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 101 Introduction to Health Information Systems
3 Class Hours
Objectives of the Course:
1. To use basic language associated with health care reimbursement methodolgies.
2. To describe the structure of the approved code sets used in the United States.
3. To identify the Official Guidelines for Coding and Reporting and to examine coding compliance issues that influence reimbursement.
4. To distinguish between the various insurance plans and government sponsored health care programs.
5. To differentiate between inpatient, post-acute care and ambulatory reimbursement systems.
6. To understand the components of revenue cycle management.
Learning Outcomes of the Course:
At the conclusion of this course the student will be able to:
1. Discuss inpatient and outpatient reimbursement methodologies.
2. Review case studies and apply specific coding guidelines to determine the principle diagnosis and procedure.
3. Define the provisions and functions of health care insurance plans.
4. Differentiate between the various government sponsored health care programs.
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