BMSC has many success stories that show the dedication and determination all coders have.
Donna Beaulieu, ACS-FP, CPC, CCP, CRP, began her healthcare career over twenty years ago in the public relations and marketing arena. She started out as a certified fitness instructor (where her anatomy and physiology education began) and dabbled in patient care, performing such tasks as taking X-rays and administering modality treatments. As a favor to physician friend, she began doing some insurance billing and found that she had a love for the paperwork behind patient care and the language of coding. Since then, she has been hooked on coding, and today works as a compliance officer at Quality Physician Services, LLC in the Atlanta, Georgia area. She is responsible for fielding all coding and compliance questions, oversees staff, and provides on-going training and auditing. She also represents her company as a coding expert witness when needed.
Donna first heard of the Board at the Coding Extravaganza in 2004. A self-proclaimed "coding snob", she became interested in obtaining her certification as a way to set herself apart as a coding guru. Excited and ready for a challenge, she signed up for the ACS-FP exam. Her nerves popped up when she finished the first page of the exam and realized it wasn't going to be a cakewalk. Donna did pass the exam, although it took two attempts. After the first attempt, she threw herself into studying and six weeks later passed the test, earning her ACS-FP.
There have been several changes that have occurred since she obtained her ACS-FP. Her organization, Quality Physician Services, is now more aware of coding standards and guidelines and works to stay inside those parameters. As a result, the group has exceeded MGMA reimbursement and days-in-accounts-receivable benchmarks. In addition, Donna has been asked by the CEO/COO of Quality Physician Services, LLC to develop and implement a Coding Compliance Plan for the group's seven locations. "I believe that keeping our organization on top of coding rules, regulations and changes has helped us collect what we should and has given [me] the confidence to question occasions when an insurance company may hold or deny a claim without just cause," says Donna, who has also earned the CPC, CCP and CRP credentials.
In addition to helping her organization reclaim its rightful reimbursement, Donna has encouraged her colleagues and staff to seek certification. Her organization now provides ongoing coding and compliance training for new hires as well as mandatory continuing education for all providers and office managers.
She advises potential test takers to audit/research some patient charts, review relevant CPT sections and make sure you're up on abbreviations and terminology.
BMSC took time to speak with newly specialty coder, Vicki Cadenhead, who earned her Advanced Coding Specialist certification in Cardiology in 2007. Read her story below!
Vicki's coding career started in 1999, in a small doctor's office, when her doctor gave her a chart and told her to "code it". After doing it for a while, she decided that she liked coding and began to study diligently, learning all that she could from the resources available to her. Vicki worked her way up the career ladder and now serves as a Coding Supervisor, supervising 10 coders at a large cardiology practice with 18 locations nationwide.
Was the exam easy or hard? How did she prep for the test? Did she pass on the first try? Vicki answers the key questions of inquiring coders everywhere.
BMSC: What made you decide to "just do it" and take this exam?
Vicki: When I decided I was going to the Extravaganza, I thought this would be as good time to sit for the exam. Although I was nervous, I consoled myself by saying I know what I know. I do this all the time.
BMSC: What did you think of the exam after you took it?
Vicki: I was a little nervous after she took her exam, but she felt good about it.
I took the entire 4 hours to complete the exam. Even though I finished early, I took time to review my answers before submitting the test booklet. I thought the questions asked were asked in a manner that I am comfortable — like questions I would receive from my doctor or other coding staff.
BMSC: What was the first thing you did when you found out that you had passed the exam?
Vicki: I screamed Yoo-hoo! I was very excited. I showed my boss my results letter, certificate and pin and I show my credentials with pride.
BMSC: How has your life changed since you've earned your ACS credential?
Vicki: My comments now carry more weight with the doctors with whom I'm in contact with.
Also, one of my coders said "When I grow up, I want to be like you." It's a great feeling!
BMSC: What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?
Vicki: I would tell them "You do this all the time. You know this. Take the prep course that is given and you'll be surprised at how much you really know. Just take the test. It's four hours out of your life that could bring you great rewards."
