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Nov 21, 2024
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HITC 2133 - Reimbursement Systems and Revenue Cycle ManagementStudents are introduced to the following reimbursement systems: Ambulatory Patient Classification (APC), Diagnosis Related Groups (DRG), Medicare Severity Diagnosis Related Groups (MS-DRG), Resource Utilization Groups (RUG), Home Health Resource Groups (HHRG), and the prospective payment systems for inpatient rehabilitation and psychiatric facilities. Retrospective and prospective reimbursement systems and capitation are examined. Revenue cycle management issues including advance beneficiary notice, bill preparation, reviewing remittance advice forms, appealing denials, case mix index, and charge master maintenance are investigated. Coding quality and compliance strategies and plans are reviewed. Prerequisites: HITC 1333 and HITC 1363 with a grade of “C” or better and HITC 2403 or concurrent enrollment.
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