CMRC + CMRR (Spring Bundle Sale)

Certified Medical Record Reviewer (CMRR™)

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

Certified Medical Record Collector (CMRC™) 

Chapter 1

The Industry of Medical Record Review

• What is a Medical Record Collector?

• What’s In a Medical Record

• Healthcare Providers

• Electronic Medical/Health Records (EMR)/(HER)

• Introduction to Medical Informatic

• Types of Chart Reviews

• What is Utilization Management or Utilization Review

​​

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

Quality of Care Initiative

• Introduction to NCQA

• Center for Medicare & Medicaid Services (CMS) STAR Ratings?

• How is HEDIS® Data Used?

• Components of HEDIS®

• Data Collections Methods

 

Chapter 4

How to Collect Records for Hybrid STAR Project

• Medical Records Retrieval Process for STARS Hybrid Project

• Sample Medical Request Letter

• Chart Pull List

• On-Site Visits

• How to Prepare for a Site Visit

• HEDIS® Call Script?

• What is a Chart Chase?

• Receiving Medical Records For STAR Ratings Project

​

Chapter 5

How to Collect Medical Records for Legal Purposes

• Requesting Medical Records For Legal Purposes

• The Fundamentals

• Requesting Medical Records From a Doctor

• Special Rules for Hospitals

• Wrongful Death

• What Is The Fastest Way To Request Medical Records?

• Should Medical Record Collectors Put The Doctor's Name Or The Name Of Their Practice On The HIPAA Authorization Form?

​

Chapter 6

• Copy Service / Third Party Vendors

 

Chapter 7

• Telephone Voice Etiquette Techniques & Best Practices