Health Information Management Professionalsmyresource.phoenix.edu/secure/resource/HCR210R4/Essentials_of... · Health Information Management Professionals 9781133889731, Essentials

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Chapter Outline

Key Termscancer registrarcase managerclaims examinercoding and reimbursement

specialistcoding specialistconsultantethicshealth data analysthealth information manager

health insurance specialisthealth services managerlistservmedical assistantmedical office administratormedical office managermedical staff coordinatormedical transcriptionistprivacy officerprofessional practice experience

professional practice experience supervisor

quality managerreciprocityrisk managertumor registrarutilization managervendor salesperson

• Key Terms

• Objectives

• Introduction

• Careers

• Professional Practice Experience

• Join Your Professional Association

• Internet Links

• Summary

• Study Checklist

• Chapter Review

Chapter 2

Health InformationManagementProfessionals

9781133889731, Essentials of Health Information Management: Principles and Practices, Second Edition, Green/Bowie - © Cengage Learning.

All rights reserved. No distribution allowed without express authorization.

ObjectivesAt the end of this chapter, the student shouldbe able to:• Define key terms

• Differentiate among health information managementcareer opportunities

36 • Chapter 2

• Identify professional associations available to healthcare professionals

• Name the benefits of completing an academic profes-sional practice experience

INTRODUCTION

This chapter will focus on a variety of career opportu-nities in health care and health information manage-ment, the role of the professional practice experience(externship or internship), the importance of joiningprofessional organizations, the interpretation of pro-fessional codes of ethics, the impact of networkingwith other professionals, and the development of op-portunities for professional advancement.

CAREERS

Health information management combines a profes-sion in health care with information technology. Em-ployment opportunities are available in differenttypes of health care settings as well as in a variety ofpositions within those settings. Depending on the aca-demic program in which you are enrolled and yourfuture health care professional aspirations, one ormore of the career opportunities discussed in thefollowing text will appeal to you. Each career dis-cussed contains an overview of job requirements aswell as information about training, credentialing, andemployment opportunities.

Cancer RegistrarCancer registrars (or tumor registrars) collect cancerdata from a variety of sources and report cancer sta-tistics to government and health care agencies (e.g.,state cancer registries). The primary responsibility ofthe cancer registrar is to ensure the timely, accurate,and complete collection and maintenance of cancerdata. The cancer registrar enters information into acomputer database, either manually or through data-base linkages and computer interfaces. They workclosely with physicians, administrators, researchers,and health care planners to provide cancer programdevelopment support, ensure compliance with reporting standards, and serve as a valuable resourcefor cancer information.

Training

College-based cancer registry management programstypically include coursework in medical terminology,anatomy and physiology, health information manage-ment, computer information systems, health data col-lection, epidemiology, cancer registry management,and cancer case abstracting, coding, and staging. Inaddition to formal college courses, students are re-quired to complete a professional practice experiencethat totals 160 unpaid hours. Once formal educationhas been achieved, continuing education is availablein a variety of formats (e.g., daylong workshops, in-tensive two-week training programs, and Web-basedtraining modules).

Credentials

Eligibility requirements for the Certified Tumor Regis-trar (CTR) credential include a combination of experi-ence in the cancer registry profession and/or formaleducation. The National Cancer Registrars Association(NCRA) administers the CTR examination to markachievement, foster professional pride, and providenational recognition in the recruitment and retentionof registry personnel. Once certified, the NCRA re-quires CTRs to pay an annual continuing educationmaintenance fee and to submit proof of continuingeducation hours every two years (so that individualsremain up-to-date in the fields of oncology and cancerregistry management).

Employment Opportunities

Job opportunities for cancer registrars exist in a vari-ety of settings, including hospital-based, state, central,or regional cancer registries; consulting firms forwhich travel is a requirement; and private and government agencies (e.g., American College of Surgeons, Centers for Disease Control). The NationalProgram of Cancer Registries (NPCR), a product ofthe 1992 Cancer Registries Amendment Act,



authorizes the Centers for Disease Control and Pre-vention (CDC—a federal government agency respon-sible for protecting the health and safety of people) toprovide funds to states and territories to improveexisting cancer registries; to plan and implement reg-istries where they do not exist; to develop model leg-islation and regulations for states to enhance theviability of registry operations; to set standards fordata completeness, timeliness, and quality; to providetraining for registry personnel; and to help establish acomputerized reporting and data-processing system.As a result of the program, employment opportunitiesfor cancer registrars have grown.

Coding and Reimbursement SpecialistA coding and reimbursement specialist (or codingspecialist) acquires a working knowledge of CPT(Current Procedural Terminology) and ICD-9-CM (In-ternational Classification of Diseases, Ninth Revision,Clinical Modification) coding principles, governmen-tal regulations, and third-party payer (e.g., insurancecompany) requirements to ensure that all diagnoses(conditions), services (e.g., office visit), and proce-dures (e.g., surgery, X-ray) documented in patientrecords are coded accurately for reimbursement, re-search, and statistical purposes. Coding is the assign-ment of numbers to diagnoses, services, andprocedures, based on patient record documentation.Excellent interpersonal skills are also required of cod-ing specialists, who must communicate withproviders about documentation and compliance is-sues related to the appropriate assignment of diagno-sis and procedure codes.

