Mar 29, 2024  
Course/Program Inventory 
    
Course/Program Inventory

HCMT 2360 - Reimbursement Practices



Credit hours: 3

Prerequisites: HCMT 2305 - Healthcare Delivery Systems HCMT 2315 - Medical Legal Issues  , and HCMT 2350 - Insurance & Reimbursement   with a grade of “C” or higher.

Course Description:
This course introduces students to major reimbursement systems, and it also focuses on prospective payment systems and the management of documentation for applicable reimbursement, while avoiding fraudulent practices.

Student Learning Outcomes:
Students will be able to:

  1. Describe Public and Private types of insurance plans.
  2. Apply payer policy, Local Coverage Determinations (LCD), and National Coverage Determinations (NCD) for successful claim submissions.
  3. Provide an overview of CPT®, ICD-10-CM, and HCPCS Level II coding guidelines.
  4. Identify the rules and regulations applying to reimbursement in the healthcare industry.
  5. Expertise in effective claim follow-up, patient follow-up, and denial resolution.