HIT 215 Revenue Cycle Management

Lecture: 1 Lab: 2 Clinic: 0 Credits: 2

This course covers the revenue cycle management process used in all healthcare settings as they relate to national billing, compliance, and reporting requirements. Topics include clinical documentation improvement, prospective payment systems, billing processes and procedures, chargemaster maintenance, regulatory guidelines, fraud and abuse, reimbursement monitoring, compliance strategies and reporting. Upon completion, students should be able to perform data quality reviews to validate code assignment and comply with reimbursement and reporting requirements.

Co-requisite(s): HIT 214.
Course is typically offered in Spring.
Student Learning Outcomes (SLOs)
At the completion of the course, the students should be able to do the following:

Domain IV. Revenue Cycle Management

Explain the various types of healthcare reimbursement methodologies and regulatory requirements. (IV.2) (IV.3)
Evaluate managed care plans and commercial healthcare insurance plans. (IV.3)
Describe government-sponsored healthcare programs. (IV.3)
Explain the Medicare-Medicaid Prospective Payment Systems for ambulatory and post-acute care. (IV.3)

Domain VI. Organizational Management & Leadership

5. Summarize revenue cycle management process, clinical improvement, and coding compliance. (VI.7)