Insurance, Billing, & Reimbursement

Catalog description

This course will examine healthcare finance reimbursement systems. The student will be introduced to reimbursement from the perspective of the healthcare administrator and provided with a comprehensive outlook on the payers in health care, the payment systems in health care, basic coding instruction, revenue cycle management, the electronic medical record, fraud and abuse and how they can have a negative impact on a facility, some key tools (e.g., transfer cases and high-cost outliers) that can negatively affect a facility if they are not managed daily, and tomorrow’s trends. The student will also be introduced to the interpreting of financial statements, ratio analysis, and payment models and payer types such as managed care, commercial insurance, Medicaid and Medicare, pay-for-performance, valuebased purchasing, and accountable care organizations. Overall, this course will provide the student with the full picture of the mechanics of insurance and reimbursement and the impact they have on the financial aspect of healthcare organizations.