HITM2210

This course provides a study of the entire revenue cycle process, from the scheduling of the appointment to the receipt of payment. Students will explore numerous health insurance plans, reimbursement methodologies, and compliance strategies. Students will learn about the current healthcare reimbursement systems used in outpatient and inpatient settings. Students will adhere to current regulations and guidelines for insurance coverage, claim submission, and denial management. Student Learning Outcomes

• Distinguish how different Reimbursement Methodologies operate. (IV.3)
• Compare the purpose and benefits of different third party payers, including government-sponsored health programs. (IV.2)
• Evaluate revenue cycle processes. IV.2 RM
• Evaluate the accuracy of diagnostic/procedural groupings for medical necessity. IV.3 RM
• Identify procedures for obtaining patient demographic information, insurance verification, authorizations and collecting time-of-service payments (IV.2)
• Interpret reimbursement monitoring reports. (IV.2)
• Demonstrate ability to correctly complete various medical insurance billing forms. (IV.3)