Recently, I got certified as “Care Guidelines Specialist in Utilization Management” from MCG.
In this blog post, I will explain what it is and how to get it.
MCG Certification verifies that you have the skills and knowledge to appropriately apply the Inpatient & Surgical Care and General Recovery Care guidelines in utilization and case management roles.
If you clearly know the patient’s diagnosis and the software shows exactly that diagnosis when you search, then you use Inpatient & Surgical Care guidelines. If its not very clear or you do not find a specific diagnosis and guidelines in the MCG software when you search, then you use General Recovery Care guidelines to determine the correct course of patient care e.g if patient should be cared for in ICU or Intermediate care or be discharged.
The knowledge in this could help with better peer to peer reviews during insurance denials.
- Licensed healthcare professionals
- Employed by an organization that licenses Inpatient & Surgical Care and General Recovery Care
Certification is obtained by completing the Care Guidelines Certification online modules/videos and passing the Certification Exam with a score of 80% or better.
MCG offers three types of certifications
- Care Guidelines Specialist in Utilization Management
- Care Guidelines Specialist in Case Management
- MCG Trainer
I got the certification as Care Guidelines Specialist in Utilization Management recently. I think that is the most useful certification for physician advisors among the three types mentioned above.
Scheduling the exam:
First you have to email to MCG using email@example.com to find out if you are eligible or not to take the exam. They will ask your work email to make sure your organization licenses MCG care guidelines so just send them email from your work email to begin with. If you are a physician, you will be eligible only if you are Employed by an organization that licenses Inpatient & Surgical Care and General Recovery Care. Once they verify your hospital, they send you a link to apply online. Once you apply, they will send an other email with a link to pay the exam fee. Once you pay the fee of $150, they send you email with password for viewing the videos. If by mistake you don’t pass the first time, you can retake the test once for a fee of $75.
Exam Due Dates:
Once you enroll in the exam, you have to take the test within one of the quarters that you enrolled in. For example:
- Q1 (1/1/20 – 3/31/20)
- Q2 (4/1/20 – 6/30/20)
- Q3 (7/1/20 – 9/30/20)
- Q4 (10/1/20 – 12/31/20)
It takes at least two full days to go through all the videos, answer questions at the end of each video and take the online 90 min exam. The exam is easy but you have to view all the videos and remember all the sample questions that you answer after each module/video.
There are a total of 5 modules.
Module 1: Introduction to Care Guidelines Certification
Module 2: Care Guidelines Certification Preparation – Searching the Care Guidelines Software
Module 3: Care Guidelines Certification Preparation – Inpatient & Surgical Care
Module 4: Care Guidelines Certification Preparation – General Recovery Care
Module 5: Care Guidelines Certification Exam – General Recovery Care
Each module has a few short videos followed by practice questions.
After finishing all the modules, there is a Mandatory practice exam which has just 3 questions. Once you do that exam, you will be able to take the final real online exam.
I think there a total of 40 questions in the exam. The questions were mostly from the videos and practice questions at the end of the videos. What helped me to make my exam easy was that I printed out different pages screenshots of their website while I was watching videos. The whole exam is about how to use their website and come up with correct status for the patient. You just have to learn their website/software language.
Your medical knowledge us useful but most of the answers are based on the software navigation. You must watch all the videos with attention to pass the exam.
The exam is closed book. You should not have any other window open on your computer while taking the exam.
You can print out a certificate at the end of the exam if you pass. I don’t think this exam gives any CME. Certificate says “Care Guidelines Specialist, Utilization Management“. This certificate is valid for 2 years from the date of issue.
I felt that these certifications are mainly for nurses who work in Utilization management. For physician advisors, this certificate as “Care Guidelines Specialist in Utilization Management” gives a good idea as to how to use MCG guidelines while evaluating a patient’s status determination-whether to admit to ICU or floor or discharge, whether observation or inpatient status etc. This certification may be useful for those who want to become Medical Directors of UM department or for any physician advisor. This can be useful tool to do better peer to peer reviews of insurance denials.
Since a few doctors did it and since some other doctors wanted to know more about it, I am sharing my experience here.
CHCQM is a different exam. It is for certifying you as a physician advisor.