Welcome to a fascinating behind-the-scenes look into the world of medical coding with our guest, Rae Jimenez, a seasoned expert with over 30 years of experience in the healthcare industry. Rae, who is currently the Chief Product Officer at AAPC, opens up about her journey and roles within the organization. Notably, Rae highlights the indispensable role of digital tools and the importance of coaching the new coders to efficiently navigate these resources in the workplace.
Our conversation takes a deep-dive into the careful procedures implemented to ascertain only the qualified individuals sit for the exams and the innovative platform being developed offering a range of motivating options. We further delve into the various levels of assessment needed for different designations and the utility of this platform for employers to evaluate their team's coding accuracy. As artificial intelligence steadily seeps into the medical coding industry, we tackle the challenges that arise. Listen in as Rae reveals how AAPC is tirelessly working to combat these hurdles, safeguarding the integrity of exams, and creating a progressive platform tailored to give individuals a wider choice of exam options. Join us for this insightful discourse on the future of healthcare and the medical coding industry, and the transformative role of technology within it.
Welcome to a fascinating behind-the-scenes look into the world of medical coding with our guest, Rae Jimenez, a seasoned expert with over 30 years of experience in the healthcare industry. Rae, who is currently the Chief Product Officer at AAPC, opens up about her journey and roles within the organization. Notably, Rae highlights the indispensable role of digital tools and the importance of coaching the new coders to efficiently navigate these resources in the workplace.
Our conversation takes a deep-dive into the careful procedures implemented to ascertain only the qualified individuals sit for the exams and the innovative platform being developed offering a range of motivating options. We further delve into the various levels of assessment needed for different designations and the utility of this platform for employers to evaluate their team's coding accuracy. As artificial intelligence steadily seeps into the medical coding industry, we tackle the challenges that arise. Listen in as Rae reveals how AAPC is tirelessly working to combat these hurdles, safeguarding the integrity of exams, and creating a progressive platform tailored to give individuals a wider choice of exam options. Join us for this insightful discourse on the future of healthcare and the medical coding industry, and the transformative role of technology within it.
It's time for the Contempo Coding Podcast.
Speaker 2:Discussions knowledge and insight to help you succeed in the medical coding industry.
Speaker 1:And now here's your host, victoria.
Speaker 2:Hey everyone, welcome back to the channel. I'm here with Ray Jimenez. Ray has over 30 years in the healthcare industry. She is the Chief Product Officer at the AAPC and she serves as a coding liaison with the AMA on the CPT Advisory Editorial Panel, right? Yes, so over the past 15 years with AAPC, you've had a lot of different responsibilities Certification exams, developing them, the preparation materials, overseeing the Department of Operations for the exam, distance learning, some of the educational licensing as well, right, and I just want to thank you so much for taking the time to come onto the channel today and talk with me and my viewers. I thank you for having me. So can you tell us a little bit about your current role as the Chief Product Officer at the AAPC and how your journey went through to this point? Like I'm always interested to like people, like how you got into medical coding, because no one graduates high school and goes into medical coding. Like you never hear that story.
Speaker 1:No, absolutely not. So when I was going through college I knew I wanted to do something in the medical field. I wasn't exactly sure. I thought it was going to be more clinical and I had to work my way through college. So I started as a chart finder in a doctor's office, just finding the chart so that the nurses could call, and I did a great job. So they're like hey, do you want to learn how to be a medical assistant? I'm like well, that's definitely pertinent for what I'm interested in. So being on the clinical side taught me a lot. And the fact that I was going to college.
Speaker 1:When I transitioned to a smaller office they were having claims denials and they said well, you go to college, here's this book, can you read it and help us figure it out?
