HIMS 2161 - Healthcare Compliance and Regulations

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

Define the purpose and components of an effective compliance program.
Describe the roles and responsibilities of compliance officers and committees.
Explain the design principles of compliance programs and the relevance of Federal Sentencing Guidelines.
Differentiate between laws, regulations, and policies, and understand their implications.
Understand HIPAA 1996, including its scope, covered entities, and key terms.
Discuss Compliance and regulation issues

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