HHCM 312 - Insurance, UR, and Discharge Planning

3 Credits
This course provides an overview of various public and private insurances, payers and appeal processes that impact case management interventions. The course will include the process of conducting a utilization review addressing issues such as prior authorization, admissions, services provided, and the length of stay. An emphasis will be placed on creating and implementing a discharge plan utilizing specific insurance benefits.

Grade Note(s): A grade of C or better is required to pass this course successfully.
Prerequisite(s): HHCM 300 and HLTH 250
Course Learning Outcomes:
1. Create a comprehensive discharge plan.
2. Evaluate coverage of public and private insurance for the client.
3. Explain utilization review criteria and process.
4. Define insuranceutilization review terminology.