Cantrell CPA Services, LLC

Certified Healthcare Financial Professional - Continuing Education Options

As with any professional certification, Certified Healthcare Financial Professionals (CHFP's) have a continuing education requirement to maintain their certification.  The Healthcare Financial Management Association (HFMA) has presented a list of these requirements and a list of what sort of activities would constitute approved continuing education.  Many local HFMA chapters offer quarterly or monthly seminars for their local members which provide a significant source of contact hours required.  However, the HFMA also offers many self-study materials that could also be used. Below are some examples of these alternatives:

1. Live Group Activities - This area of education activities includes college courses, audio webcasts, and seminars presented by HFMA or some other entity.  Remember these education activities do not have to be sponsored by HFMA to qualify.  If your healthcare institution provides on-site training in some area of accounting and auditing, healthcare finance, administration, ethics, management, marketing, computer hardware and software applications, production, or statistics, then those training sessions would qualify.
2. Presenter Activities - Any presentations given on any of the above healthcare topics will provide contact hours whether they are presentation for HFMA or some other entity.  In addition, seminar presentations provide contact hours for preparation on the first time only of a presentation in an amount up to the length of the actual session. 
3. Proctoring - CHFP's can receive one contact hour each time they monitor an HFMA certification exam.
4. Publication - A CHFP can receive contact hours for the minutes invested in writing HFMA or non-HFMA articles for publication. 
5. Self-study Activities - This area provides the greatest opportunity for a CHFP to accumulate continuing education in the most economical fashion.  All HFMA certification self-study courses have continuing education when the proper documentation is submitted.  HFMA also provides e-learning programs on-line at its website.  But, the most readily available continuing education can come from annual subscriptions to various on-line programs such as CPExpress from the AICPA.  With these programs you have accumulate an unlimited amount of continuing education for an annual fee.  Often, this fee is far less than a number of conference fees.

The HFMA has a great pdf with details on each of the above options.  Don't let the continuing education requirement scare you away from certification.  There are plenty of options. 

Certified Healthcare Financial Professional - Study Course - Part 1

I've been preparing for the last week for a training course for the Certified Healthcare Financial Professional (CHFP) specialty exam in Accounting and Finance.  This gave me the idea of putting together a couple of posts on the exam content and helpful hints in studying for the exams.  The first post will cover the Core Exam and then in a subsequent post I will cover the Accounting and Finance Specialty Exam.  The Healthcare Financial Management Association (HFMA) has a great self-study program and all the following information is provided in that material. 

CHFP Certification Requirements

Before we get too far into the exam information, we should probably go over the list of CHFP certification requirements.

1. Two years total as an HFMA member.
2. Two years of professional experience in the healthcare finance industry.
3. 60 semester hours of college coursework or 60 professional development contact hours.
4. Successful completion of the Core Exam.
5. Successful completion of at least one of the Specialty Exams.
6. References from a current elected chapter officer and the applicant's CEO or supervisor.
7. Completed application with fee within 24 months of successfully completing the first exam.

Core Exam

The core exam, as the name suggests, covers the basic healthcare financial information which should be understood by all financial professionals in healthcare regardless of their area of specialty.  The content of this exam is very broad.  We will analyze a few of the more important issues in this area of the exam.

Accounting Concepts

This section of the exam focuses on the basic financial statements.  The first step in analyzing any financial data is to recognize exactly what type of entity you are dealing with.  Healthcare organizations can operate as a for-profit, investor-owned business, a not-for-profit organization, or as a governmental entity.  It is very important to initially understand the entity you are dealing with because the reporting standards are very different for each of these.  For the exam you will need to understand the reporting standards for assets, liabilities, and equity for each of these.  You will also need to understand the flow of the financial statements required for each.  However, this area of the Core Exam does not require a detail understanding of all the accounting principles that apply to a variety of complex areas of reporting.  The Core Exam is really simply focusing on understanding the financials and how they are presented.

Cost Analysis

The Cost Analysis section of the exam focuses on the application of traditional cost accounting issues to the healthcare industry.  You should know the basic types of costs including fixed, variable, semi-variable, and step costs.  You should be able to calculate a break-even point.  You should also be able to understand and calculate a contribution margin for a revenue stream in a healthcare organization.  This area of the exam also requires an understanding of the variances in costs and rates.  Remember that the per unit calculation of contribution and profit margin is a simple mathematical equation.  The exam will requre you to calculate various components of this calculation while varying the unknowns.  However, if you know the equation, regardless of the unknown, you will be able to calculate the answer.

Bugeting

On the coattails of the cost analysis section is the budget section.  In this section, you should know the three major types of budgets - operating, cash, and capital.  And, you should have a solid understanding of the three types of operating budgets - statistical, revenue, and expense.  This section really requires you to study the components of each of these budgets and the variances used in analyzing each.  Once again, a good understanding of cost behavior is imperative in the understanding of each budget type.  This section will contain questions regarding the definitions of each budget type and questions on tools to analyze each type.

Strategic Planning

Where the budgeting process focuses on analyzing specific timeframes in the operations of a healthcare organization, strategic planning focuses on the big picture.  Strategic planning looks at what resources an organization has at its disposal and the environment within which it operates and builds a roadmap for long-term success within these limitations.  This section of the exam requires an understanding of the internal and external forces and how to analyze these in planning.  Strategic planning also requires an analysis of the financial feasibility and implementation issues of any long-term plan for an organization.  Finally, any strategic plan that has been successfully implemented must be constantly evaluated to determine its effectiveness.  This section of the exam will require an understanding of certain indicators of performace for the strategic plan.

