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HIT 217 - 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.
Prerequisite- Corequisite
Prerequisites: HIT 204 ICD-10-CM Coding, HIT 205 ICD-10-PCS Coding
Corequisites: HIT 214 CPT and HCPCS Coding
Credits: 3
Hours
3 Class Hours
Course Profile
Learning Outcomes of the Course:
Upon successful completion of this course the student will be able to:
- Use basic language associated with the health care reimbursement methodologies.
- Describe the structure of the approved code sets used in the United States.
- Identify the Official Guidelines for Coding and Reporting and to examine coding compliance issues that influence reimbursement.
- Distinguish between various insurance plans and government sponsored health care.
- Differentiate between inpatient, post-acute care and ambulatory reimbursement systems.
- Describe the components of revenue cycle management.
- Discuss inpatient and outpatient reimbursement methodologies.
- Define the provisions and functions of health care insurance plans.
- Differentiate between the various government sponsored health care programs.
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