This course will introduce the student to a multitude of reimbursement systems including but not limited to Ambulatory Patient Classification (APC), Diagnosis Related Groups (DRG), Medicare Severity Diagnosis Related Groups (MS-DRG), Resource Utilization Groups (RUG), and other Prospective Payment Systems (PPS) to include inpatient and outpatient reimbursement. Revenue cycle management processes including claims, advanced beneficiary notice (ABN), explanation of benefits (EOB), electronic data interchange (EDI) as well as case mix index (CDI), chargemaster maintenance and the denial appeals process are reviewed and discussed. Coding quality and compliance strategies and plans are reviewed. – 5 quarter credit
- Teacher: Shelly Rideout