NOTE: ICD-9-CM will be replaced by ICD-10-CMand ICD-10-PCS on October 1, 2013.

Training

A variety of training methods are available to thoseinterested in a coding and reimbursement specialistcareer. College-based programs include courseworkin medical terminology, anatomy and physiology,health information management, pathophysiology,pharmacology, ICD-9-CM, CPT, and HCPCS Level IIcoding, and reimbursement procedures. In addition,most academic programs require students to com-plete an unpaid professional practice experience (e.g.,240 hours). Professional associations (e.g., American

Health Information Management Association,AHIMA) offer noncredit-based coding training, usu-ally as distance learning (e.g., Internet-based), andsome health care facilities develop internal programsto retrain health professionals (e.g., nurses) who areinterested in a career change.

Credentials

Three professional associations offer coding certifi-cation:

• American Academy of Professional Coders (AAPC)• American College of Medical Coding Specialists

(ACMCS)• American Health Information Association (AHIMA)

AAPC credentials include the Certified Profes-sional Coder (CPC), Certified ProfessionalCoder–Hospital (CPC-H), and Apprentice status foreach (e.g., CPC-A, CPC-H-A). The AAPC also offersthe Certified Professional Coder–Payer (CPC-P) and amultitude of specialty credentials. ACMCS creden-tials include the Coding Specialist for Payors (CSP),Facility Coding Specialist (FCS), and ProfessionalCoding Specialist (PCS). AHIMA’s coding credentialsinclude the Certified Specialist Associate (CCA), Cer-tified Coding Specialist (CCS), and Certified CodingSpecialist–Physician-based (CCS-P).

The type of health care setting in which you seekemployment will direct you to the proper credential. Forexample, inpatient coders usually obtain CCS certifica-tion, while physician office coders choose CCS-P or CPCcertification. Those who have not met requirements forfield experience as a coder can seek apprentice-levelcertification as a CCA, CPC-A, or CPC-H-A.


Coding and Reimbursement Specialists can obtainemployment in a variety of settings, including clin-ics, consulting firms, government agencies, hospi-tals, insurance companies, nursing facilities, homehealth agencies, hospices, and physician offices.Coding specialists also have the opportunity to workat home for employers who partner with an Internet-based application service provider (ASP). For exam-ple, eWebHealth.com is a third-party entity thatmanages and distributes eWebCoding software-based services and solutions to customers across awide area network (WAN—computers that are far

Health Information Management Professionals • 37



apart and are connected by telephone lines) from acentral data center.

Health Information ManagersEach time patients receive health care, a record is gen-erated to document the patient’s current symptoms,medical history, results of examination, treatmentsrendered along with outcomes, ancillary report re-sults (e.g., laboratory), diagnoses, and plans for treat-ment. This patient data is organized, analyzed, andmaintained by health information managers to ensurethe delivery of quality health care. According to theAHIMA, health information managers are consid-ered experts in managing patient health informationand medical records, administering computer infor-mation systems, and coding diagnoses and proce-dures for health care services provided to patients.

Training

A health information technician (HIT) earns an asso-ciate degree from a community, junior, or technicalcollege; and a health information administrator(HIA) earns a bachelor’s degree from college or uni-versity. To be eligible to take the national certificationexam offered by AHIMA, a person must graduatefrom a program accredited by the Commission onAccreditation of Health Informatics and InformationManagement (CAHIIM). In addition to general edu-cation, coursework includes medical terminology,anatomy and physiology; legal aspects of healthinformation; coding and abstraction of data; statis-tics; database management; quality improvementmethods; and computer training. Students are alsorequired to complete professional practices in thehealth information management departments of avariety of health care settings (e.g., acute, ambula-tory, long-term, and mental health care).

Credentials

Most employers prefer to hire Registered Health In-formation Technicians (RHIT) or Registered HealthInformation Administrators (RHIA), who must pass a written credentialing examination offered byAHIMA. AHIMA requires credentialed individualsto pay an annual continuing education maintenancefee and to submit proof of continuing educationhours every two years to ensure that individuals re-main up-to-date in the field of health informationmanagement.


Health information technicians and administratorscan obtain employment in a variety of settings,including clinics, consulting firms, government agen-cies, hospitals, insurance companies, nursing facili-ties, home health agencies, hospices, and physicianoffices. Job titles for RHITs include health data ana-lyst, insurance claims analyst, records technician spe-cialist, clinical coding specialist, physician practicemanager, and patient information coordinator. RHIAjob titles include department director, system man-ager, data quality manager, information security offi-cer, educator, and consultant.

Health Insurance SpecialistA health insurance specialist (or claims examiner)reviews health-related claims to determine whetherthe costs are reasonable and medically necessary,based on the patient’s diagnosis. This process in-volves verification of the claim against third-partypayer guidelines to authorize appropriate payment orrefer the claim to an investigator for a more thoroughreview. A health information manager can also per-form medical billing, coding, record keeping, andother medical office administrative duties.