Information Systems

Healthcare information systems focus primarily on the adminstrative / financial information and the clinical data gathered and processed.  This section of the exam will require an understanding of the flow of information in the network and the associated components of the electronic medical record.  Electronic data interchange should be understood as it applies to the preparation of healthcare claims.  And, data wharehousing will also be tested.

Patient Financial Services

The revenue cycle is the single most unique component to healthcare finance.  This section requires an understanding of the accounts receivable cycle from the point of a bed request and pre-admission to collection of an accounts receivable.  This section also requires an understanding of the various outcome measures for accounts receivable including Days Revenue in Accounts Receivable and Receivables Turnover.  These and other analyses are critical in the valuation of accounts receivable.  This section only looks at each part of the revenue cycle from a very generalized perspective.  So, it is really only necessary to have a good understanding of what exactly is going on at each point in the cycle.

Managed Care

One of the hardest sections of this exam for me personally was managed care.  You must have an understanding of the various reimbursement methods unique to each of the different types of managed care contracts.  While one may use a capitation payment, another might pay a specific day rate.  Understanding how each different contract pays will go a long way in being able to logically work through this section of the exam.

Corporate Compliance

The corporate compliance section centers around how to establish an effective compliance program and code of ethics for the heathcare organization.  You need to understand why a compliance program is important and the importance of a strong code of ethics.  This section will not go into great detail of the specific issues the the OIG has stated must be in each hospital compliance program.  You are simply required to have a broad understanding of what a compliance program is and why it is important.

Other Areas

We have gone over the most important areas in the exam (the ones with the most points).  However, you should also spend some time on the following:

1. Physician Practice - You should have an understanding of the coding and payments systems unique to physician practices.  You should also study the various compensation methodologies for physicians.  The area, however, that might pose the most problems and requires the most time is credentialing.
2. Management Skills - This area analyzes various management theories and the functions of managers under each.  You should be able to describe the most important differences between each theory.
3. Regulatory Environment - This section analyzes the role that the various governmental regulatory agencies play in healthcare organizations.  You should have an understanding of the roles the IRS and Medicare play in regulating healthcare.  You should also have a basic understanding of the types of Medicare reimbursement.

The CHFP designation is a credential that you can be very proud to attach to the end of your name.  The exams are not easy and require some study.  I studied about three weeks before taking the Core and Accounting and Finance exams.  However, in my opinion the single most important factor in guaging the amount of study time you will require is your experience in the areas tested.  You will find that your experience in dealing with specific issues will make studying very easy.  This exam is not trying to be only an academic exercise.  Many of the questions and topics are very pertinent to the day-to-day operations of a healthcare entity. 

Good luck!

Certified Healthcare Financial Professional Training

In 2006, I sat for the exam through the Healthcare Financial Management Association (HFMA) for certification as a Certified Healthcare Financial Professional (CHFP).  The certification requires that a candidate pass a core exam and a specialty exam in a specific area of healthcare finance.  Mercifully, I was able to complete both exams in one attempt after studying for about two weeks.  I decided to purchase the HFMA Self-Study Preparation Materials and prepare on my own and this worked for me.

However, some people get more out of active group presentations than from a book.  For these people, the Louisiana Chapter of the HFMA offers training seminars at each of its quarterly two-day conferences.  The idea is to present a crash course in the exam content for participants to aid them in focusing their individual study.  The Louisiana Chapter has had great success in getting people through the exam process and on to certification. 

I have volunteered to teach a specialty exam course in Shreveport on August 23rd.  I suddenly realized that all the study and work that I had to do in getting ready for the exam was going to have to be repeated for the seminar.  When I was provided with the Power Point presentation, I was amazed at how much of the material I needed to review before trying to stand in front of a crowd and try to teach it.  But, at least I'm not jumping into the material cold.

The truth is I'm very excited at this opportunity.  I have never had a problem with getting in front of a crowd.  And, I have considered speaking positions in the past.  This is just my first chance at seeing what I can do.  Wish me luck!

Certified Fraud Examiner

I am very proud of the professional designations that I have received.  The process of becoming a CPA was long and arduous.  But, it is an accomplishment that no one can take away from me.  My wife put up with a lot of pain and turmoil for me to be able to reach this goal.  I studied for approximately 3 months before each of the two times I had to sit for the exam to pass all 4 parts.  But, in August 1993 I received the blessed news that I had passed the exam and could put that struggle behind me for good.

Then, in 2006 I prepared for and passed the examination process to become a Certified Healthcare Financial Professional (CHFP).  This process required me to pass a core exam on basic financial issues specific to healthcare and a specialty exam on healthcare finance and accounting.  I was able to pass both exams at one sitting.  These exams were difficult.  And, I was very proud to gain the CHFP designation earlier this year.  In fact, I have volunteered to teach the training seminar classes for the CHFP exam that are sponsored by our local chapter of the Healthcare Financial Management Association (HFMA). 

To me, these designations are far more that just letters behind my name - there simply to impress the masses.  They represent a lot of hard work and training.  They both came as the result of sacrifice and study. 

Well, I have decided to take the plunge one more time.  I am preparing to sit for the Certified Fraud Examiner (CFE) exam sponsored by the Association of Certified Fraud Examiners (ACFE).  In order to obtain the CFE designation, an applicant must be a member of the ACFE, must meet the academic and professional requirements, must pass the CFE examination, must be of high moral character, and must agree to abide by a strict Code of Professional Ethics.  After all these requirements have been met, the applicant must gain final approval from the certification committee of the ACFE.

In order to prepare for the exam, I have ordered the Fraud Examiners Manual.  This promises hours of study and preparation.  The exam comes in the form of a Windows-based application on CD.  30 days are allowed for the completion of all 4 parts of the exam.  I will keep you all informed of my progress and will offer a synopsis of the entire process after I have successfully completed the exam and my certification is awarded.