Denise Chartier, ACS-GS started out as a collector at Tulane Hospital in New Orleans. After two years of seeing denial after denial due to lack of pre-certification and prior authorization, she decided she wanted to help reduce the number of denials by working in the front office. A patient account coordinator position opened and Denise was hired to handle the front-end collections and pre-certifications at Tulane's urology and fertility clinic. After just two months, the denial rate and collections were lower and Denise had established herself in the clinic. "By this time, everyone knew you don't do any testing or procedures without checking with Denise first," she says.
After staying in the position for two years, Denise moved to a new challenge: surgery coding. Coding for surgery was harder than she expected and has good friends to thank for helping her through those first few months. "They walked me through so many cases, I should have given them half my paycheck!" she says.
Denise's reputation for putting departments back on track prompted two doctors to refer her to a department billing coordinator position being created in the Tulane University School of Medicine, Department of Surgery. That was in 1999 and she still works there today, and is responsible for all of the pre-certification of all procedures performed outside of the department. In addition, she handles all of the medical and legal billing and collections for the doctors in the department of surgery.
In 2004, Denise saw a flyer in Part B News about BMSC and convinced her supervisor it would be worthwhile for her to sit for the ACS-GS exam.
By the time she got to the exam, Denise admits that she was a nervous wreck. "People go to school for years to learn all this stuff," she kept telling herself. "I'll never pass!" But as she opened the test, her confidence increased as she breezed through the medical terminology and procedure coding sections of the test. The lab and X-ray portions were a bit more difficult as she had never coded those procedures before. Fortunately, the good grades on her strong sections made up for the grades on the lab and X-ray portions, and she passed the test. She was elated.
What has happened to Denise since receiving her ACS-GS? She received praise from her co-workers and family, and received a nice raise. In addition, Denise finally feels as though her boss is more than confident in her coding ability. "He knows that I know what I am talking about, when it comes to coding issues," she says. What's the best thing that happened as a result of becoming ACS certified? The feeling of accomplishment and confidence she experiences every time she sees the certificate on the wall or signs the letters "ACS-GS" after her name. "Although I never attended college, I feel as though I've accomplished something with my life."
Meet Joann Huenink, who earned her Advanced Coding Specialist (ACS) credential for Orthopedics in February 2008.
Joann's coding story begins with her first foray into the healthcare arena -- at 17 years old. Very early on, she was intrigued by the interworking of surgical cases and decided to go to surgical tech school. She then, was hired as a surgical tech and even spent time in the burn center after her graduation. During that time, Joann was approached by orthopedic surgeons who were impressed by her skill and commitment and encouraged her to join their practice. The surgeons got their wish! Now, with clinical and hospital experience under her belt, there was one more facet to learn. A medical records and ICD-9 coding position became available when the practices' coder moved away, so she took it. The rest — as they say — is history. Joann fell in love with coding and billing and has been in this field for 10 years. In her current role as a Coding Supervisor for a Midwestern orthopedic practice, Joann codes for the 13 surgeons and appeals all of the carrier and Medicare-related denials. Joann also frequently conducts training for the practice's billing team and keeps the doctors up to date on all new CPT and ICD-9 codes.
Was Joann nervous about taking the orthopedic-specialty exam? Did she have test anxiety or does passing tests just come naturally to her? Did she even study for the exam? If so, how long did she study? BMSC asks Joann the tough questions that specialty coders everywhere want to know.
How did you hear about BMSC and the Orthopedic coding credential?
I learned about the Orthopedic coding credential during the Specialty Coding Extravaganza in 2006. When I heard about it, I thought it was fine, but wasn't really convinced that I needed it because my doctors really didn't require it [certification] at that time.
What made you decide to "just do it" and take this exam?
At the 2007 Advanced Orthopedic Coding Symposium, I thought, after being involved in the full circle of patient care for 20 yrs, "why not? I deserve this". I wavered between the SCP level and ACS level examination, but decided to go for the ACS level examination because of my level of experience.
What did you think of the exam after you took it?
I'll be honest. It tested me on things I wasn't very familiar with even after several years of coding. I was very nervous about my results after taking it.
What was the first thing you did when you found out that you had passed the exam?