Training

Training and entry-level requirements vary widely forhealth insurance specialists; most third-party payersprefer to hire college or vocational school graduatesand provide additional training on the job.

Credentials

While most health insurance specialists become certi-fied through AHIMA or the AAPC, three other orga-nizations offer specialty certifications.

The American Medical Billing Association (AMBA)was created to network, share information and ideas,support one another, and publicly market profes-sional services as a group. AMBA is targeted towardproviding assistance for small and home-based pro-fessional medical billers with similar needs, interests,and goals. AMBA offers the Certified Medical Reim-bursement Specialist (CMRS) exam.

The International Claim Association (ICA) pro-vides a program of education for its member life andhealth insurance companies, reinsurers, managedcare companies, third-party administrators (TPAs),and Blue Cross and Blue Shield organizations

38 • Chapter 2



worldwide. The ICA offers Associate, Life and HealthClaims (ALHC) and the Fellow, Life and HealthClaims (FLHC) examinations to claims examiners inthe life and health insurance industries. According tothe ICA, the ALHC and FLHC designations areawarded only upon successful completion of all re-quired courses in both the introductory and ICAcourse segments. The ALHC program containssix courses designed to provide students with a thor-ough background in the administration of life andhealth insurance claims. The FLHC program providesadvanced claims education by requiring additionalcourses.

The Medical Association of Billers (MAB) is an in-surance claims organization that offers certification asa Certified Medical Billing Specialist (CMBS), CertifiedMedical Billing Specialist for Hospitals (CMBS-H),Certified Medical Billing Specialist-Chiropractic Assis-tants (CMBS-CA), and Certified Medical BillingSpecialist Instructor (CMBS-I). CMBSs must completecontinuing education units (CEUs) each year toremain current.


Health insurance specialists are employed by insur-ance companies, third-party administrators, and man-aged care companies. They are also employed inhealth care facilities, physician offices, and clinics.Home-based employment opportunities are alsoavailable for health insurance specialists who becomeself-employed or work for an organization that allowsclaims to be processed off-site.

Health Services ManagerHealth services managers are individuals whoplan, direct, coordinate, and supervise the deliveryof health care. They include specialists who directclinical departments or services and generalists whomanage an entire facility or system. Because ofhealth care restructuring and refinancing, healthservices managers often deal with evolving inte-grated health care delivery systems (an arrange-ment between health care providers to offercomprehensive services as a single health care de-livery system), technological innovations, complexregulations, and an increased focus on preventivecare. They are also required to improve health careefficiency and quality.

Training

According to the Bureau of Labor Statistics, most gen-eral health services managers earn a master’s degreein a related health services administration field, whilea bachelor’s degree is adequate for most entry-levelpositions in smaller facilities and at the departmentallevel within health care organizations. Clinical de-partment heads usually require a degree in the appro-priate field along with work experience (e.g., nursingdepartment).

Credentials

Health services managers who become nursing homeadministrators are required by all states and the Dis-trict of Columbia to have a bachelor’s degree, pass alicensing examination, complete a state-approvedtraining program, and pursue continuing education.The American College of Health Care Administrators(ACHCA) offers the Certified Nursing Home Admin-istrator (CNHA) credential, which is endorsed by theNational Association of Boards of Examiners for LongTerm Care Administrators (NAB) as an option forstate licensure reciprocity (credential is recognized byanother entity). Many states currently recognize theACHCA’s CNHA program, and additional states arein the process of officially recognizing the CNHA pro-gram or are favorably considering the program as anoption for reciprocity.

NOTE: A license is not required in other areas ofmedical and health services management.


Hospitals employ a large number of health servicesmanagers. However, employment opportunities willalso be available in clinics and other outpatient caresettings (e.g., home health care).

Medical AssistantMedical assistants perform routine administrativeand clinical tasks to keep the offices and clinics ofphysicians, podiatrists, chiropractors, and opto-metrists running smoothly. (They should not be con-fused with physician assistants who examine,diagnose, and treat patients under the direct supervi-sion of a physician.) Medical assistants who performmainly administrative duties answer telephones,greet patients, update and file patient medical




records, complete insurance claims, process corre-spondence, schedule appointments, arrange for hos-pital admission and laboratory services, and managethe office’s billing and bookkeeping.

The clinical duties of a medical assistant vary ac-cording to state law and include taking medical histo-ries and recording vital signs, explaining treatmentprocedures to patients, preparing patients for exami-nation, and assisting the physician during the exami-nation. Medical assistants also collect and preparelaboratory specimens or perform basic laboratorytests on the premises, dispose of contaminated sup-plies, and sterilize medical instruments. They instructpatients about medication and special diets, prepareand administer medications as directed by a physi-cian (if allowed under state law), authorize drug re-fills as directed, telephone or fax prescriptions to apharmacy, draw blood, prepare patients for X-rays,take electrocardiograms, remove sutures, and changedressings.

