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Certification & Accreditation Exam Content & Resources

Exam Content & Resources

The CHBME exam was restructured in 2018 to include updated content to further reflect changes in our field. The updated content ensures the knowledge and skills evaluated in the exam fully align with the competencies revenue cycle management professionals need to perform their jobs responsibilities.

The CHBME exam reviews six domains of competencies and must be taken in person. The exam is offered at the HBMA Healthcare Revenue Cycle Conference and can also be taken throughout the year using peer proctoring. Click here for peer proctoring guidelines.

Understand the exam requirements when preparing for the exam. All exam participants must be enrolled in the CHBME program and complete 60 credit hours before sitting for the exam. The exam is administered in a single two-hour time frame and candidates must register to take the test no later than two weeks prior to the testing date.

At the bottom of the page is also a list of resources, reference documents, and websites that were used in the development of the exam. These are great places to review as you prepare to take the exam.

Domain 1: Strategic Planning

Strategic Planning

I. Competency: Define the elements of and the process for building a strategic plan
II. Competency: Explain the steps for determining how and when to add new products and services into the business

Succession Planning

I. Competency: Articulate succession planning options
II. Competency: Define elements of a thorough SWOT analysis

Disaster Planning

I. Competency: Define the elements of successful disaster plan

Domain 2: Financial Management

Accounting Principles

I. Competency: Define cash vs. accrual accounting

Reporting

I.   Competency: Identify various payment models
II. Competency: Manage the RFP/procurement process for a business
III.  Competency: Describe pricing models and identify how they affect the business structure
IV.  Competency: Ability to read and interpret basic financial reports

Financial Decision Making

I.   Competency: Explain key concepts of financial decision making including:
a.   Retained earnings
b.   Taxes
c.   Asset Accounting and Depreciation
d.   Lease v. Buy
II.   Competency: Define the elements of successful cash management

Domain 3: Operations

Corporate Structure/Business Type

I. Competency: Define how various type of corporate structure affects the business model

Human Resources

I.   Competency: Describe the necessary elements for managing a remote workforce
II.   Competency: Define successful methods for managing off-shore employees
III.  Competency: Identify components of a successful performance management process

KPIs

I. Competency: Articulate the concept of revenue per claim
II. Competency: Tips for establishing KPIs

Operational Workflow

I. Competency: Articulate the fundamental elements of revenue cycle management by function and client
II. Competency: Outline the steps in a successful denial management process

Coding

I. Competency: Outline the elements of the coding process and how that affects the revenue cycle

Practice Management

I.   Competency: Define the payment models:
a.   P4P payment model
b.   ACOs
II. Competency: Outline the steps involved in Provider Enrollment including Managed Care and Contracting

Domain 4: Customer Relations

Sales Marketing

I. Competency: Tabulate ROI on various marketing efforts including print and electronic media and trade shows

Business Development

I. Competency: Define several options for business development and their cost to the company

Client Communication/Relationship Building

I. Competency: Identify methods of outreach via electronic media

Domain 5: Technology

Automation

I.   Competency: Define the system requirement needs for:
a.   Downloads and Interfaces
b.   Integrated Scanning
c.   Electronic Scanning
d.   OCR
e.   Coding Support Products

System Software

I. Competency: Define the necessary requirements for setting up a practice management software system.

System Security

I.   Competency: Define the appropriate elements to keep your system secure
II.   Competency: Outline the requirements for a HIPAA compliant system
III.  Competency: Describe the necessary controls for voice mail, data systems, electronic media and remote access
IV.  Competency: Define the necessary components to meet meaningful use requirements.

Domain 6: Compliance and Legal

Risk Management

I. Competency: Define how to integrate a risk management strategy into your corporate structure

Auditing

I.   Competency: Define the types of audits and monitoring for compliance
a.   Internal Control Audits
b.   CERT/RAC/PQRS Audits

OIG Compliance Guidelines

I. Competency: Define the seven elements of OIG Compliance

General Operations

I.   Competency: Articulate the Government and Commercial Payer Rules
a.   Payments
b.   Medicare/Secondary Payers
c.   Pre-authorization
d.   Balance Billing
e.   Meaningful use/HER
f.   Collecting unclaimed funds

Reference & Resource Documents

Exam questions are based on a wide variety of publications, regulations, and resources in the healthcare business management field. Suggested preparation for the examination may include, but is not limited to, the following resources:

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