Certificate in Healthcare Fraud and Abuse in the Application of Medical Coding
Program
This convenient online Certificate in Healthcare Fraud and Abuse in the Application of Medical Coding program was developed in collaboration with IntelStrategy, Inc. The goal is to provide you with an in-depth and applied understanding of the knowledge and skills required to effectively detect possible abuse and to flawlessly decipher medical billing and reimbursement documentations. An enhanced understanding of terminologies will also prepare you for in-depth discussions about coding reimbursements, and help equip you with the knowledge to answer healthcare provider questions quickly and accurately.
It is estimated that up to 10% of U.S. healthcare total expenditures are overpayments due to fraud and abuse. Fraud can take many forms ranging from billing for services not rendered to organized schemes in provider identity theft.
Certificate in Healthcare Fraud and Abuse in the Application of Medical Coding will allow medical coders currently working in the insurance and healthcare industries to further enhance and validate their level of coding expertise. It will also provide professional development for existing claims processors and auditors who seek additional knowledge of medical coding.
The Certificate in Healthcare Fraud and Abuse in the Application of Medical Coding consists of three classes totaling 28 hours of lecture and hands-on exercises. 2.8 Continuing Education Units will be awarded to the certificate graduate.
Program Objective
Upon completion of the certificate program, graduates will be able to:
- Review medical terminology relative to medical coding
- Provide an overview of medical coding and the application of codes in the reimbursement process
- Understand the proper use of ICD-9CM, CPT, and HCPCS code books
- Gain an understanding of the Correct Coding Initiative (CCI)
- Discuss the fraud and abuse often found in the application of medical codes
Who Should Attend
- Anyone working in the healthcare industry
- Employees of third-party administrators and self-insured organizations
- Insurance claims processors and other insurance company staff
Contact Denelle Pankratz, 657.278.2605, dpankratz@fullerton.edu