Speaker 1:So then I just figured out ICD-9 coding, got them paid and then started with pre-certification for surgeries, and that's how I ended up being interested in the clinical side, but then transitioning into the business side and then, luckily, through my career, I was able to go into the education and then placement of coders into roles. And that's really what prompted me into getting into AAPC, because we had started Project X-Turn at the time. Yes. So with my SME knowledge of the industry plus my placement background, they said why don't you come and help us try to get this program off the ground? And then, just through my evolution with AAPC I've been there 16 years now in various roles, and Chief Product Officer allows me to look at all that we're doing holistically. Me understanding what our members need, what the industry needs, just helps me influence and say okay, how are we going to approach things from a holistic approach versus here's a book, here's an exam, here's like little aspects of pieces.
Speaker 2:So I love that I never had any clinical experience. I would say if you asked me to take a blood pressure, if it was like an automatic one, I might be able to figure that out. Yeah, but that's about the extent of it Like maybe an automatic blood pressure and a thermometer, I could run nothing else clinical.
Speaker 1:Well, I tell you I was lucky enough to work for a few physicians that loved teaching. Yeah. So for the family physician that I worked for, dr Pearl Steen, it became a game where he'd be like okay, I'm going to do a procedure in this room, I want you to go set up the tray and you tell me what you think I'm going to use in this procedure. So when it comes to like excisions of lesions like that has always resonated with me because of that clinical exposure that's awesome.
Speaker 2:That's one of the things you miss when you're working remotely Like you don't get that hands-on experience. I remember I was working at one organization and I asked if I could go shadow in the OR and they're like, no, absolutely not. And then I switched over to this other organization and I'm like I asked again hey, can I shadow in the other? They're like, yeah, go. I'm like this is the coolest thing ever. They're going to let me go. And I got to watch a breast reconstruction, yeah, and I just thought that was just like so amazing that they let me do that. And that experience still sticks with me to this day.
Speaker 2:So, speaking about all of the different services the AEPC offers and the oversight of that, I noticed that the AEPC has been stressing a lot of the digital tools. Recently I even purchased the package where, if you pre-order next year's books, you can get the eBooks included, which was great. So I'm starting to stress to others the importance of using eBooks and I think, with you know the workforce that we've got a lot of employers. They don't want to ship out physical books to 50 different people in 50 different locations and I think they need more the digital tools right, Because they want that remote workforce to just have access to them from anywhere, Right, but how long do you think it's going to take for coders to adapt using digital tools when we're so used to? We love our books and we like to mark up things in our physical books.
Speaker 1:Yeah, that's a great point. I think that there's more than one aspect at play. As long as we continue to teach and require code books during exams, we're going to continue to have people learning on books, and that's what they become accustomed to, right. So I think that as we train new coders in this field, teaching them on the electronic tools that their employers are going to expect them to use in the workplace makes sense. You know, in some offices when they had physical books, they wouldn't buy necessarily a set for every person, but maybe some for the department that they could share. So now, with the remote workforce where everyone has to have their own resources, it's a lot economically sound for an employer to purchase the electronic tools, right. It also has benefits of using the electronic tools. They can be updated immediately.
Speaker 1:When you look at all of the lab codes that get added and COVID, for example, with vaccines, right, you can update physical books and you can't have access to all of the other tools that you're going to be researching about, the codes like the LCDs and CCI edits, yeah, so I am a person that held on to my books forever too, and that's the reason why in codify, we've created the index, just like you would look up in a physical book to be able to get to those codes.
Speaker 1:Because me, like many of our members that I hear, they find that navigating the books is something they're used to and they feel they could get to the code quicker with their books versus doing a code search or a keyword search and having to look at all of the options that come up. So that's the reason why we kept the index. It's another reason why we have linked codify to the code books We've started with ICD-10 so that you can look it up like you would in a book and then have all the electronic tools. So I think that you know if I were to say when is Physical books going away, I can't say that we're ever going to be a hundred percent off books, but I do start seeing the transition to more electronic usage.
