HLTH 250 - Health Care Reimbursement Management

3 Credits
This course is an introduction to health care reimbursement systems used throughout the United States. Students will gain a detailed understanding of various payment methodologies currently used (i.e. managed care, third party payers, federal programs, etc.), and apply this understanding to the monitoring and management of the revenue cycle. Students will verify completeness of clinical documentation, manage the use of clinical data systems used in claims management and utilize the principles of health care finance to monitor healthcare facility revenue. Current HIPAA guidelines will be covered along with financial ethics and the identification and eliminations of financial fraud and abuse.

Grade Note(s): A grade of C or better is required to pass this course successfully.
Fees: Additional course fees apply.
Course Learning Outcomes:
1. Apply revenue cycle and reimbursement principles.
2. Identify fraud surveillance activities in healthcare organizations.
3. Identify documentation in the health record that supports billing reimbursement processes to meet regulatory requirements.