Training

A medical assistant earns an associate degree from acommunity, junior, or technical college or a vocationalschool. In addition to general education, students takeanatomy, physiology, medical terminology, keyboard-ing, medical transcription, administrative and clinicalmedical assisting, accounting, and insurance process-ing. Students learn laboratory techniques, clinical anddiagnostic procedures, pharmaceutical principles,medication administration, and first aid. They studyoffice practices, patient relations, medical law, andethics. Most programs require students to completeprofessional practice in physicians’ offices or otherhealth care facilities.

Credentials

Medical assistants become credentialed as a CertifiedMedical Assistant, abbreviated as CMA (AAMA),through the American Association of Medical Assis-tants (AAMA) or a Registered Medical Assistant(RMA) (AMT) through the American Medical Tech-nologists (AMT). The credentials are not mandatoryin most states, and the federal government does notrequire a medical assistant to be credentialed. To be el-igible to take the CMA exam, students must graduatefrom a medical assisting program accredited by eitherthe Commission on Accreditation of Allied Health Ed-ucation Programs (CAAHEP) or the Accrediting

Bureau of Health Education Schools (ABHES).(Be sure to check the accreditation status of your aca-demic program.) Students enrolled in programs notaccredited by CAAHEP or ABHES, but whose collegeis accredited by an organization approved by theUnited States Department of Education, are eligiblefor RMA (AMT) certification.


Medical assistants traditionally become employed inphysician offices and clinics. Other employment op-portunities include public and private hospitals aswell as nursing and residential care facilities.

Medical TranscriptionistMedical transcriptionists transcribe prerecorded dic-tation, creating medical reports (e.g., history, physical,discharge summary), correspondence, and other ad-ministrative material (e.g., committee minutes). Theyuse a special headset to listen to dictation and a footpedal to pause dictation as they key text into a per-sonal computer (editing grammar as necessary). Before becoming a permanent part of the patient’srecord, the transcribed documents are forwarded tothe dictator for review and signature, or correction.

Many medical transcriptionists work at home, andthe Internet has transformed the procedure of receiv-ing dictation and returning transcribed reports toclients for approval. (In the past, cassette tapes weredelivered to medical transcriptionists.) An emergingtrend is the implementation of speech recognitiontechnology, which electronically translates sound intotext and creates drafts of reports. Reports are then for-matted; edited for mistakes in translation, punctua-tion, or grammar; and checked for consistency andpossible medical errors. Transcriptionists working inspecialized areas with more standard terminology,such as radiology or pathology, are more likely to en-counter speech recognition technology.

Training

Employers prefer to hire medical transcriptionistswho have completed postsecondary training in med-ical transcription offered by many vocational schools,community colleges, and distance-learning pro-grams. In addition to medical transcription practicecoursework, students take anatomy, physiology,medical terminology, disease processes, pharmacol-ogy, medicolegal issues, keyboarding, and English

40 • Chapter 2



grammar and punctuation. Most academic programsalso require students to complete a professional prac-tice in the medical transcription department of ahealth care facility.

Credentials

The Association for Healthcare DocumentationIntegrity (AHDI), formerly the American Associationfor Medical Transcription (AAMT), offers the Certi-fied Medical Transcriptionist (CMT) credential to ex-perienced professionals and the Registered MedicalTranscriptionist (RMT) credential to those who do notqualify to take the CMT exam. The AHDI requiresCMTs and RMTs to become recertified every threeyears.


Medical transcriptionists are employed in a wide va-riety of health care settings, such as hospitals, clinics,and physician offices. Home-based employment isalso available for individuals who wish to becomeself-employed or work for a medical transcription ser-vice organization. The demand for transcription ser-vices is influenced by the need for electronicdocumentation that can be easily shared amongproviders, third-party payers, regulators, and con-sumers. Advancements in speech recognition technol-ogy will not adversely impact job opportunities formedical transcriptionists because of the need toamend patient records, edit documents from speechrecognition systems, and identify discrepancies inmedical reports.

Other Employment Opportunities inHealth Information ManagementA health data analyst obtains employment in a vari-ety of health care settings and is also employed bydata warehousing companies to conduct researchdata management and clinical trials management.Because businesses enter information into differentdatabases (e.g., financial, case management), a datawarehouse combines the data in a consistent way sothat inquiries can be made across the entire data set.An individual with a health information manage-ment background is a logical person to serve as ahealth data analyst. AHIMA offers a Certified HealthData Analyst (CHDA) credential for professionalswho have the ability to “acquire, manage, analyze,

interpret, and transform data into accurate, consis-tent, and timely information, while balancing the “bigpicture” strategic vision with day-to-day details.”

A consultant practices a profession. Consultant is ageneral term that can be applied to any number of in-dividuals with a wide variety of educational back-grounds, knowledge, and skills. Health informationmanagement consultants specialize in coding, long-term care, information security, ambulatory care, andso on. They provide assistance (e.g., backlog codingprojects), advice (e.g., coding validation studies to de-termine staff training needs), and information (e.g.,credentialed person who consults for a long term carefacility).

A medical office manager (or medical office administrator) coordinates the communication, con-tract, data, financial, human resource, health informa-tion, insurance, marketing, and risk managementoperations of a provider’s office. (Refer to Table 2-1for detailed tasks associated with each area of officemanagement.)