Speaker 2:Yeah, and I think it'll be interesting to see the trending because I know Bevan has spoken about the certification exams and how we're piloting, testing out how to do the exam with an electronic book versus a paper book and seeing you know how that's going to play out and you know people have different exam strategies about. We highlight and we underline this and we circle that and and I'm fascinated to see how people will transition their coloring book methodology in the in the code books, to the Electronic format. You know there's tools there but not quite as always as easy as just like. Oh, I'm just gonna highlight that in purple.
Speaker 1:Yes, for sure I mean, and because if we're training people how to do it that way, I think with electronic tools there's ways for us to add that highlighting and add those features in to distinguish what, quickly distinguish one code from another. In the beta Testing we've been doing with the ebooks, we have found that seven out of ten individuals that have gone through the beta process with us using the ebook on an exam have recommended the ebook over the paper book.
Speaker 2:Yeah, I think it's easy to with the electronic tools to just do that control f and find and there it is, and here's. It takes me right to and set up flipping through all the pages exactly and wasting that time.
Speaker 1:Yeah, looking for what you're looking for.
Speaker 2:Yeah, speaking of the exams, you know I hear viewers and hear these comments about oh, the exams are so strict. When I do the online exam, the proctors they want to check underneath my desk and, you know, protecting the integrity of the exam. It is so, so critical because if the exam isn't worth anything, our credentials aren't correct. Can you help my viewers understand just how much work goes into Creating these certification exams and then kind of walk us through what happens if the exam is compromised somehow?
Speaker 1:right, so with the item creation, we're pulling exam questions for from a very large test bank and you're continually Updating that content and there's ways of making a very solid base question and then changing small Variations within that question to make a replica or an alternate version of that test question. So this is a continual development that we use committees to help us create these items. Aepc obviously Leads that Development and testing of the items and making sure that they're consistently written in order to adequately Test the competency that that question is geared toward. So you're talking about Many people involved in item development. We also have the analytical side of things. So even in a paper environment, we were always tracking items to see how often is this question being missed, how often is this question Right. There's also forensic analysis that they do on exam data To let us know if we have a problem in a certain location, a certain proctor.
Speaker 2:Yeah, a certain group of people.
Speaker 1:Yeah know if our items are being compromised. Okay, with the paper exams you would have to wait until all that data came, but all the Bubble sheets came back. You were able to load it into the system and send those files out for analysis. With the electronic Platform you get that information real time so that if there is a compromise question, you could invalidate someone if it looks like they did have access to information that they shouldn't have had prior to taking the exam.
Speaker 1:So that's one of the things that Really motivated us to get to a fully electronic platform was because you can change out items that are unfair to examinees. That's another opportunity for us is if we see a question is not performing well, we can suppress it from grading and saying that question, for whatever reason, is not performing well and it's not fair to our test takers. So we can suppress it from the grading so that they're not penalized for a poorly written item for whatever reason. So that data capture and constant analysis gives us validation that we've got sound exams that are fair, but also that we're maintaining the integrity, because, just like you said, it would be so easy for AAPC to make all of our tests so easy that anyone can pass, but then it doesn't hold credibility for the industry to monitor who really knows what they're doing.
Speaker 2:Exactly so. I know with the paper exams there was always different versions Historically. There was a version A, b, c, d, e, f. Is the electronic exam the same or is it just pulling just randomized questions?
Speaker 1:from the data right Randomized questions. So everyone will have a different version of the exam but testing the same competency. So you can change the variations but still get to the same type of competency that you're trying to test Prior to going to electronic. In the paper version we have 12 to 16 different versions of the exam that we cycle through the entire year to always change up what the exams are so that if someone did have information on the exam, it wouldn't benefit others.
Speaker 2:Now I think there's been some confusion with exams and what's going on in 2024. Correct, Because I keep hearing people say there's no more in-person exams and I'm like, no, no, no, that's not quite correct. There's still gonna be in-person exams. They might not be necessarily paper exams. They're not gonna be with the chapters. So what can examiners expect in 2024?
