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Sep 25, 2026
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Website Catalog (In Development)
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HIT 217 - Revenue Cycle Management
This course examines billing, reimbursement, payment models, RCM processes, payer rules, claims, denials, underpayments, and the influence of coding and documentation on financial outcomes.
Prerequisite- Corequisite
Prerequisites: HIT 204 ICD-10 Coding, HIT 205 Clinical Coding Practicum
Corequisite: HIT 214 CPT and HCPCS Coding
Credits: 4
Hours
3 Lecture Hours; 2 Laboratory Hours
Course Profile
Learning Outcomes of the Course:
Upon successful completion of this course the student will be able to:
- Describe the components and regulatory requirements of the revenue cycle.
- Differentiate among various insurance plans, government programs, and reimbursement systems.
- Apply coding knowledge to support compliant reimbursement and accurate claims.
- Identify payer requirements and navigate CMS transmittals.
- Document encounters and perform charge capture and billing tasks.
- Assemble prior authorization, eligibility checks, and pricing estimates.
- Conduct audits to detect issues, underpayments, or missed revenue.
- Process denials and appeals and recommend corrective actions.
- Explain code set structures, guidelines, and compliance standards.
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