HIM 182 : Introduction to Reimbursement and Classification Systems

Transcript title

Intro Reimbrsmt/Class Systems

Credits

4

Grade mode

Standard letter grades

Contact hours total

50

Lecture hours

30

Other hours

20

Prerequisites

Instructor approval.

Description

Provides an introductory survey of healthcare reimbursement methodologies and healthcare classification systems (coding systems).

Learning outcomes

1. Identify and model prospective payment reimbursement systems.
2. Articulate reimbursement methodologies: fee-for-service, capitation, pay for performance and others.
3. Identify fee schedule types and their application in various health care settings.
4. Differentiate the classification systems and their application in health care service reporting and claims for reimbursement.
5. Apply guidelines and conventions for various classification systems.

Content outline

1. Reimbursement systems concepts.
2. Classification systems concepts.
3. Prospective payment reimbursement systems.
4. Reimbursement methodologies.
5. Resource-based relative value scale (RBRVS) reimbursement system.
6. Fee schedules.
7. Classification systems: Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) Level II, International Classification of Diseases, 10th Revision, Clinical Modification/Procedure Classification (ICD-10-CM/PCS), and others (DSM-5, ICD-O, ICF, NDC).

Required materials

Required textbook. CPT, HCPCS Level II, and ICD-10-CM coding resources provided. Computer and reliable internet access. Portable storage device (ie. usb drive).

Grading methods

Knowledge Is assessed through graded exams, quizzes, assignments and projects; this class requires a passing grade of 75% or better.

Outside of
expected

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