Speaker 1:So in 2024, we are going away from paper-based. Everything will be in the electronic format, the electronic platform, for all the benefits that we've already talked about. They will have the opportunity to either select that they wanna take live remote proctoring, like we already have available, or to take it through a physical center through the measure platform, which was Scantron, so people that are familiar with bubble sheets. Scantron's a well-known name, so they have testing centers across the United States and globally. So the individual, if they choose to take an in-person exam, in their email when they purchase the exam they will be given instructions on how to schedule their exam in the testing center that's closest to them. The reason why those test centers aren't publicized on their website is they don't want people that aren't qualified or approved to be taking an exam to be showing up their test centers. So that information will be made available to the exam and once they purchase the exam, then it will open up to say, okay, here are your options.
Speaker 2:So then, are the independent instructors. Their students will be advised either to go through the online remote proctoring or through the measure locations as well.
Speaker 1:Okay, Correct Now. Any school can apply to be part of the measure offering. Oh, okay, the one thing that schools would have to realize is that if they do want to be a measure site, they're gonna have to follow their parameters of what's expected of a test center, and it's gonna open them up as a test center, not just for AAPC exams, but for other exams as well. So if they want to host exams, we're not saying that they can't, it's just gonna have to be under that umbrella. Okay, that makes sense then.
Speaker 2:So recently AHIMA has released these micro credentials and it's been a fascinating thing to kind of see and there's a lot of hype around that. Is this something that the AAPC is looking at and kind of evaluating some of our own certifications and own training and determining if there is a different sort of way we should be looking at some of our training and credentials as far as these specialty trainings?
Speaker 1:Absolutely, and it's been a product that we've been developing for over a year now. So we're really excited about when we can launch the beta of this. We're taking a little bit of a different approach. You know, right now we've got many CPCs and one of the things that we hear like me, I've had it for over 20 years now. So what differentiates me from others that hold the same credential that I do Someone that just received their CPC versus someone that's had it for many, many years?
Speaker 1:So the platform that we are building is going to give individuals many different options as far as what's motivating to them. It will give them an all-inclusive library of all AAPC content. So if they want to learn how to code a cardiac cath, they'll be able to search for cardiac cath. All of our micro learnings, articles, webinars, anything that's in our content library by topic, will be available to that individual. The other part of this platform that they have the option is to attain different levels of competency. So if I say I am an expert in cardiology, I want to be able to show my employer that there's going to be a path for them to take different levels of assessment to attain different designations, so they will be able to start on the intermediate track move up to expert, move up to master based on this Wow, yes, that's awesome.
Speaker 1:So there's going to be three levels of designation by specialty. We're starting with coding. We will also have a version into billing as well as auditing, but coding is what we're going to be launching as our first version of the product. The other part of this is that right now, we've got a ton of really good content. We have the ability to assess. This platform is going to allow us to pair, when you're going through these practice assessments, what areas are you not coding well? And it gives you OK, cardiac cath, you didn't code this well.
Speaker 1:Here's the micro learning that goes with it. Rather than just a rationale explaining the answers, they'll have micro learning units assigned to each one of the competencies assigned to an assessment, and the other part of this is that, from an employer's perspective, they can enroll them in the assessment to benchmark how their employees are performing. So it'll let you rank your team based on who's got the best scores. Who might need additional education. We have a fee schedule is tied to it, so not only can you save accuracy of coding, but you can also tie dollars to it. So we really are excited about this and feel like it's going to really change the way that we demonstrate competency, and employers can assess competency and give their employees the tools based on where they need the most help.
Speaker 2:Yeah, and I think that's so phenomenal because I'm someone who has one of the sunset credentials. I have my plastic and reconstructive surgery, and their rationale is always well, we just didn't have enough people that were interested in testing for it to maintain all of the exam costs and printing them and maintaining it, which is totally understandable. But I feel like now, with micro competencies, that might open the door now to some of those additional specialties and having training for them not necessarily credentials, but being able to direct someone that's like hey, I'm having to learn this new specialty, I don't know what I'm doing, and seeing where they might rank and then being able to direct some additional training to them, I love that. I think that's so needed in this industry right now.
