Coder Success Story

In this month’s Coder Spotlight, we will feature Donna Beaulieu, ACS-FP, CPC, CCP, CRP. Donna obtained her Advanced Coding Specialist – Family Practice (ACS-FP) certification in 2004 and has agreed to share her story with us. We thank Donna for allowing us to shine our spotlight on her!

Donna 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 Atlanta, GA area. There, Donna 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 called upon.

Donna first heard of the Board at the 2nd Annual 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. When asked if she was nervous, she said, “It wasn’t until I finished the first page of the exam that I realized this test wasn’t going to be a cake walk, and began to get nervous.” Donna did pass the exam, although it took two attempts. “I ALWAYS pass tests!” says Donna. 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 obtaining 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.

In addition to helping her organization reclaim its rightful reimbursement, Donna has encouraged her colleagues and staff to seek certification. Her organization now provides on-going coding and compliance training for new hires as well as mandatory continuing education for all providers and office managers.

“The result of the training is that our providers are coding more logically and using modifiers when appropriate. They have a better understanding of not just what they need to do, but why.”

Donna also has some advice for coders seeking certification. “Audit/research some patient charts. Look at your office’s encounter forms and then go to the CPT book and study the chapters that pertain to what your office does. If you have access to your specialty’s Coder’s Pink Sheets or a specialty coding reference books, review them. Know your medical abbreviations and terminology. If there are any LCD or LMRP’s specific to procedures or services you offer, learn them.

Finally, Donna has some comments for her fellow coders. “Twenty years ago, there wasn’t really a title or description for what coders do. In today’s world, I believe coders are finally getting the recognition that has long been overdue. I yearn for the day when CMS finally says anyone who bills Medicare / Medicaid must have a certified coder involved in the process. I also look forward to the day when coders are more fairly compensated for their work.”

So do we, Donna!

Are you interested in pursuing your ACS credential? Find out more about how to become certified by visiting www.advancedmedicalcoding.com. Donna - congratulations on your ACS-FP, and thanks for letting us share your story!