I told my boss and soon thereafter, added the credential to my email signature and appeal letters. My boss also sent around a memo to everyone in our practice and told everyone how happy she was that I had passed and was now an ACS-OR credential holder!
How has your life changed since you've earned your ACS credential?
My doctors have more respect for me. They truly respect and believe in what I say. Certification shows that you care to make things right"You are not one who gives in easily."
What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?
Let's get something straight -- I do not test well. I studied hard by visiting the ortho listservs, past conference material, online references, practice questions, the orthopedic study guide — you name it, I used it to study. However, I learned something profound through the process. Once you start studying, other questions come up, so I learned a lot by just studying for the test. But you know what? It's soooo worth it. I feel like I'm part of an elite family of coders. My advice is "Just do it for you!"
Tammy Hutchinson, ACS-CA began her career as an executive secretary for the Respiratory Therapy Department at Central Mississippi Medical Center. During her years there, she worked with physicians in the internal medicine, otolaryngology, pulmonary and cardiology departments. That was more than a decade ago. Today, Tammy is the insurance manager, responsible for all aspects of coding, billing and reimbursements for the Hines Cardiology Clinic, P.A. She handles the input of any charge changes or coding changes, ensures that claims are paid at the right PPO rates and that all claims are worked accordingly.
In 2003, she saw a brochure about BMSC. She was excited to read about an organization that offered certification specifically in cardiology and knew she wanted to be involved with it.
Tammy was scared to death about taking the exam. She attended the conference and sat in on Cardiology Board Lead Linda Gates-Striby's education sessions. The test was as she had expected — easy in the areas that she coded on a daily basis and harder in the areas that she hardly ever coded. But the conference sessions helped her in the areas where she was weak, and she passed the test on her first attempt.
Since earning her credential, Tammy has seen several changes in her life, both personally and professionally. On a personal level, she is proud of her herself for setting a goal and reaching it. On a professional level, the physicians Tammy works with knew she could code even before she took the test. Since passing, however, she believes she has the ability to produce more clean claims than ever, leading her physicians to have more confidence in her as well. So much confidence, in fact, she was promoted from insurance clerk to insurance manager for her entire clinic. Her practice continues to support her career goals by giving her the time and money needed to sit for the ACS exam and to attend continuing education sessions.
Meet Sharon Klug, who earned her Advanced Coding Specialist certification in E/M Auditing in May 2007.
Sharon came into coding after working as a nurse manager in a large multi-specialty clinic. She admits that a lot of her knowledge of coding initially was "self-taught." Then, she made it a priority to start attending coding-related conference in order to increase her knowledgebase. Her company didn't have a formal billing department and she was asked if she wanted to participate in the development such a department. Sharon jumped at the chance! Sharon has since earned her CPC and her PMCC teaching certificate. Now, after over 20 years in the healthcare industry, Sharon is the Supervisor of Provider Coding Education for a large healthcare provider in the Midwest.
What does Sharon think about certification? What encouragement would she give anyone thinking about taking the exam? Did her doctors treat her differently after certification? Sharon takes time out of her busy schedule to chat with BMSC about what earning the ACS-EM credential has meant to her — personally and professionally.
BMSC: Why is it important for coders to have a coding certification?
Sharon: I currently teach a coding curriculum to my staff of coders. Our company identified a need for coders to become certified as a benefit to physicians and coders alike. This certification also adds a level of protection for our providers.
BMSC: How did you hear about BMSC and the E/M Auditing credential?
Sharon: Actually, I won a free registration at the Specialty Coding Extravaganza, so since I do E/M coding education and auditing most of the time, I thought that was a good fit for me.
BMSC: How did you prepare for the examination? What made you decide to "just do it" and take this exam?
Sharon: I really didn't do a lot to prepare because I do E/M coding on a daily basis. As a precaution, I did review the documentation guidelines and asked questions about things I thought were subjective.
BMSC: What did you think of the exam after you took it?
Sharon: Overall, I thought it was a fair exam. The complexity of exam ranged from easy to difficult.
BMSC: What was the first thing you did when you found out that you had passed the exam?
Sharon: Once I learned that I had passed, I immediately called my proctor and let her know. And I quickly added the credentials after my name in my email signature.
