HIT 117 - Reimbursement Methodologies
A study of the reimbursement and prospective payment systems used in the health care industry. Comprehensive review of the Official Guidelines for Coding and reporting, as well as Revenue Cycle Management.
Prerequisitie: HIT 204 ICD-10-CM & PCS Coding, HIT 205 Coding Practicum
Corequisite: HIT 214 CPT and HCPCS Coding
3 Class Hours
Learning Outcomes of the Course:
At the conclusion of this course the student will be able to:
1. Use basic language associated with the health care reimbursement methodologies.
2. Describe the structure of the approved code sets used in the United States.
3. Identify the Official Guidelines for Coding and Reporting and to examine coding compliance issues that influence reimbursement.
4. Distinguish between various insurance plans and government sponsored health care.
5. Differentiate between inpatient, post-acute care and ambulatory reimbursement systems.
6. Understand the components of revenue cycle management.
7. Discuss inpatient and outpatient reimbursement methodologies.
8. Define the provisions and functions of health care insurance plans.
9. Differentiate between the various government sponsored health care programs.
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