance terms. Various types of insurance coverage are discussed, with particular focus on government funded insurance programs (such as Medicare and Medicaid) and non-government funded insurance programs (such as Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), etc.).
1 Educational Contact Hour
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Patient Access: Insurance Verification
Patient Access: Insurance Verification course describes the function in detail, lists key terminology, identifies methods used to verify insurance information, provides reasons to appropriately verify, and identifies key insurance elements to document on a patient’s account. The importance of insurance verification to the billing process, and its impact on bill/claim holds, claim submission and reimbursement from insurers (payment methodologies) and patients (identifying patient payment responsibility) is emphasized.
1 Educational Contact Hour
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Patient Access: Financial Counseling
Patient Access: Financial Counseling. Patient Access financial counseling roles and responsibilities are presented for the pre-service, service, and post-service encounters. Methods of identifying potential insurance coverage are presented, and patient payment options are identified (including patient payment plans).
1 Educational Contact Hour
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Patient Access: Point of Service Collections
Patient Access: Point of Service (POS) Collections course discusses the importance for hospitals to collect patient responsibilities. Throughout the course, we will cover determining patient payment responsibility for medical services, describing methods used to collect patient payments, and establishing appropriate cash controls for monies collected.
1 Educational Contact Hour
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Patient Accounting Overview
The Patient Accounting Overview course begins with a description of the major departments of a Patient Accounting Department - Billing, Account Maintenance, Follow-Up, Pre-Collections, Collections and Customer Service. A number of the professional organizations that service the Patient Accounting industry are then described.
The course then shifts focus to a discussion of Patient Accounting’s customers (both internal and external). Regulatory agencies overseeing Patient Accounting are presented, and a legislation overview is provided, focusing on medical coverage, collections, and compliance.
1 Educational Contact Hour
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Patient Accounting and the Revenue Cycle
Patient Accounting and the Revenue Cycle course explains its role in the overall success of a hospital’s Revenue Cycle process is presented, and then the course provides an overview of account coding, providing descriptions of major non-clinical and clinical codes used for patient accounts.
1 Educational Contact Hour
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Patient Accounting Payers and Payments
Patient Accounting’s Payers and Payments course has an overview of Insurance Guideline. Key terms are presented and types of medical coverage are discussed, focusing on government funded insurance programs (such as Medicare and Medicaid) and non-government funded insurance programs (such as Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), etc.). The course concludes with a discussion on payment methodologies.
1 Educational Contact Hour
Approved by the AAPC, NAHAM, AAHAM and HCCA for CEUs.
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Patient Accounting: Billing Functions
Patient Accounting: Billing Functions - This course begins with a description of Billing in a Patient Accounting department – its function, staff, and standard policies and procedures. Specific types of billing generated are discussed - inpatient, outpatient, observation and specialty. The course ends with a description of major Key Performance Indicators (KPIs) used to monitor the effectiveness of a hospital’s billing activities, and includes Bill Holds, DNFB and Late Charges.
1 Educational Contact Hour
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Patient Accounting: Billing Claim Preparation and Submission
Patient Accounting: Billing Claim Preparation and Submission – This course focuses on claim and patient statement preparation and submission. The various types of claim forms and patient statements used for billing are described, and Biller activity to prepare claim forms and patient statements for billing (including adding attachments to forms and statements) is discussed. A description of claim and patient statement submission processes (electronic, paper, etc.) is provided, and definitions of billing specific topics are provided, including net billing, conversion files, global fees and filing deadlines.
1 Educational Contact Hour
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Patient Accounting: Account Maintenance Functions
Patient Accounting: Account Maintenance Functions - This course begins with a description of Account Maintenance in a Patient Accounting department – its function, staff, and the various types of transactions it handles on a routine basis. The management tools used to monitor Account Maintenance activity, standard policies and procedures and key performance indicators are introduced and explained.
1 Educational Contact Hour
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Patient Accounting: Account Posting
Patient Accounting: Account Posting - This course describes the posting preparation and actual posting process. The posting preparation discussion includes the identification of payment sources (where an Account Maintenance department receives funds from), types of remittances (explanation of benefits) received from insurers, deposit preparation, and then batch preparation. Actual posting - methods, processes, and reconciliation is then defined and described.