Did your staff or doctors treat you any differently once you became certified?
Sharon: No one overtly treated me differently. However, it comes out when I am questioned regarding coding decisions with doctors or other coding staff. Earning this certification improved my self-image and self-confidence. And because of that, it gives me a more confident base to present this information to the doctors.
What would you tell any coder who is on the fence about whether they should take an Advanced Coding Specialist exam?
Sharon: I would ask them "did you take the basic first step examination, and how did you do?" I would encourage everyone to make sure that they have the foundation [coding education and experience] to be successful before taking the test. If they say they did well and if they believe they're functioning at a higher level, then go for it!
Evelyn Kim Ma started out in the health care industry over 22 years ago. Because of her husband's job, she has traveled the world and has worked in many roles in many health care settings. Previous positions include medical assisting as well as patient care, and eventually Evelyn settled on coding. As she says, paper is sometimes easier to deal with than people are. Today she works as a Team Lead Coder at the University of Texas Health Science Center at San Antonio, Department of Orthopedics. She is responsible for a staff of four: two coders and two clerks. She codes the surgeries, inpatient E/Ms, special clinics and general clinics, when she is needed. She is also the "go-to" person for anyone who has an orthopedic question. When she isn't busy with all of that, she also helps to educate physicians on new codes and new changes in procedures.
Evelyn first heard of BMSC last year when her administrator showed her a flyer about the organization. The administrator offered to pay for Evelyn to take the test and wanted her to do so as soon as possible. Evelyn, however, wasn't excited about the idea of taking another test — she felt that she might not know enough to pass as she had only been coding orthopedics for 3 years. But, she passed the test on her first attempt. "I guess I knew more than I thought!" she said.
In addition to receiving a promotion and a raise since earning her ACS-OR, Evelyn now sees changes in her coworkers' and physicians' behavior towards her. "The doctors pay more attention to what I say when I bring coding issues to them," she says.
The overall result, Evelyn believes, is that her coding team is more cohesive and has a better working relationship with the physicians and administrators within her department.
Shirley Todd, ACS-GS, sent a letter to BMSC soon after earning her credential. Please read on as she relates her experiences:
When I started in this business (July 1960), there were no codes to put on charts for procedures or diagnoses. The physician just wrote down what he did. Now things are much more complicated. As you grow in this type of occupation, you understand the reason. It helps to keep track of certain types of CA, illnesses, diseases, etc. In many ways, this can become a headache.
I have been coding for many years. I was taught by one of my surgeons. I really enjoy coding. It is not only interesting, but a great challenge to see how many different codes you can use for different types of surgery. I work for four general surgeons as office manager and coder. They are very supportive of me when I want to attend a meeting.
The meeting I attended was giving an examination for "specialty coding," (i.e., surgery, urology, ob-gyn, etc.) and I thought to myself, "I wonder if I can pass this test?" Well, I went to the Extravaganza and it was great (very intense, but I learned a lot). The test was on a Saturday and my husband and daughter (who came to the meeting with me) encouraged me daily to take this test, but I was afraid I wasn't knowledgeable enough to pass.
Well, on Friday, I signed up for the test and thought, "I have nothing to lose and everything to gain if I pass it." You know, when you are in the profession as long as I have been, it really means something if you find out, "Hey! I really do know what I am doing!" You feel pride in yourself if you can accomplish this certification. Well, lo and behold, I PASSED THE TEST, and I am now an Advanced Coding Specialist in General Surgery. You can't believe how proud my family and doctors are.
I would encourage anyone in a specialty to take this exam. If I can do it, so can you! Thanks to the Board of Advanced Medical Coding people and staff.
Sheila Vanderlin, CPC, ACS-CA, CCP, started her health career in the accounts receivable department of Cardiovascular Provider Resources in Dallas, TX. When an opening came up in the coding department, she decided to apply. She got the job and has watched her responsibilities grow to include auditing and denial coding.
In 2004, Sheila had been thinking about ways to become more proficient in coding. She attended a cardiology coding seminar and saw a BMSC flyer. She decided to sign up for the ACS-CA exam and she put her thinking cap on and passed on her first attempt.
