HIMT 2305 - Revenue Cycle Management

Credit hours: 3

Prerequisites: Pre- and corequisites should be defined by individual institutions and must be courses from General Education Requirements - Core and Major Field Core Courses.

Course Description:
This course focuses on advanced topics in healthcare reimbursement. The course includes an introduction to third party payers, revenue cycle management and chargemaster development and administration. It also focuses on principles of healthcare reimbursement including health insurance plans, government-sponsored healthcare programs, managed care plans, fee schedules, resource based relative value system for physician payment and prospective payment for various healthcare settings.

Student Learning Outcomes:
Students will be able to:

Describe and evaluate revenue cycle management processes associated with billing processes and procedures including chargemaster, EDI and bill reconciliation and the, role of utilization, content of claim forms and case management in revenue cycle management.
Identify different payment methodologies and systems such as but not limited to:capitation, prospective payment systems used in various care settings, RBRVS, case mix indices, and MSDRGs.