Speaker 1:We feel really good about our approach because we've been using an employer-focused committee to help guide us, because you wanna make sure that you're developing tools. If I say that someone's an expert in cardiology, if it doesn't resonate with the employer, then what does it mean? Right, it's just something that I earn that might not hold weight from an employer's perspective. So in the development of this product, we've been incorporating their points of view so that we know that it's going to mean something to them. So we feel really good about the approach. The other thing about this platform is it will also show you your ranking against others that are also in the platform. So an employer's not just gonna be able to see how their employees are ranking, but how they rank against the entire universe that's in there, so you know how competitive we are.
Speaker 2:Yeah, I know it's exciting and it's a little scary, Like I like when we do that to physicians. But now I'm like, oh, I don't know how I feel about them do, about that happening to us now.
Speaker 1:But yeah, we're really close to being able to show a little bit of the product and we're excited about it. We will be releasing a beta version to get people in there and just get feedback, make sure we're on the right track before we build out all specialties. So we're excited.
Speaker 2:Yeah, one of the things that I always say, like if I could snap my fingers and fix the problem. As everyone says, oh well, you know, I can't find a job, and we have these also assessments out there saying oh well, there's a shortage of medical coders and I'm like, well, I think it's more so a shortage of experienced medical coders Once they have two plus years experience and can hit the ground running doing, you know, gi surgery or something like that, and that might be a good gap for that as well. Is there anything that you wish you could like snap your fingers and fix in this industry? Wow.
Speaker 1:I wish that we could definitely make sure that all patients have access to healthcare. Number one. Number two is reducing some of the administrative burden and make it more consistent so that it's not so hard to navigate. You know, big problem that we're having right now is clinician burnout just from all of the administrative burdens and just the difficulties of getting reimbursement in. You know, when you look at in the proposed rule, physicians again are going to get a decrease. They can't take on all of this cost with less dollars coming in. So some of the regulation and some of the complexity I don't think is needed.
Speaker 2:And now it's even affecting patients that it's taking forever to get into just to see your provider for a routine visit or even if you're having a concern. You know there's just so much that they have to track anymore that they're so behind. And yeah, healthcare is not easy.
Speaker 1:Well, and unfortunately there's those that game the system that kind of ruin it for everybody else. You know you see, it in all of the audits. Now with telehealth, it was a good concept to open it up and make care more accessible, but you saw people that saw that as a vulnerability in the system and took advantage of it.
Speaker 2:Right is there anything else coming up with the AAPC that you want to let my audience know about or that you're excited about?
Speaker 1:Well, I know that there's a ton of talk about AI and some of the insecurities of what that means and, just like any technology, I think I compare this a lot to the electronic health record and the kind of scare that we received, where, with electronic health records, coders jobs are going to go away, we're not going to be needed. Anytime technology is incorporated, it change and modifies our jobs but opens up other opportunities. You know, I think CDI is going to be so important because garbage in, garbage out, you know, and the audit aspect afterwards, the compliant aspect afterwards, there's going to need to be a check and balance.
Speaker 2:Yeah, I think I have some friends that work in in the legal end of things and they're like we're pop and like business. I can't hire people fast enough to keep up with the case load that's coming, and I think we'll probably see more than that coming up over the next few years, especially as even physicians are adopting AI and we're finding out that. You know we're seeing incorrect information and repetitive information and the challenges that are going to come with that as well Exactly Well, thank you so much, ray, for taking your time out to speak with me today. I'm going to link below all the AAPC social media so that people can follow more information about the AAPC and what they're doing and check out all those products and services that are going to be coming up.
Speaker 1:All right, thanks, and thank your viewers too, for listening. Thanks.