1 Educational Contact Hour
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Patient Accounting: Follow-up Functions
The Patient Accounting Follow-up Functions course begins with a discussion of the responsibilities of the Follow Up function, and the staff who perform it. Standard policies and procedures, as well as key performance indicators used to monitor Follow Up activities, are presented. The impact of legislation on Follow Up, and descriptions of specific laws and regulations (both state and federal) are presented.
1 Educational Contact Hour
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Patient Accounting: Follow-up Tools and Techniques
The Patient Accounting Follow-up Tools and Techniques course starts with the contribution other revenue cycle departments make to successful Follow-up activity. The roles Patient Access, Utilization Management, departments performing Charge Capture and Entry, Health Information Management (HIM), and the Patient Accounting functions of Billing, Account Maintenance and Customer Service are all discussed.
The course moves to a description of Follow-up process - tools, strategies and processes used to collect monies from payers (insurers) and patients.
The course ends with a description of the migration of a patient account from routine Patient Accounting Follow-Up activity to more aggressive collection activity.
1 Educational Contact Hour
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Patient Accounting: Customer Service Departments
The Patient Accounting: Customer Service Department course begins with a description of Customer Service in a Patient Accounting department, focusing on how the function is organized and is staffed. The types of customers served by the department are defined. The management tools used to monitor Customer Service activity - standard policies and procedures and key performance indicators – are introduced and explained
The course then describes the role Customer Service plays in the Revenue Cycle and the unique opportunity Customer Service has to provide revenue cycle feedback to those departments that precede it in the revenue cycle process.
1 Educational Contact Hour
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Patient Accounting: Customer Service Functions
The Patient Accounting: Customer Service Functions course cover communication skills used by Customer Service representatives. A presentation of verbal skills used in customer service is done, with particular focus on speaking and active listening. Telephone etiquette is presented, as well as techniques for working with difficult customers. The importance of written skills, specifically used for outgoing correspondence, is discussed. The course concludes with providing guidance for when management involvement in needed in customer issue resolution.
1 Educational Contact Hour
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Physician Practice - Revenue Cycle Overview
The Physician Practice – Revenue Cycle Overview course focuses on the revenue cycle from the perspective of a physician practice, introduces patient account coding, and describes the impact of incorrect and inaccurate patient information.
The Revenue Cycle section of the course identifies, defines, and describes physician practice functional areas – both Front and Back Office – and discusses their unique contributions to revenue cycle effectiveness.
The patient account coding section of the course defines and describes major non-clinical and clinical codes used for accounts.
The course concludes with a discussion of the impact of incorrect and inaccurate patient information from a clinical, financial and legal perspective.
2 Educational Contact Hours
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Physician Practice - Insurance Fundamentals
The Physician Practice – Insurance Fundamentals course focuses on insurance industry terminology, guidelines for determining orders of insurance, various types of insurance coverage, and insurer payment methodologies.
The insurance industry terminology section of the course presents key insurance terms, including some specific to managed care and information system technology (as it relates to insurance). The course then progresses to providing guidelines to assist practice staff with determining orders of insurance (primary, secondary, tertiary) for patients with more than one plan.
Various types of insurance coverage are discussed in the next section of the course, with particular focus on government funded insurance programs (such as Medicare and Medicaid) and non-government funded insurance programs (such as Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), etc.).
The course concludes with a discussion of various methods insurers use to reimburse providers for services (also called payment methodologies).
2 Educational Contact Hours
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Physician Practice - Front Office
The Physician Practice – Front Office course describes the Front Office functions in a physician practice from a Pre-Encounter and Patient Encounter perspective. Pre-Encounter is defined as those activities occurring prior to the patient arriving in the office; Patient Encounter is defined as those activities occurring when the patient arrives in the office. The course expands on specific Front Office functional descriptions (such as scheduling, registration, etc.) introduced in the Revenue Cycle overview course.
Pre-encounter activities are defined as: pre-registration, scheduling, insurance verification and financial counseling. Patient encounter activities are defined as: registration and check-in, the clinical visit, check out (including point of service collections), coding, and end of day procedures. Other Front Office functions, such as credentialing, referral desk, and clerical support, are also discussed.
The course concludes with a brief discussion of the importance of standard policies and procedures governing Front Office physician practice activities.
2 Educational Contact Hours
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Physician Practice - Billing
The Physician Practice – Billing course provides an overview of the billing function in a physician practice setting.
