HIM-2600 Medical Reimbursement and Billing

Credits 3
In this course students learn about revenue cycle management in healthcare, including reimbursement and payment systems, appropriate to managed, federal and private care settings. Emphasis is placed on regulatory compliance and prospective payment systems. Students will examine fraud and abuse in medical claims. Finally, students examine clinical documentation improvement.
Prerequisite(s): HIM-1600 with grade of C or higher
Corequisite(s): HIM-2540
3 class/1 lab hours.
Course Outcomes

Describe components of revenue cycle management in healthcare.
Identify compliance issues as they relate to fraud and abuse when associated with claims coding.
Compare and contrast the three major classes of health insurance contracts (managed, federal and private care settings).
Relate clinical documentation improvement to revenue increase.