Reimbursement Systems in Healthcare
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Overview
Description
In this course students will learn the history, rationale, and methodology of the systems used by third-party payers to determine the reimbursement that health care providers will receive. Reimbursement concepts include fee-for-service, managed care, capitation systems, Diagnosis-Related Groups (DRGs), Resource Based Relative Value Scale (RBRVS), Ambulatory Payment Classifications (APCs) and related concepts. The use of the charge description master (chargemaster) in reimbursement will be discussed. The importance of compliance with regulations and the related issues of fraud and abuse will also be addressed.
Career
ACAD
Credits
Value
0
Max
3
Min
3
Course Count
1
Number Of Credits
3
Number Of Repeats
1
Repeatable
No
Contact Use
Yes
Generate Attendance
No
Left Use
Yes
Present Use
Yes
Reason Use
Yes
Tardy Use
Yes
Template Override
No
Time Use
Yes
Attendance Type
MTG
Auto Create
No
Code
LEC
Instructor Contact Hours
0
Default Section Size
20
Final Exam Type
Yes
Include in Dynamic Date Calc
Yes
Instruction Mode
X
LMS File Type
BKB
Name
Lecture
OEE Workload Hours
0
Optional Component
No
Workload Hours
3
Requisites
Free Form Requisites
Prerequisites: HIT 115 (C or better) AND one coding course (HIT 117, HIT 131, HIT 132) (C or better) AND admission into the HIT program. Corequisite: A second coding course (HIT 117, HIT 131, HIT 132) (C or better)