A medical office manager usually earns at least acertificate or an associate degree from a community,junior, or technical college. Academic programs aredesigned to provide students with practical and man-agerial skills required by medical practices. Some areassociated with medical assistant programs, requiringstudents to study office practices, patient relations,medical law, and ethics. Most programs require stu-dents to complete professional practice in physicians’offices or other health care facilities. The ProfessionalAssociation of Health Care Office Managers sponsorsa Certified Medical Manager (CMM) credential,which is available to members who meet eligibilitycriteria.

Medical staff coordinators usually report directlyto the health care facility’s administrator, and they areresponsible for managing the medical staff office (e.g.,attending medical staff meetings) and complyingwith medical staff bylaws (e.g., physician credential-ing and recredentialing process) and accreditationand regulatory agencies. Educational opportunitiesinclude enrollment in the National Association forMedical Staff Services (NAMSS) Independent StudyProgram or at a community, junior, or technical col-lege. The NAMSS sponsors two credentials: the Certi-fied Professional in Medical Services Management(CPMSM) and the Certified Provider CredentialingSpecialist (CPCS). Examination eligibility require-ments are available from the NAMSS.




According to AHIMA, a privacy officer overseesall ongoing activities related to the development, im-plementation, maintenance of, and adherence to theorganization’s policies and procedures covering theprivacy of, and access to, patient health informationin compliance with federal and state laws and thehealth care organization’s information privacy prac-tices. Privacy officers have an appropriate educationalbackground and work experience in legislation (laws)related to information privacy, access to records, andrelease of information. They are also knowledgeableabout security technologies and apply HIM principlesto project and change management. Education as ahealth information technician or health informationadministrator plus appropriate experience in healthcare legislation will qualify you for a privacy officer

position in a health care facility. AHIMA offers theCertified in Healthcare Privacy and Security (CHPS)credential, which is intended to represent advancedknowledge and competencies in health informationprivacy and security management.

A quality manager coordinates a health care facil-ity’s quality improvement program to ensure qualitypatient care, improve patient outcomes, confirm accreditation/regulatory compliance, and prepare forsurveys. Quality managers have usually obtained ap-propriate work experience in a related field (e.g., di-rector of health information) after first pursuingformal education (e.g., bachelor’s degree in healthinformation management). The National Associationfor Healthcare Quality (NAHQ) sponsors the Certi-fied Professional in Healthcare Quality (CPHQ)

42 • Chapter 2

Table 2-1 Medical Office Management Responsibilities

Management Area Associated Responsibilities

Communication Conflict resolution (e.g., patients, office staff)Public speaking (e.g., staff training)Telephone (e.g., patients, sales representatives)Written communication (e.g., policies, procedures)

Contracts Analysis and interpretationDevelopment and negotiation

Data Computer applications (e.g., database, spreadsheet, word processing)Interpretation of computer data printoutsVendor systems (e.g., medical office management software)Software analysis and training

Financial Accounts payable and receivableBudget—personnel and supplies/expensesInventory controlPayrollPurchasing

Human Resources BenefitsInterviewing, hiring, training, counseling, and terminating personnelJob descriptionsLegislationPerformance evaluation

Health Information Legislation (e.g., retention laws, privacy, and security)Patient record management (e.g., storage, retrieval)

Insurance Claims processingCodingThird-party payers

Marketing Community referralsMedical practice products

Risk ConfidentialityEthicsMedical malpractice



credential. Eligibility requirements are available fromthe NAHQ.

A risk manager is responsible for gathering infor-mation and recommending settlements concerningprofessional and general liability incidents, claims,and lawsuits. They initially investigate and analyze ac-tual and potential risks to the health care facility aswell as review and investigate incident reports for thepurpose of recommending appropriate corrective ac-tion. Educational requirements for a risk manager in-clude a bachelor’s degree and work experience in oneor more of the following areas: patient care, public pol-icy, health care administration, business administra-tion, legal support, or insurance/claims investigationand settlement. The Global Risk Management Insti-tute, Inc. (GRMI), a subsidiary of the Risk & InsuranceManagement Society, Inc. (RIMS), sponsors the Cana-dian Risk Management (CRM), Fellow in Risk Man-agement (CRM), and RIMS Fellow (RF) designations.

A utilization manager (or case manager) is re-sponsible for coordinating patient care to ensure theappropriate utilization of resources, delivery of healthcare services, and timely discharge or transfer. Uti-lization managers usually have a bachelor’s degree(e.g., nursing, social work), professional licensure(e.g., RN), and clinical practice experience. Becausesome utilization managers must have extensiveknowledge of coding and reimbursement systems,health information managers are also employed inthese positions. The Certified Case Manager (CCM)credential is sponsored by the Commission for CaseManager Certification (CCMC), which is accreditedby the National Commission for Certifying Agencies(NCCA). McKesson Corporation offers a CertifiedProfessional in Healthcare Management (CPHM) cre-dential, combining original certification programs inutilization review (CPUR) and utilization manage-ment (CPUM). The American Board of Quality Assur-ance and Utilization Review Physicians, Inc.(ABQAURP) offers the Certified in Health Care Qual-ity and Management (CHCQM) credential.

