In the health care community, there is a growing movement towards value-based payment (VBP) methods and programs that reward health care providers for the quality of care they deliver. In light of this important shift away from quantity-based payment, medical coding expertise is becoming even more integral to Primary Care Development Corporation (PCDC)’s high-quality coaching and capacity building programs for our healthcare partners and clients.
PCDC’s Capacity Building team is made up of experts with numerous combined industry certifications and other credentials. Their specialties include:
- guiding primary care practices to achieve Patient-Centered Medical Home (PCMH) recognition;
- capturing, managing, and collecting revenue from insurance payers in support of high-quality care;
- enabling practices to make the most of connections between PCMH activities, such as coordinating and managing care, and the reporting requirements for other VBP programs;
- guiding practices in quality improvement initiatives to maximize billing and excellent care. For example: identifying incentive payments that are included in VBP contracts with insurers; reviewing these contracts to reconcile missed opportunities for billing and incentive payments; facilitating selection and measurement of quality indicators to meet reporting requirements; and providing deep-dive analysis to address system inefficiencies and patterns such as repeated claim denials.
In support of these services, three Capacity Building team members recently obtained their Certified Professional Coder (CPC) certification, the most recognized medical coding certification in the healthcare industry.
Maia Bhirud Morse, Senior Program Manager; Angelo Marciano, Project Manager; and Kimberly Mirabella, Senior Project Coordinator finalized the year-long certification process after completing over 100 hours of coursework and an extensive exam. Through this process, they demonstrated mastery of International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS).