HINM 220 - Advanced Coding and Reimbursement

(TP/SS only) CE

Emphasis on management principles and techniques of clinical classification and reimbursement systems in health care settings. The course covers coding competency skills, coding quality control and compliance issues, and federal government compliance institutions. Other topics include reimbursement software applications, data definitions, data security, data compliance and regulatory requirements. PREREQUISITE(S): HINM 155 and HINM 165 , or consent of program coordinator. One hour lecture, four hours laboratory each week. Formerly HI 220.

3 semester hours

Course Outcomes:
Upon course completion, a student will be able to:

Apply basic language associated with healthcare reimbursement methodologies.
Describe the importance of effective revenue cycle management in a provider’s fiscal stability.
Define revenue cycle management.
Explain common models and policies of payment for Medicare and Medicaid healthcare payment systems for physicians and outpatient settings.
Define basic language associated with reimbursement under Medicare and Medicaid healthcare payment systems.
Differentiate between major types of Medicare and Medicaid reimbursement systems for beneficiaries.
Explain common models and policies of payment for inpatient Medicare and Medicaid prospective payment systems.
Define basic language associated with reimbursement under Medicare and Medicaid prospective payment systems.
Compare major types of Medicare and Medicaid prospective payment systems for inpatients.
Define and differentiate major types of voluntary healthcare insurance plans.
Recognize the impact that government-sponsored healthcare programs have on the American healthcare system.
Interpret and understand the history of the Medicare and Medicaid programs in America.
Differentiate among and identify the various government-sponsored healthcare programs.
Define basic language associated with reimbursement by commercial healthcare insurance plans and by Blue Cross and Blue Shield plans.
Examine coding compliance issues that influence reimbursement.
Describe the structure of approved code sets.
Interpret and differentiate between the code sets approved by the Health Insurance Portability and Accountability Act of 1996.
Distinguish major payment methods in the United States.
Differentiate between payment methods, timeframes and risk.

View Schedule of Classes