Vendor salespersons manage a company’s salesfor a given territory, provide information about avail-able consulting services, and demonstrate products topotential customers. Professional advancement op-portunities usually exist within the organization withpromotion to marketing manager, customer manager,or corporate account manager. Computer vendor po-sitions usually require a bachelor’s degree level ofeducation or higher and prior experience in health

information management sales. Personal characteris-tics include the ability to be a team player and to man-age critical issues.

Other employment settings for health informationmanagers include government agencies (e.g., state de-partments of health, peer review organizations), thepharmaceutical industry (e.g., data collection/studiesfor new drug approval), and research support (e.g.,Centers for Disease Control).

Exercise 2–1 Careers

Instructions: Research career information at the Bu-reau of Labor Statistics (BLS) Web site.

1. Open your Internet browser (e.g., Internet Ex-plorer, Netscape Navigator, and so on).

2. Enter http://www.bls.gov to access the BLSWeb site.

3. Locate the section entitled Occupations. Click onOCCUPATIONAL OUTLOOK HANDBOOK.

4. Use the index to search for information regardingyour future career (e.g., Health Information Tech-nician, Medical Assistant, and so on).

5. Once you locate your career, click on its title.

6. Prepare a one-page, double-spaced summary of ca-reer information, including a description of thework, working conditions, employment, training,other qualifications and advancement, job outlook,and earnings. Include facts listed on the Web site.

PROFESSIONAL PRACTICEEXPERIENCE

The professional practice experience (PPE) (alsocalled an externship or internship) benefits both thestudent and the facility that accepts the student forplacement. Students receive on-the-job experienceprior to graduation, which assists them in obtainingpermanent employment, and facilities have the op-portunity to participate in and improve the formal ed-ucation process. Quite often, students who completeprofessional practices are later employed by the facil-ity at which they completed the experience. Academicprograms (e.g., health information management,medical assistant) are required to place students inprofessional practice experiences to comply with ac-creditation requirements; other programs that alsorequire such experiences provide students with a




value-added education. (Even if your academic pro-gram doesn’t require you to complete a professionalpractice experience, you can arrange to volunteer in ahealth care facility so that you can benefit from actualwork experience.)

Preparing for the Professional PracticeTo provide the maximum benefit to students, profes-sional practices are non-paid work experiences thatare arranged by the academic program faculty. Stu-dents are usually told about the professional practicerequirement in their first semester of study, and in-formation about possible practice sites may be ob-tained at that time or during a later semester. Oncethe practice sites are identified, communicate themto the academic program faculty to determinewhether student placement is possible. The programdirector sends a letter (Figure 2-1) to the site, whichintroduces the student and details academic coursesthat will have been completed by the start of the pro-fessional practice experience. Attached to the letterare the standard articulation agreement (Figure 2-2),which must be signed by an administrative repre-sentative of the site, and a student evaluation instru-ment (Figure 2-3) that delineates tasks to beaccomplished by the student.

Creating a Professional Résumé andPreparing for an InterviewStudents are often required to submit a professional ré-sumé to the professional practice experience supervi-sor (the person to whom the student reports) and toschedule an interview prior to being accepted forplacement. While this can be an intimidating process, itis excellent experience for the interview process youwill undergo prior to obtaining permanent employ-ment. Be sure to research the résumé writing and inter-view technique services available from your college’scareer services office. This office will review yourrésumé and provide you with interview tips. Someoffices even videotape mock interviews for students.

Student Responsibilities During theProfessional PracticeThe professional practice experience is on-the-jobtraining even though it is non-paid, and studentsshould expect to provide proof of immunizations

(available from your physician), undergo a pre-employment physical examination, and participate infacility-wide and department-specific orientations. Inaddition, because of the focus on privacy and securityof patient information, the facility will require you tosign a non-disclosure agreement (Figure 2-4), which iskept on file at your college and by the professionalpractice site.

NOTE: Breach of patient confidentiality can resultin termination from the professional practice experi-ence site, failure of the professional practice experi-ence course, and even possible suspension and/orexpulsion from your academic program. Be sure tocheck your academic program’s requirements regard-ing this issue.

During the professional practice experience, youare expected to report to work according to the sched-ule established by your supervisor. If you cannot at-tend on a particular day or if you will arrive late, besure to call in. (You will be required to make up anylost time.) Because this is a simulated job experience,you are also expected to be well groomed and to dressprofessionally. In addition, it is very important thatyou act interested in all aspects of the experience, de-velop good working relationships with coworkers,and react appropriately to criticism and direction. Ifany concerns arise during the experience, be sure todiscuss them with your professional practice supervi-sor and/or instructor.

Professional Code of Ethics

Ethics are judgments about what is right and wrong,and each professional association has a code of ethicsthat is to be followed by its membership. Even if youare not an active member in your professional as-sociation, you are expected to comply with the established ethics. (Professional codes of ethics can befound in Appendix I and at your professional associ-ation’s Web site.)

