Reimbursement Systems in Healthcare
Course Information
Subject
HIT
Course Number
272
Division
Status
Active
Course Title
Reimbursement Systems in Healthcare
Course Description
In this course students will learn the history, rationale, and methodology of the systems used by third-party payers to determine the reimbursement that health care providers will receive. Reimbursement concepts include fee-for-service, managed care, capitation systems, Diagnosis-Related Groups (DRGs), Resource Based Relative Value Scale (RBRVS), Ambulatory Payment Classifications (APCs) and related concepts. The use of the charge description master (chargemaster) in reimbursement will be discussed. The importance of compliance with regulations and the related issues of fraud and abuse will also be addressed.
Minimum Credit Hours
3
Maximum Credit Hours
3
Total Completions Allowed for Credit
1
Lecture - Lab Hours
(2-2)
Requirements
Prerequisites: HIT 115 (C or better) AND one coding course (HIT 117, HIT 131, HIT 132) (C or better) AND admission into the HIT program. Corequisite: A second coding course (HIT 117, HIT 131, HIT 132) (C or better)
PCS Code
1.2