How important is it to make certain your billing staff is properly trained and certified (ie.CPR, ACLS, CPC and RHIT certifications current)?  Very important.

If you are like most healthcare organization you will have internal requirement policies for each department. The purpose of these requirement policies are to ensure that employees are properly trained, certified, licensed and/or maintain sufficient continuting education and training.  Without these minimum documentation, your organization is open to potential litigation, inconsistencies and possible accreditation issues in concern with the healthcare license. 

One department that is often overlooked is the billing department. Yet this department is so crucial to how, if and when your organization is reimbursed by CMS. There are certificates that billers should maintain. One is CPC (Certified Professional Coder) and the other is RHIT (Registered Health Information Technician).

Keeping track of the existence of the certificate, the dates of expiration, number of continuing education credits and proof of training, can be a daunting task. If the biller is not current on biling codes and regulations/training, he/she can expose the organization to improper bililng and can lead to false and fraudulent billing. 

In reviewing recent OIG cases where organizations improperly or fraudulently billed CMS for an OIG exclusion list check for an individual/entity or applied incorrect billing codes, it only highlights and proves that tracking, maintaining and monitoring required certificates and training is imperative.  It is best practice for your organizationto review your requirement policies like, nursing license verification, to ensure the proper certificates are in existence and in good standing. 

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