HIMS 1420 - Revenue Cycle in Healthcare

4.5 Credits

This course will focus on the healthcare reimbursement in the hospital and physician perspective use. Students will gain knowledge and skills related to revenue cycle management (RCM) which include:

Measuring hospital performance, patient case mix, risk adjustment, clinical documentation integrity, physician queries, claim audits, denials, and appeals, pay for performance, and other topics associated with RMC.

Note: This course must be completed with a grade of C or better.

Prerequisites: (1) HIMS 1410

Lecture Hours: 4.5
Lab Hours: 0.0
Internship Hours: 0.0
Clinical or Practicum Hours: 0.0

Course Objectives

Apply knowledge and use related Revenue Cycle and Reimbursement
Show best practice and use related to HIPAA and Healthcare Compliance related to revenue cycle
Demonstrate concepts related to healthcare finance and pricing
Demonstrate knowledge related to payment methodologies for reimbursement
Demonstrate knowledge of key concepts related to Clinical Documentation Integrity
Perform effective use of documentation queries
Research and determine best practices related claims processing and audit readiness
Discuss different topics related to revenue cycle

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