Exercise 2–2 Professional Practice Experience

1. Identify five health care facilities and/or officesthat could serve as professional practice sites. Usethe telephone book or search the Internet to locatefacilities and/or offices in your area.

2. Contact each facility and/or office, and talk withthe switchboard operator or office receptionist toidentify the name and phone number of the

44 • Chapter 2



department manager or other professional towhom you would report during the professionalpractice. Be sure to explain that you are a studentin an academic program (identify the program)and that you are gathering preliminary informa-tion for an assignment. It is possible that you willbe transferred to the department in which youwould complete the professional practice.

Remember! You are not authorized to discuss thespecifics of the professional practice placement. Thatis the responsibility of your college’s professionalpractice coordinator, who has performed this taskhundreds of times and is in a position to provide spe-cific information upon request. When students initiateconversations about professional practices, it can beperceived as inappropriate and unauthorized. This


,

Figure 2-1 Professional Practice Letter (Permission to reprint granted by Alfred State College.)



46 • Chapter 2

Figure 2-2 Professional Practice Articulation Agreement (partial) (Permission to reprint granted by AlfredState College.)




Figure 2-3 Student Evaluation Instrument (Permission to reprint granted by Alfred State College.)



can result in a site refusing to accept a student forplacement.

NOTE: Because this assignment provides an excel-lent way to initiate contact with working profession-als who can eventually help you obtain employment,be courteous, patient, and polite.3. Generate a list of potential professional practice

experience sites including the name of the facility,mailing address, contact person in the HIM de-partment, and the contact person’s telephone num-ber (including area code).

4. Submit the information to your instructor (or otherindividual identified by your instructor) using theformat in Table 2-2.

JOIN YOUR PROFESSIONALASSOCIATION

Students are often able to join their professional asso-ciation (Table 2-3) for a reduced membership fee andreceive most of the same benefits as active members

48 • Chapter 2

Figure 2-4 Non-Disclosure Agreement (Copyright © Courtesy of Bibbero Systems, Inc., Petaluma, CA.Phone: 800-242-2376; Fax: 800-242-9330; www.bibbero.com.)




Table 2-2 Professional Practice Experience Placement Form

Student Name: _______________________________________________________________________________________________

Mailing Address: _____________________________________________________________________________________________

Telephone Number (Daytime): _________________________________________________________________________________

Telephone Number (Evening): _________________________________________________________________________________

Email Address: _______________________________________________________________________________________________

Name of Academic Program: __________________________________________________________________________________

Number/Name of Professional Practice Course: __________________________________________________________________

Name of Facility or Office Mailing Address Contact Person Telephone Number

(1)

(2)

(3)

(4)

(5)

Table 2-3 Careers and Related Professional Associations

Career Professional Associations

Cancer Registrar National Cancer Registrars Association (NCRA)Coding Specialist American Academy of Professional Coders (AAPC)

American College of Medical Coding Specialists (ACMCS)American Health Information Association (AHIMA)

Health Information Manager American Health Information Management Association (AHIMA)Health Insurance Specialist American Medical Billing Association (AMBA)

International Claim Association (ICA)Medical Association of Billers (MAB)

Health Services Manager American College of Health Care Administrators (ACHCA)Medical Assistant American Association of Medical Assistants (AAMA)

American Medical Technologists (AMT)Medical Office Manager Professional Association of Health Care Office Managers (PAHCOM)Medical Staff Coordinator National Association for Medical Staff Services (NAMSS)Medical Transcriptionist Association for Healthcare Documentation Integrity (AHDI)Quality Manager National Association for Healthcare Quality (NAHQ)Risk Manager Risk & Insurance Management Society, Inc. (RIMS)Utilization Manager Case Management Society of America (CMSA)

(who pay much more!). Benefits of joining your pro-fessional association include:

• Receiving publications (e.g., professionaljournals)

• Web site access for members only• Networking with members (professional practice

and job placement)• Reduced certification exam fees• Eligibility for scholarships and grants



Attending professional conferences and meetingsis one way to network with professionals. Another isto join a listserv, which is an Internet-based or emaildiscussion forum that covers a variety of topics andissues (Table 2-4).

Exercise 2–3 Join Your Professional Association

1. Review Table 2-3 to identify the professional asso-ciation for your health-related careers.

2. Contact your professional association and re-quest a student membership application. (Mostapplication forms are available at the professional association’s Web site. Refer to the Internet Linkssection of this chapter.)

3. Complete the application form and, if required, ob-tain your program director’s signature.

4. Submit the application to the professional associa-tion with payment.

NOTE: Student membership fees are usually lessthan for active members, but you receive many of thesame benefits.

