HLTH CARE REIMBURSEMNT

Catalog description

Students will review the organization of healthcare delivery systems including managed care and capitation. The theory and use of reimbursement systems such as Diagnostic Related Groups (DRGs), Ambulatory Payment Classifications (APCs), and Resource-Based Relative Value Scale (RBRVS) are applied. Revenue cycle discussions and analysis include data flow from admission to billing and the analysis of case-mix. In addition, other external forces, such as Health Insurance Portability and Accountability Act (HIPAA) and Recovery Audit Contractors (RACs), are reviewed. TAG: OHL022