Description
This course explores reimbursement and payment methodologies applicable within the various healthcare settings. Forms, processes, practices and the roles of health information management professionals are examined. Concepts related to insurance products, third-party, prospective payment, and managed care capitation are explored. Issues of data exchange among patient, provider, and insurer are analyzed in terms of organizational policy, regulatory issues, and information technology operating systems. Management of the chargemaster and importance of coding integrity are emphasized.