Become a Certified Risk-Adjustment Auditor.
The first online course that meets the criteria for Hierarchical Condition Categories (HCC)
Hierarchical Condition Categories (HCC) aka the Risk Adjustment Model has been around for years and auditing for outcomes in this area has become increasingly important due to evolving regulations and policies in the healthcare sector.
Risk adjustment auditing is a specialized field within the healthcare and insurance industries. By gaining expertise in this area, you can open up new career opportunities. Many healthcare organizations, insurance companies, consulting firms, and government agencies hire professionals with risk adjustment auditing skills.
Health plans and providers need to ensure accurate and complete documentation of patients’ diagnoses to receive appropriate reimbursement. Therefore, there is a high demand for professionals who can conduct risk adjustment audits to identify any discrepancies or coding errors.
This bootcamp is an 8-hour training divided into four-hour training sessions over two days.
Classes are instructor-led, live and interactive, and virtual and include hands-on training examples, chapter knowledge roundups, and patient sample encounters to test your ability to audit to ensure comprehension
Our Course Registration
Starts
with Setting You Up for Success
Our Course Registration
Starts
with Setting
You Up for Success
Your Registration will Include:
on your order.
This program meets AAPC guidelines for 8.0 CEUs. These can be split between Core A, CIC, CRC, CPCO and CPMA for continuing education units.
(Applicable for new members only; registrations from current NAMAS members will receive a discounted membership renewal rate)
CPA-RA EXAMINATION PROCESS
Attendees have the opportunity to test for our auditing credential, Certified Professional Risk Adjustment Auditor (CPRA) from the comfort of your desk! All you need is your webcam and an ID!
Testers May Use:
- NAMAS training course materials
- ICD-10 book
- ICD-10 guidelines
- Reference notes taken during bootcamp
Testing Qualifications:
- Must be a current NAMAS Member
- 2 years of auditing risk-adjustment/HCC
services recommended
The exam is online and a NAMAS team member proctors the Certified Risk Adjustment Auditor (CPRA) exam. Prior to logging in to take the Certified Risk Adjustment Auditor exam, please ensure that your computer is equipped with a webcam and microphone. You may use either a built-in webcam and microphone or an external webcam and microphone. Please note that mobile phones or tablets may not be used for online testing.
Maintaining the Certification
CEUs are about ensuring application and continuing education in RA/HCC auditing.
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS training events
- AHIMA/AAPC CEUs that are specific to risk adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS Training Events
- AHIMA/AAPC CEUs that are specific to Risk Adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS Training Events
- AHIMA/AAPC CEUs that are specific to Risk Adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
CPA-RA EXAMINATION PROCESS
Attendees have the opportunity to test for our auditing credential, Certified Professional Risk Adjustment Auditor (CPRA) from the comfort of your desk! All you need is your webcam and an ID!
Testers May Use:
- NAMAS Training Course Materials
- ICD-10 Book
- ICD-10 Guidelines
- Reference notes taken during bootcamp
Testing Qualifications:
- Must be a current NAMAS Member
- 2 Years of auditing risk-adjustment/HCC
services recommended
The exam is online and a NAMAS team member proctors the Certified Risk Adjustment Auditor (CPRA) exam. Prior to logging in to take the Certified Risk Adjustment Auditor exam, please ensure that your computer is equipped with a webcam and microphone. You may use either a built-in webcam and microphone or an external webcam and microphone. Please note that mobile phones or tablets may not be used for online testing.
Maintaining the Certification
CEUs are about ensuring application and continuing education in RA/HCC auditing.
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS Training Events
- AHIMA/AAPC CEUs that are specific to Risk Adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS Training Events
- AHIMA/AAPC CEUs that are specific to Risk Adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
The following forms of CEUs are accepted to maintain the credential:
- Approved NAMAS Training Events
- AHIMA/AAPC CEUs that are specific to Risk Adjustment auditing services
- CEU Exchange Program: Many organizations require QA of their auditors, and NAMAS views this process as continued education and improvement of your knowledge and skill base to act as CEUs.
The following guide indicates the exchange rate:
- 95% Precision Rating= 5 CEUs
- 90% Precision Rating= 4 CEUs
- 85% Precision Rating= 3 CEUs
- 80% Precision Rating= 2 CEUs
- <79% Precision Rating= 1 CEU
Additional Information
- The curriculum manual will be available for you on or before the first day of class
- Late sign-ups may be subject to an additional fee
- Classes are transferrable, but we apologize that they are not refundable
- Each course has a required minimum attendance of 5 registrations; in the event your selected course does not reach the minimum number of registered attendees, you may be asked to reschedule
- Attendees will receive a certificate of completion along with a CEU certificate for the earned credits upon completing the full online training program
FAQ
Is this training right for me?
Understanding risk adjustment auditing is crucial to detecting coding errors, gaps in documentation, and opportunities for improvement in diagnostic coding systems like ICD-10-CM and CPT. Engaging in this process can not only open up career paths involving reviewing medical records and coding, but also lead to better patient care, improved outcomes, and compliance with regulations while minimizing any potential legal issues. It is imperative to prioritize risk adjustment auditing in order to ensure accuracy, completeness, and overall success in the medical field.
We are looking more at revenue integrity than coding these days.
Accurate risk adjustment coding is crucial for healthcare organizations and insurance companies to maintain their revenue and reimbursement. Risk adjustment audits can help pinpoint and correct any coding discrepancies, leading to better reimbursement and optimized revenue capture. Improving your knowledge of risk adjustment auditing can also enhance the quality of care provided. Following regulations can minimize any potential penalties or legal issues.
My department reports to compliance, not audits. How do I justify this training?
Compliance with regulations and guidelines related to risk adjustment is crucial for healthcare organizations and insurance companies. By conducting risk adjustment audits, areas for documentation and coding practice improvement can be identified, leading to better healthcare delivery. Learning how to conduct these audits can also enhance your career and improve the quality of care provided. By adhering to regulations, the risk of penalties or legal issues can be minimized.
Will this training help me with physician/provider education on risk adjustment and ICD-10?
Improving healthcare delivery is crucial for achieving better patient outcomes, and one way to contribute to this is by conducting risk adjustment audits.
These audits can help identify areas for improvement in documentation and coding practices, which ultimately enhances the quality of care provided. By learning how to conduct risk adjustment audits, you can gain valuable skills that can make a significant impact in the healthcare industry and improve your career opportunities.
Becoming a CPA-RA is a great way to gain valuable skills that are highly sought after in the job market. This certification can lead to improved career opportunities and the ability to make a significant impact in accurate coding, compliance, and ultimately, better healthcare outcomes.
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