Since taking the exam, Sheila has received several benefits. "The most important thing I got out of this test was the personal satisfaction of knowing more than I thought I did. That is better than any raise or other recognition," says Sheila. In addition, her supervisors now have more confidence in her coding, which boosts her confidence even more.
Sheila found the cardiology exam difficult, but realizes "this credential will give you more confidence in your coding."
Kelly Dennis' career began in 1983 in a fee-for-service billing company in Leesburg, Florida. With no medical experience or background, she began working part time as a data entry clerk/administrative assistant. "I will never forget how much there was to learn!" she says. But always ready for a challenge, Kelly embraced the ever-changing healthcare field. Throughout the next 18 years, she made the transition from fee-for-service to a management company hired to form one group of anesthesiologists, working in almost every position imaginable. In 1996, the billing was brought in-house where Kelly had sole responsibility for hiring and training the office personnel. What began as a part time job to supplement her family's income became a lifelong career in anesthesiology coding, and today she offers her knowledge and advice to medical offices around the country.
Aside from the on the job experience she received, Kelly also attended a local community college, receiving her associate's degree in Business Administration. In 2004, she earned her bachelor's degree in Business and Healthcare administration through American Intercontinental University. "I distinctly remember that my medical terminology class was like learning a new language," she says. In 1999, Kelly earned her CPC and in 2002 she passed the Professional Medical Coding Curriculum test. In 2004, she earned her status as an Advanced Coding Specialist — Anesthesia and Pain Management.
What prompted her to seek all of these additional credentials? "I believe in continuing education," she says. She also became aware of the importance of certification during an external review of her anesthesiologists' practice. The consultant conducting the review highly recommended that the coders in the office become certified for compliance purposes, at which point she began researching certification options.
In 2003, Kelly was consulting, and she was interested in demonstrating that she had deep knowledge specifically in anesthesia coding. It was about this time she discovered The Board of Advanced Medical Coding through a meeting she attended in Las Vegas. "BMSC recognizes the difficulty that some coders have in passing a timed test that may not apply to their specialty," she said. "It offers these specialty coders a method to prove they are knowledgeable in their own field."
Kelly also likes BMSC's recertification policy. "One of the most impressive aspects of BMSC is that they require retesting on changes that have occurred [in one's specialty] in the past two years," says Kelly. Rather than requiring certified coders to retake the entire 4 hour exam every two years, certified coders are only tested on changes in their specialty that have occurred since their previous exam.
Kelly decided to sit for her ACSAP exam and naturally passed. Since then, she has assisted BMSC in developing and refining the ACS-AN exam. [In 2005, the Advanced Coding Specialist — Anesthesia/Pain Management was separated into two certifications — Advanced Coding Specialist — Anesthesia (ACS-AN) and Advanced Coding Specialist — Pain Management (ACS-PM).]
What advice does Kelly have for fellow coders? "I believe people MUST have knowledge in their area. Whether it is the physician who codes, or an employee who codes on behalf of the physician, there is an inherent responsibility to submit correct and appropriate claims."
Kelly Dennis, BBA, CPC, ACS-AP, has been a BMSC board member since January 2004, when she helped develop our original anesthesia and pain management certifications. She has since provided invaluable advice and input into the creation of the ACS-AN exam and certification development. Kelly is president of Perfect Office Solutions, Inc. a billing and compliance auditing firm based in Leesburg, Florida.
Before Debra Rossi became a coder, she worked in the legal profession specializing in health care. She worked with a physician who had great vision about the future of health care regulation. This piqued her interest in coding and compliance, and she was encouraged by her physician to further her education in these areas. Today, Debra oversees the auditing and training of over 800 physicians on documentation and coding guidelines in all specialties.
Debra first heard of BMSC at the First Annual Coding Extravaganza in 2003. After doing some research, she felt that while general coding certifications are a great place to start to further a coding career, the BMSC exams are a validation of a certain level of expertise in various coding specialties. So, confident in her coding knowledge, she decided that the family practice exam was for her and looked forward to the challenge of the test.
