Chapter 1 
The Industry of Medical Record Review 
•    The Role of a Medical Record Reviewer 
•    What’s In a Medical Record
•    Healthcare Providers 
•    Electronic Medical/Health Records (EMR)/(EHR)
•    Introduction to Medical Informatic 
•    Types of Chart Reviews

Chapter 2
Patient’s Rights & Insurance Products 
•    Health Insurance Portability & Accountability Act (HIPAA)
•    What is PHI?
•    Health Maintenance Organization (HMO)
•    Medicare
•    Medicaid
•    Tricare
•    Health Care Reform Bill

Chapter 3 
Chart Review for Legal Purposes
•    How to Collect Medical Records for Legal Purposes 
•    What is a Legal Document Review? 
•    How to Review and Summarize Medical Records in Personal Injury Cases
•    Sample Record Review for Legal Purposes 
•    Scenario 1
•    Scenario 2

Chapter 4

Risk Adjustment Models for Coding – Chronic Diseases
•    What is Risk Adjustment? 
•    What is Chronic Illness and Disability (CDPS) Model
•    What is Hierarchical Condition Category (HCC) Model
•    Sample Record Review for Risk Adjustment Coding 

Chapter 5 
Employee Benefits and Disability Claims Review
•    Employee Benefits and Disability Claim 
•    Sample Review for Disability Claim 

Chapter 6
Utilization Review
•    What is Utilization Management and Utilization Review 
•    Sample Record Review for Utilization Review 

Chapter 7
Quality of Care Initiative 
•    Introduction to NCQA
•    Center for Medicare & Medicaid Services (CMS) STAR Ratings
•    How is HEDIS® Data Used?
•    Components of HEDIS® 
•    Data Collection Methods 
•    Cervical Cancer 
•    STAR Hybrid Sample Record
Chapter 8
How to Request Medical Records 
•    Telephone Voice Etiquette Techniques & Best Practices
•    On-Site Visits
•    Chart Pull List
•    What is a Call Script?
•    What is a Chart Chase?
•    Receiving Medical Records for STAR Ratings Project