INTERNET LINKS

American Associationof Medical Assistants(AAMA) http://www.aama-ntl.org

American Academyof Professional Coders(AAPC) http://www.aapc.com

American College of Medical Coding Specialists (ACMCS) http://www.acmcs.org

American HealthInformation ManagementAssociation(AHIMA) http://www.ahima.org

Association for Healthcare Documentation Integrity (AHDI) http://www.ahdionline.org

American MedicalBilling Association(AMBA) http://www.ambanet.net/amba.htm

American MedicalTechnologists(AMT) http://www.amt1.com

Bureau of LaborStatistics http://www.bls.gov

Healthcare IT YellowPages http://www.health-infosys-dir.com

National Cancer RegistrarsAssociation (NCRA) http://www.ncra-usa.org

Professional Associationof Health Care OfficeManagement(PAHCOM) http://www.pahcom.com

SUMMARY

Health information management combines a profes-sion in health care with information technology, and

50 • Chapter 2

Table 2-4 Internet-Based Bulletin Boards and Discussion Forums (Listservs) NOTE: Go to https://list.nih.gov,click on the Browse link to view a list of federal government listservs (e.g., HIPAA-REGS), and join those thatinterest you.

Type of List Listserv Name Web Site

AAOC Members Forums Go to http://www.aapc.com, click on the Account Login link, and click on the Forums link.

Coders Discussion Groups Go to http://coding911.com, and click on the "Discussion—Join" link.

AHIMA Members Communities of Practice Go to http://www.ahima.org, and log in.Health Information Advance Forum Go to http://community.advanceweb.com, and click on the HIM

Professionals Insider: Forums link, located below the "ADVANCE for Health Information Professionals" heading.

Medicare Part B Claims PartB-L Go to http://www.partbnews.com, scroll down and click on the "JOIN Part B-L" listserv link to join.



employment opportunities are available in many typesof health care settings. The professional practice expe-rience provides students with on-the-job experienceprior to graduation and assists students in obtainingpermanent employment. Students are usually able tojoin their professional association for a reduced mem-bership fee and receive most of the same benefits as ac-tive members. The benefits of joining a professionalassociation include receiving publications, logging into Web sites reserved for members only, networkingwith members, paying reduced certification exam fees,and becoming eligible for scholarships and grants.

STUDY CHECKLIST

• Read the textbook chapter, and highlight key con-cepts. (Use colored highlighter sparingly through-out the chapter.)

• Create an index card for each key term. (Write thekey term on one side of the index card and the con-cept on the other. Learn the definition of each keyterm, and match the term to the concept.)

• Access chapter Internet links to learn more aboutconcepts.

• Answer the chapter Exercises and Review ques-tions, verifying answers with your instructor.

• Complete the chapter StudyWare activities.• Complete WebTutor assignments and take online

quizzes.• Complete lab manual assignments, verifying an-

swers with your instructor.• Form a study group with classmates to discuss

chapter concepts in preparation for an exam.

CHAPTER REVIEW

True/False: Indicate whether each statement is True(T) or False (F).

1. Once certified, a certified tumor registrar pays anannual fee to the NCRA and, therefore, does nothave to participate in continuing education.

2. Coding and Reimbursement Specialists can obtainemployment in a variety of health care settings.

3. A health information manager has a wider rangeof skills than a certified coder.

4. Registered Health Information Technician job ti-tles include data quality manager, information se-curity officer, educator, and consultant.

5. Medical assistants examine, diagnose, and treat pa-tients under the direct supervision of a physician.

Multiple Choice: Select the most appropriateresponse.

6. A health care professional who has the primaryresponsibility of ensuring the timely, accurate,and complete collection and maintenance of can-cer data is known as a(n)a. cancer registrar.b. coder.c. health information manager.d. medical staff coordinator.

7. Two professional associations that offer certifica-tion in coding area. AAPC, AHIMA.b. AHIMA, CDC.c. ICA, CDC.d. NCRA, AAPC.

8. Which is a benefit of joining a professional associ-ation?a. guarantee of a grant or scholarshipb. joint membership with other associationsc. membership fee that is reduced for alld. networking with professional members

9. Which professional is required to pass a licensingexamination in all states and the District of Columbia?a. chief executive officerb. health information managerc. information systems managerd. nursing home administrator

10. Medical transcriptionists have unique skills thatenable them toa. code diagnostic and procedural information.b. enter information into computerized data banks.c. keyboard prerecorded medical dictation.d. stage tumors according to SEER and TNM.

Fill-In-The-Blank: Enter the appropriate term(s) tocomplete each statement.

11. The assignment of numbers to diagnoses, ser-vices, and procedures based on patient recorddocumentation is known as ________.

12. The Bureau of Labor Statistics states that employ-ment for the health information managementprofession is expected to grow ________ for alloccupations through 2010.




13. The insurance claims organization that offers cer-tification as a Certified Medical Billing Specialistis the ________.

14. The American Association of Medical Assistantscredentials medical assistants as ________ andthe American Medical Technologists credentialsmedical assistants as ________.

15. Each professional association has a(n) ________,which are judgments about what is right orwrong.

Short Answer: Briefly respond to each question.

16. Sally Smith is interested in pursuing a career as aphysician office coder. What is the most appropri-ate coding certification for her to obtain?

17. How has Internet-based technology allowed cod-ing specialists to work at home?

18. According to the American Health InformationManagement Association, health informationmanagers have specific areas of expertise. Statethe areas of expertise of health information managers.

19. What is the purpose of a professional practiceexperience?

20. Professional associations often allow students tojoin the association as student members. List the student benefits of joining a professional association.

52 • Chapter 2



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