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Published 3/1/2007
Jennifer Bever, MS, FACHE

Staffing certifications: What they mean and why they are important

Are you a DO or an MD? An FACS, an FAAOS, or both? And what difference does it make?

You know that the letters after your name add a particular cachet to your professionalism, particularly now when consumers are being encouraged to ask questions about fellowship training and board certification when selecting a physician. But did you realize that the same holds true for your office staff?

Clinical staff credentials apply to physician assistants and nurses. Orthopaedic surgeons may hire physician assistants—individuals with advanced degrees who are licensed by the state and certified by a national accrediting body. Their letter credentials, PA-C, stand for Physician Assistant, Certified. Registered nurses and licensed practical nurses/licensed vocational nurses are similarly licensed by their state and list their names with the appropriate letters: RN and LPN/LVN.

Coding certification
In the back office, physicians are often concerned that their coding specialists be certified. In fact, you, as the physician, should initiate the coding process; your coders should be specialists who spot check cases and claims as needed, facilitate coding-related appeals, participate in compliance activities such as prospective sample auditing, and serve as expert resources and educational specialists on coding issues. These individuals should have annual education opportunities in orthopaedic-related coding matters. Although a certified professional in the practice is desirable, it is not mandatory if regular education and management oversight occurs.

Currently, two organizations offer coding certification. The American Health Information Management Association (AHIMA), founded in 1928, has more than 50,000 members and chapters in all 50 states. AHIMA offers three different coding certifications:

  • Certified Coding Associate (CCA), an entry-level coder designation
  • Certified Coding Specialist, Physician-based (CCS-P), which denotes mastery of coding concepts
  • Certified Coding Specialist (CCS), which is geared toward hospital coders

The American Association of Professional Coders (AAPC) was established in 1988 and has approximately 38,000 certified members. It offers a Certified Professional Coder (CPC) certification, with an added Orthopedic Specialist (OS) designation.

Both organizations have study guides so staff members can prepare at home for the computer-based exams administered regularly at testing centers around the country. Individuals who become certified are required to obtain a certain number of continuing education units (CEUs) to maintain their certification. Attending a coding and reimbursement workshop sponsored by the AAOS and KarenZupko & Associates is one way for certified coders to obtain CEUs. For dates and workshop locations, visit www.karenzupko.com

Practice management
When it comes to practice managers and practice administrators, an undergraduate degree in a business-related field is often helpful. A master’s degree in health administration (MHA) or in business administration (MBA) may be particularly relevant for large practices with multiple business lines.

Many practice managers may have no formal degree, but possess 20 years or more of solid management experience. These individuals may want to pursue certification through one of the two main administrator professional societies to ensure a solid base of skills and encourage ongoing education and professional growth.

Individuals who pass the exam offered by the Medical Group Management Association in conjunction with the American College of Medical Practice Executives (ACMPE) are Certified Medical Practice Executives (CMPE). The certifying exam covers eight knowledge areas: financial management, human resource management, planning and marketing, information management, risk management, governance and organizational dynamics, business and clinical operations, and professional responsibility. Candidates for certification and those already certified must accumulate 50 CEUs every three years to retain their certification status. Practice managers can also apply for Fellow status within ACMPE, resulting in a designation of FACMPE. This requires continuing education and submission of a thesis or case studies.

Another national organization, the Professional Association of Health Care Office Managers (PAHCOM), offers the Certified Medical Office Manager (CMM) credential. The exam covers the following 10 areas: insurance/managed healthcare plans, risk management, finance, contract management, data management, human resource management, communication, administrative objectives, clinical knowledge administration, and marketing. Recertification requires 24 CEUs every two years. PAHCOM is an especially supportive organization for office managers of solo or small physician practices, because its education offerings may focus on their unique needs.

Other designations
AHIMA offers two additional certifications that may be of interest to practices. The Certified in Healthcare Privacy and Security (CHPS) designation would be appropriate for practice administrators and/or compliance officers. The Registered Health Information Technician (RHIT) designation is more often seen in hospital medical records departments but might also be found in large orthopaedic practices. An RHIT certification provides specific training in the management of medical records, covering both operational and risk management issues such as medical records release, storage, and HIPAA compliance.

A certified medical assistant, or CMA, has graduated from an accredited medical assisting program that covers both clinical assisting and administrative skills and includes an externship. CMAs must pass the American Association of Medical Assistants certification exam and recertify every five years. This program focuses on a broad spectrum of issues common to medical practices; physicians and clinical supervisors will need to introduce new medical assistants to practice protocols. Additional training in orthopaedic-related procedures such as casting, joint injection preparation, and fitting of durable medical equipment may be required unless the CMA has had previous experience in an orthopaedic office.

Because there is no certification track for medical practice billers, many billers eventually obtain coding credentials. The American Medical Billing Association (AMBA) offers an examination and a Certified Medical Reimbursement Specialist (CMRS) designation. AMBA was founded eight years ago and is geared toward independent billing service vendors. The exam covers topics such as medical terminology, anatomy and physiology, information technology, web technology, coding, insurance, compliance, fraud and abuse, and case studies.

Ongoing education pays
Investing in staff development and certification requires that the practice promotes and values learning and ongoing education. Ongoing education should be a budget line item and discussed at each employee’s annual performance review. Occasionally, physicians express frustration that staff who receive educational opportunities and then leave the practice, taking their new learning with them. Although staff turnover is a common problem, sending someone to a seminar may be beneficial for the practice. Requiring employees to write up and distribute a summary of what they learned immediately after the course spreads the knowledge among other staff.

Make ongoing education your “new year’s resolution.” As your staff members obtain their new credentials, be sure to take the time to recognize their accomplishments and celebrate their success. After all, it is your success, too.

Jennifer Bever, MS, FACHE, is a consultant with KarenZupko & Associates.