The course begins with a description of the organization of the billing function in a physician practice – its staff and the standard policies and procedures supporting it. The course then focuses on charge capture and entry (in preparation for billing) and the various types of billing produced in a physician practice.
The course then shifts its focus to claim and patient statement preparation and submission. Preparation activities introduced include bill holds, billing schedule, pre-bill edits, and timing of billing. Following preparation activities, billing submission activities are presented, focusing on electronic and paper submission and the attachments needed for certain claims to insurers.
2 Educational Contact Hours
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Physician Practice - Customer Service
The Physician Practice – Customer Service course provides an overview of Customer Service in a physician practice setting.
The course focuses first on identifying and then describing both internal and external customers of a physician practice. Internal customers identified include Front and Back Office physician staff, the Practice Administrator, and Clinicians (physicians, physician extenders, nurses and others). External customers identified include patients and their families, hospitals, nursing homes, other physician practices, and insurance carriers.
The policies and procedures supporting Customer Service in a physician practice are presented next. Incoming calls, incoming correspondence, confidentiality, and requests for information are highlighted. Policies and procedures of other functional areas in a physician practice that impact Customer Service activities in the Front Office and Back Office are also presented.
The final section of the course focuses on communication skills - speaking, active listening, and writing - and offers suggestions for the best ways to use those skills when interacting with patients. Standard telephone techniques and basic telephone features physician practice staff can use are presented. The course concludes with suggestions for working with dissatisfied customers.
2 Educational Contact Hours
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Physician Practice - Follow-Up
The Physician Practice – Follow-Up course is an overview of Accounts Receivable Follow-Up in a physician practice setting.
The course begins with a discussion of the Follow-Up function in a physician setting and the staff who perform Follow-Up. Ways to organize staff to optimize the Follow-Up process are presented.
Correspondence (both incoming and outgoing) used in Follow-Up is discussed, as well as standard policies and procedures supporting the Follow-Up function. The course then moves to a presentation of federal and state laws and regulations impacting Follow-Up activity.
Strategies, tools and processes/techniques for both payer and patient receivables provide the focus for the next section of the course. A discussion of patient payment options is also included.
The course ends with a discussion of the migration of accounts from Follow-Up to collections.
2 Educational Contact Hours
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Physician Practice - Account Maintenance
The Physician Practice – Account Maintenance course provides an overview of Account Maintenance in a physician practice setting.
The course begins with an overview of the Account Maintenance role in a physician practice. Account Maintenance staff, including posters, clerical support, and the supervisor, are identified. Standard Account Maintenance policies and procedures are introduced and described.
The course then focuses on the types of transactions handled in Account Maintenance, including payments, adjustments, denials, write-offs, charges and corrections. Payment sources are identified and described and the remittances accompanying payments (or denials) are also discussed.
The final section of the course focuses on the activities surrounding the deposit preparation and posting processes. Posting preparation and methods (electronic, tape and manual) are described.
2 Educational Contact Hours
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Physician Practice - Key Performance Indicators
The Physician Practice -Key Performance Indicators (KPIs) course introduces KPIs as a data tracking and trending tool to optimize practice operational and financial performance.
The course is organized into Front and Back Office KPIs. The Front Office KPIs introduced focus on the registration, scheduling and check-out functions. The Back Office KPIs introduced focus on the Billing, Account Maintenance, and Follow-up functions. Each KPI is defined, and an explanation of its importance follows, so that practice staff can fully understand the KPI, and then positively impact it within the scope of their job duties.
The course concludes with the introduction of a forum, the Revenue Cycle task force, and describes how the task force can use KPIs and other data to monitor the health of the practice’s revenue cycle on an ongoing basis.
1 Educational Contact Hours
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Physician Practice - Healthcare Oversight and Professional Organizations
The Physician Practice - Healthcare Oversight and Professional Organizations course provides valuable information on legislation and healthcare agencies and their impact on practice activities. The course then identifies professional organizations available to assist practices with complying with legislation and healthcare agency mandates.
The course begins with an overview, and is then organized into three (3) separate sections: Legislation, Agencies Overseeing Healthcare and Professional Organizations.
The legislation section of the course focuses on: Patient Treatment; Compliance, Fraud and Abuse; and Medical Coverage. A brief description of Collections Legislation is also included in this section, as well as information on Consolidated Omnibus Budget Reconciliation Act (COBRA) and Omnibus Budget Reconciliation Act (OBRA).
