Cost:

Free for HFMA Members
$399 for Non-members

Audience:

Hospitals and Other Providers
Physicians and Other Practitioners

Career level:

Experienced Professional
Mid-Senior

Recommended for:

Billing
Healthcare Revenue Integrity
Physician Practice
Revenue Cycle

Delivery Method:

QAS Self Study

Advance Preparation:

None

Field of Study:

Finance: 4.5 hours
Specialized Knowledge: 7.0 hours

Prerequisites:

None

Course Availability:

18 Months

Certification | Intermediate | Physician Practice Revenue

Certified Specialist Physician Practice Management (CSPPM)

Certification | Intermediate | Physician Practice Revenue

Certified Specialist Physician Practice Management (CSPPM)

Description

This online program discusses the full range of topics and techniques that are central to the effective management of physician practices. The program provides an overview of the revenue cycle, with emphasis on the accounts receivable and collection phases. Managed care payment issues, bad debts and charity accounts, and use of collection agencies are among the topics covered. Coding and payment systems, which establish the potential revenue of the physician practice are also explained. Other topics include fee schedules and relative value systems as well as compliance and rules for teaching physicians.

Information systems are a significant investment and this program describes the process of implementing an information system from the RFP stage to the integration of financial and clinical information.

Budget preparation techniques are presented, along with methods of assessing financial performance, projecting revenue, and evaluating capital projects. The program describes the value of cost accounting and how it is performed. In addition, the program explains methods for evaluating and negotiating payer contracts.

Estimated course completion time: 10 - 12 hours
After this program, you'll be able to..
  • Identify the key contributory elements of evaluation and management services
  • Recognize the Resource Based Relative Value System (RBRVS) and its components
  • Identify the elements of managing third-party receivables and self-pay receivables
  • Name techniques commonly used to measure accounts receivable
  • Recognize the difference between bad debt and charity accounts
  • Identify activities for evaluating and acquiring a medical group information system
  • Identify three types of data used to estimate demand for a medical group's practice
  • Define components of a comprehensive budget
  • Define ratios valuable in monitoring financial performance of a practice
  • Define cost accounting
  • Recognize how break-even analysis can be of use to the medical group
  • Identify processes for evaluating a contract
  • Recognize Stark legislation and the laws it has developed for regulation of the medical group
  • Identify elements of strategic planning and the role of marketing
Online program last updated: 5/24/2018

Related Courses | Physician Practice Revenue

On Demand Webinar | Overview | Revenue Cycle

The road to analytics: Where are providers today? Where are they headed?

The near-crisis our industry is facing right stems in part from analytical stagnancy during a time when analytics are most critical. Doing the "same old, same old" is no longer an acceptable option for market viability in the future. Generating return on analytics has been a constant challenge and unmet need - fueled by both internal resistance as well as technology limitations. HFMA and EPSi collaboratively identified those most pressing issues and jointly fielded a survey of healthcare finance professionals to shed light on analytics-related challenges and opportunities in an effort to uncover where providers are headed.

Original live webinar date: 10/29/2019

On Demand Webinar | Basic | Revenue Cycle

Advancing decision support at Wake Forest Baptist Health

As a nationally-recognized academic medical center in Winston-Salem, N.C., Wake Forest Baptist Health wanted to advance their decision support data to enable their team of financial, clinical, technology, and other specialty staff in both their academic and non-academic medical center.

Leveraging data governance, enhanced pharmaceutical data for costing, and alignment between professional and technical activity, the organization was able to define and standardize their solution across the enterprise, implementing and iterating to educate analysts across the organization.

On Demand Webinar | Intermediate | Revenue Cycle

Denial management and prevention: What is the difference and why you need both


Working denials is costly, it delays collections and uses valuable and expensive resource time.

The webinar will cover the process and analytics needed to identify denials that are preventable, how to work within your organization to assign actions needed to prevent denials and how to continuously measure and monitor data and workflows to increase clean claims.

We also cover how to develop and implement a denial management plan, using reporting, analytics, technology, measuring, monitoring and communication to reduce denial and appeal turnaround time, decreasing days in A/R, timely filing and appeal denials.

The subject will be presented from three perspectives: billing operations, front-end operations and analytics development.

You will be introduced to a 12-step program for developing and implementing your own denial prevention and management plan.

Course | Basic | Physician Payment and Reimbursement

PPM: Coding and Payment Systems

This course discusses coding and payment systems, which establish the potential revenue of the physician practice. Other topics include fee schedules and relative value systems as well as compliance and rules for teaching physicians.


Estimated course completion time: 1 hour