Story by Jake Smiths
In the complex ecosystem of healthcare, where the intersection of patient care and financial viability converge, medical billing and coding, otherwise known as revenue cycle management (RCM), serves as the cornerstone for the financial health of healthcare organizations. At its core lies a meticulous process aimed at capturing, managing, and optimizing revenue from patient services. However, maintaining accuracy and integrity within this intricate web of transactions and data flows is painstakingly difficult.
Medical billing involves submitting and following up on claims with payers (health insurance carriers) to reimburse healthcare providers for services rendered. This includes both commercial insurance, and government programs such as Medicare and Medicaid. Medical coding is the transformation of healthcare diagnoses, procedures, medical services, and equipment into universal medical alphanumeric codes. This data is obtained from medical records such as a physician’s visit or operative notes, laboratory results, radiology results, and more.
Medical billing and coding can be complex and technical, requiring specialized knowledge and skills. Even minor discrepancies in patient data, coding errors, or inaccuracies in claims can lead to significant revenue losses. To be a successful medical biller or coder, one must undergo comprehensive training to have in-depth knowledge of regulatory compliance, the medical field, billing protocols, and payer workflows and policies. In response, Fellow Health Partners (FHP), a leading medical business solutions company, has developed Knowledge College™, a training and testing center for both internal and external resources, certified by the American Academy of Professional Coders (AAPC).
Knowledge College™ is led by a group of FHP’s on-staff medical billing and coding experts, including orthopedic surgeons, nationally recognized coders, and healthcare attorneys. These subject matter experts collaborate to certify FHP staff as professional coders (CPCs) and billers (CPBs), thereby achieving and maintaining operational excellence. According to FHP, its curriculum is based on AAPC standards as well as Validated Adult Learning Theory, which helps staffers retain information more effectively, resulting in happier employees – and more satisfied clients.
“Knowledge College™ is a one-of-a-kind training program that ensures medical billers and coders are knowledgeable, skillful, and trustworthy when dealing with insurance companies and patients,” Brown says. “Medical billing and coding are crucial components of the health system, especially with many healthcare providers struggling with the rising cost of medical services. We believe that it is crucial to have highly-trained staff who are able to do the best work possible for our clients, because they deserve a proven partner that they can trust to deliver outstanding results.”
Among the training courses offered by FHP, Knowledge College offerings include The Fundamentals of Medicine, which is a 12-week course with live/remote clinical instruction in Anatomy, Physiology, and Pathophysiology, and is designed for individuals planning to pursue a non-clinical career in healthcare. FHP recommends that learners without clinical experience take this course first before other certification exam preparation courses.
The Certified Professional Biller (CPB) course lasts 16 weeks and prepares students to take the AAPC-sponsored CPB exam and attain Certified Professional Biller status. It imparts knowledge across all aspects of revenue cycle management, such as healthcare regulations, healthcare insurance types, payer-specific policies, and the skills necessary to navigate the intricacies of medical collections. Meanwhile, the Certified Professional Coder(CPC) course also lasts 16 weeks and prepares the student for the AAPC-sponsored CPC course and Certified Professional Coder status.
While Knowledge College™ was originally conceived as FHP’s internal training department, Brown noticed that administrative and clinical clients craved guidance on best practices across a spectrum of specialties and practice management areas. In response, an external division of Knowledge College™ was born, offering customized courses for healthcare providers to optimize revenue capture. This can take the form of practice management training, including front desk workflows and Physician Assistant utilization, to complex coding education. A popular example of FHP’s clinician-to-clinician training is FHP’s Evaluation and Management (E&M) coding module, which organically followed the AMA’s dramatic Evaluation & Management policy shift published January 1, 2021.
According to Michael N. Brown, founder and CEO of Fellow Health Partners, Knowledge College has been instrumental in the company’s growth over the years. By ensuring that its staff and clients are well-trained, FHP has increased its market share and gained the trust of many healthcare providers. FHP has been able to scale by multiples year over year since its inception, leading it to be one of the largest specialty billing providers in the U.S.
