HIT 2203 - Reimbursement Methods

3 Credits

Course includes a study of the uses of coded data and health information in reimbursement and payment systems appropriate to all health care settings and managed care. Charge master maintenance, identify fraudulent billing practices.

Spring Semesters

Prerequisite: HIT 1014 Medical Coding I

Corequisite: HIT 2014 Medical Coding II

Course Level Objectives
Upon successful completion of this course, the student will be able to:

1. Acquire knowledge regarding the use of clinical data in reimbursement within various healthcare settings including acute and ambulatory care along with the importance of MS-DRG assignment, the Prospective Payment System, and accurate billing among various payors. (PLO 1, 7, 9)
2. Summarize how various payment systems, facility charges, coding, billing, healthcare legislation and external audits have a connected role in reimbursement. (PLO 9)
3. Utilize meaningful use and hospital policies and guidelines to handle data used in healthcare reimbursement. (PLO 1, 3, 4, 7, 8, 9)
4. Articulate changing regulations and local issues and trends related to reimbursement for acute care and ambulatory settings. (PLO 3, 9)
5. Explain revenue cycle processes. (PLO 9)