The Agencies Overseeing Healthcare section of the course identifies six (6) agencies – DHHS, CMS, OIG, DOH, GAO, and JCAHO - and their specific healthcare governance missions.
The Professional Organizations section of the course identifies many of the professional organizations available to physician practice managers and staff for training, education, resource information, and industry news.
1 Educational Contact Hour
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The Role of Clinical Staff in the Revenue Cycle
This course considers two (2) critical functions in a healthcare facility – the clinical functions and the business (Revenue Cycle) functions – and attempts to show the ways in which the former affects the latter. The goals of this course include:
- Define Revenue Cycle functions and describe their relevance for clinical staff.
- Demonstrate the impact Clinical Service Department activities have on Revenue Cycle activities.
- Illustrate the critical role clinical staff members have in promoting the fiscal strength of a healthcare facility via the timely, accurate, and efficient completion of their clinical responsibilities.
The course begins by defining and describing Revenue Cycle functions from a Clinical Service Department’s perspective, with a focus on Patient Access, Stay Management, Charge Capture, Health Information Management/Medical Records, and Patient Financial Services. The associated roles and responsibilities of the Clinical Service Departments and their staff, which include data collection, charge capture, communication, documentation, and information flow, are discussed. The course demonstrates that efficient Revenue Cycle processes are essential to the management of patient financial information and the timely collection of hospital revenue.
A case study is presented, complete with practical solutions clinical staff can employ to improve Revenue Cycle processes. Embedded in the case study is information pertaining to precertification/authorization/referrals, insurance plans, the master patient index (MPI), medical necessity/ABNs, management of observation status, coding and many other pertinent topics. Key terms are defined. Some potential pitfalls resulting from failure to properly fulfill Revenue Cycle responsibilities are indicated.
4 Educational Contact Hours
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Development and Management of Labor Expense Budget for Nursing Services
Preparing the operating budget for a hospital department is a basic skill required for all managers. A well prepared budget will assist the manager and staff to provide safe clinical care to patients using a cost effective staffing plan. In this course, you will:
Identify the relevant data required prior to developing the budget.
Understand the relevance of the unit of service for your department.
Prepare a staffing plan based on the budgeted unit of service.
Understand how operational changes on your unit can affect the planned budget.
Know how to make staffing modifications that will allow you to remain “on budget” through the course of the Fiscal Year.
Understand the meaning of the following terms: workload indicator/unit of service, patient day, average daily census (ADC), full-time equivalent (FTE), worked nursing hours per patient day (WNHPPD), paid nursing hours per patient day (PNHPPD), fixed FTE, variable FTE, direct caregiver, indirect caregiver.
2 Educational Contact Hours
Approved by the PA State Nursing Assoication for Continuing Education
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Departmental Operating Budget - Development and Management of Non-Salary Expenses
Preparing the operating budget for a hospital department is a basic skill required for all managers. The annual operating budget consists of two main parts, salary and non-salary (supply) expense. Because the operating budget places the responsibility for meeting budget targets on department managers, every manager needs to know how to develop and manage an operating budget.
In this course, you will learn the budgeting practicalities for developing the non-salary expense component of the operating budget. This course presents a basic understanding of how costs are allocated for the routine operations of a department or patient care unit. The costs are related to categories such as general and patient-care supplies, utilities, minor equipment, education, drugs, dietary items, and fixed overhead.
Before beginning this course, answer the pre-test questions to measure your current knowledge about developing the non-salary expense component of the operating budget. At the completion of this course, you will take a post-test to measure how much you have learned about preparing the non-salary operating budget.
1 Educational Contact Hour
Approved by the PA State Nursing Assoication for Continuing Education
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Development and Management of Labor Expense Budget for Acute Care
Preparing the operating budget for a hospital department is a basic skill required for all managers. A well prepared budget will assist the manager and staff to provide safe clinical care and services for patients. In this learning course, you will:
Identify the relevant data required prior to developing an operating budget.
Understand the relevance of the unit of service for your department.
Understand how operational changes in your department can effect the planned budget.
Know how to monitor the labor component of the operating to allow you to remain “on budget” through the course of the Fiscal Year.
Understand the meaning of the following terms: workload indicator, unit of service, full-time equivalent, worked hours, paid hours.
2 Educational Contact Hours
Approved by the PA State Nursing Assoication for Continuing Education
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