Medical Billing and Medical Records
Management for Tribal Health and
Social Service Organizations

If you work with tribal health or social services programs, you face many challenges in maintaining a quality medical records system and an efficient billing process. Well-run provider organizations rely on medical records and health information management to ensure high-quality service delivery, maximum revenue and minimal cost. Tribes and tribal health organizations must maintain medical records and health information that not only serve their internal needs, but also meet the standards of external agencies, such as JCAHO, HCFA, Medicare, Medicaid, HMOs, PPOs and private insurance carriers.

The majority of the revenue generated by a tribal or IHS facility comes from third-party reimbursements, namely health maintenance organizations, private health insurance companies, Medicaid or Medicare. Attend this class and find out how to improve your medical records management and billing processes. This class addresses the importance of documentation, billing/ accounts receivable processing and the future of health information.

You’ll learn how to maintain quality medical records, design and manage health care information and control disclosure of medical information. Our experienced instructor will guide you through the complexities of the third-party reimbursement process and provide tips for complying with the privacy, security and confidentiality standards of HIPAA (Health Insurance Portability and Accountability Act of 1996).

Help your department save money and increase revenue. Don’t miss this opportunity to get the know-how to improve your medical records management and billing processes.

T O P I C S   I N C L U D E
What is Medical Records Management?
  • The big picture
  • How the individual topics fit together
  • Health information guidelines
  • Inpatients vs. outpatients
PCC Data Entry
  • Efficiency and accuracy
  • RPMS statistical reports
Medical Transcription
  • 24-hour turnaround
  • Outsource services
Release of Information
  • HIPAA privacy practices
  • Records retention
Medical Records Management
  • Resource management system:
    • RPMS applications
  • Electronic Health Record (EHR)
  • ICD-10-Coding
  • Patient scheduling
  • Patient demographics
  • Updating information
Benefits Coordinator
  • Patient eligibility
  • Medicare, Medicaid and private insurance
  • Claims processing (electronic billing)
  • Time limitations
  • Coding
Accounts Receivable
  • Posting payments
  • EOB auditing
  • Aging reports
Contract Health Services
  • Alternate resources and payor of last resort
Maximizing Reimbursement
  • Importance of documentation
  • Documentation — the key to reimbursement
  • Common coding issues

*Topics subject to change.

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