The certification exam consists of 101 questions. First question is just agreement not to share exam questions, not to use any resources while taking the exam.
There are two PATHWAYS TO RECEIVE ACPA CERTIFICATION.
- Complete The Learning Center (TLC) Certification Modules or attend Essentials & Fundamentals, followed by passing the exam with an 80% or higher.
2. Submit one of the following [a or b below], followed by passing the exam with an 80% or higher:
a. CV showing 3 years of Physician Advisor experience.
b. Current physician advisor certification.
Here are the contents of THE LEARNING CENTER (TLC) CERTIFICATION MODULES [first pathway mentioned above]:
Medicare’s Two-Midnight Rule
Medicare Advantage Basics
Medicare Basics
Observation Services & Outpatient Status
Overview of the Utilization Management Committee
Medicare Severity Diagnosis-Related Groups (MS-DRG) Basics
The Physician Advisor Role in Clinical Validation
Pediatric Physician Advisors
Condition Code 44 Basics
Medicare Notices
Clinical Validity Denials & Appeals
The Contemporary Role of Physician Advisors
Peer-to-Peers for Level of Care Determination: The Basics
Below is the PRICING: ACPA MEMBERS may RECEIVE 10% OFF
Once you get through the modules you should get an email saying you’re “eligible” for the exam.
If you purchased the exam through Pathway 1, you will need to complete the educational component (either the TLC module bundle or attendance at Essentials and Fundamentals) before the test will unlock.
If you purchased the exam through Pathway 2, then you may take the exam at any time.
I paid $450 for the exam.
Since I have CHCQM-PHYADV certificate, I submitted that and also I submitted my CV indicating more than 3 yrs of UM experience. In less than a week I got an email indicating my exam is ready on the website.
A couple of notes for the exam itself:
1) You may want to have a writing utensil and piece of paper handy to take notes.
2) The exam will not allow you to move on from a question until you have answered, but you can go back and change your answer later if you wish.
3) The exam has a 1 hour and 40 minute time limit. The timer will continue to count-down regardless of whether or not you are still logged in. Therefore it is imperative that you block off enough time to finish once you begin because there is no way to pause the exam.
4) You will receive your results immediately after submitting the exam.
5) You must answer 80% or more questions correctly to pass the exam. Total points: 101.
6) If you pass, you will get an electronic copy of your certificate as well as an email with further information about your paper certificate and pin.
7) If you do not pass on your first attempt, you will be able to retake the exam in 2 weeks. You may take the exam a total of 3 times before needing to re-register for the exam.
My experience: Exam day 4/4/24.
I had been a physician advisor since 2019. I read some of content of the exam while preparing for my CCDS exam. I did not do all the modules but it’s very useful if you have never read the content of the modules.
You can take the exam at home. You don’t need to go to a testing center at this time. I don’t know if it will change in future.
An other good thing about this exam is that you can take it any day of the year. There is no specific deadline at this time.
The time is just sufficient to finish the exam. I felt the content of the exam is perfect for physician advisors. I think every physician advisor should take the test.
I got score immediately after the exam.
The certificate did not fit my full name. Hopefully, it will be corrected.
Good luck.
Go to ACPA Certification page