* The ABC community is a rural area known for cattle, cotton, and peanut farming. Several areas of this community do not have broadband or adequate internet speed to maintain health information exchange this is a barrier to EHR implementation and health information exchange. Although there are some businesses and many family-owned farms they do not heavily use technology and often do not offer health insurance benefits to their employees. The community also has a significant population of undocumented immigrants that work on the farms and in oil fields. The Smiles critical access hospitals is a small free standing clinic with under 25 beds.

* Smiles clinic has on staff one IT/telephony expert, two coders and one billing administrative clerks.

* IT/Telephony expert

* Coding experts: * Submit claims in accordance with government regulations and private payer policies, follow-up on claim statuses, resolution of claim denials, appeals submission, posting of payments and adjustments, and collections management. * Coding professionals are expected to support the importance of accurate, complete, and consistent coding practices for the production of quality healthcare data. * Coding professionals in all healthcare settings should adhere to the ICD-9-CM (International Classification of Diseases, 9th revision, Clinical Modification) coding conventions, official coding guidelines approved by the Cooperating Parties,* the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets for applicable healthcare settings. * Coding professionals should use their skills, their knowledge of currently mandated coding