What did she think of the test? "The exam was not easy, but it was fair," she says. The test required her to use her experience in family practice and covered all areas she would be expected to code for on the job. She passed on her first attempt, and now feels a sense of personal accomplishment by earning the ACS-FP, in addition to her other credentials: CCS-P and ACS-MS.
Since earning her ACS-FP, Debra's career has taken off. She has been able to advance and continues to take on new responsibilities, including hiring and overseeing the education of new coders and compliance analysts. She has also published several coding and compliance articles and has spoken at various national conferences. "My certifications have assisted me in becoming recognized as the resident 'expert' in coding." she says.
Debra's certification has encouraged her organization to offer a comprehensive coding and compliance program/resource to physicians and staff. As a result, many employees at NSLIJ (North Shore/Long Island Jewish Hospital) want to further their coding education, and Debra is able to offer advice on the career paths to follow. "Although [coding] is a respected profession it is not a well publicized profession. Education is the key to letting prospective employees know what their opportunities are. With increased interest in continuing education in coding, we can encourage current and future coders to strive toward certification and promote within our system."
Finally, Debra has some advice for coders considering their certification. "This certification is not for beginner coders. You need to have experience in your specialty and confidence in your knowledge of that specialty," she says. She advises coders to keep up on the latest coding and documentation regulations and guidelines, use the test outlines provided by BMSC and, if possible, attend a review session offered by BMSC board members at conferences prior to the exam.
But all in all, "go for it!" she says. "It is a stamp of excellence that will give you both the professional recognition you deserve for all of your hard work and dedication, and personal satisfaction for a job well done," she says.
Margie Scalley-Vaught first began her career in healthcare as a nurse's aide at the age of 16 in a local nursing home. She has held positions in the healthcare arena ever since, including medical records clerk, ward clerk, hospital transcriptionist, office manager, auditor and trainer and consultant in the office and hospital settings.
Throughout the years, she was sure she could help build her career and credibility by sitting for credential exams, including the CPC in 1995 and the CCS-P in 2000. "Getting the CPC in 1995 was a wonderful feeling," she says. "But I wanted to continue to test myself to see if I was still learning and understanding." She wanted to see if she was still understanding and applying the guidelines and rules appropriately. Her certifications now take up several lines on a business card: CPC, CPC-H, CCS-P, MCS-P, ACS-EM and ACS-OR.
Around 2000 is when Nancy Maguire asked Margie to sit in on a meeting about a new specialty coding organization (BMSC) at an Extravaganza in Florida. Margie felt that a specialty exam that allowed for continued knowledge and growth was the next natural step in her coding career.
Always wanting to push herself, Margie decided to sit for both the ACS- EM and the ACS-OR, even though she confesses she "HATES" tests. "I know that might surprise some people when they see the credentials behind my name," she says, "but trust me, I HATE tests! Each time I have taken [certification] tests I have always left asking, 'Okay, when can I take the retest?' They always remind me of those hateful SATs or, even worse, those dreaded typing tests where they make you type sentences that make no sense as fast as you can just to see how many words you can type in a minute. Whenever they said 'start' my fingers could never find the keys."
Despite her nerves, she passed both exams and today works as an independent consultant. She is in a unique situation in that she doesn't have a supervisor per se, but earning the ACS-OR and ACS-EM in addition to her other credentials has built up her confidence and has allowed her to network with others who have taken the ACS exams. It also helps her clients to realize that she is continuing to test herself and that she values the importance of knowledge and education.
What advice does Margie have for others considering taking an ACS exam? These specialty exams test you in terminology, anatomy, ICD-9 coding, E/M coding, modifiers, procedure notes, Medicare issues and even how to fill out a CMS 1500 form. If you are taking a surgical specialty credential, you should also make sure you understand terms, anatomy, abbreviations, etc. It is also important to understand billing issues. For the E/M, it is important to read through the 1995 and 1997 documentation guidelines (although they are supplied to you during the test)."
Margie tells fellow coders to "Just DO IT!!! — DO IT!!" She emphasizes that certification helps your supervisors/providers to know that, as part of the team, "you will always go the extra mile and make sure that you are keeping them out of harm's way."