Curriculum: Revenue Cycle Management Certificate

This course is designed to introduce the student to medical terminology, including roots, prefixes,and suffixes, with emphasis on spelling, definition and pronunciation. The course consists of the basic rules for interpreting, constructing,and spelling medical terminology. The course includes common terminology, definitions and pronunciations for prefixes, suffixes, general body terms, and body system terminology. Each bodysystem lesson includes terms for anatomy, pathology, pharmacology, radiology, procedures, and tests. Emphasis is upon learning word roots, prefixes and suffixes and how they are combined toform medical words.

This course covers an introduction to medical coding including an overview of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DSM-IV and SNOMED. The role that medical coding plays in the billing and claims management processes will be discussed. Rules and regulations, ethics and compliance effecting medical coding, including official coding guidelines and clinical documentation improvement are discussed. The National Correct Coding Initiative, global packages, and unbundling will be covered.

This course covers reimbursement methodologies used in all healthcare settings as they relate to national billing, health insurance, reimbursement, compliance, and reporting requirements.

This course covers the foundations of insurance and billing and includes a review of the types of healthcare payers, a determination of covered patient services and the completion of different types of claim forms. The importance and application of the revenue cycle will be discussed. Claims submission and follow up are covered. Compliance and ethical standards are discussed.

This course provides a comprehensive understanding and application of revenue cycle management. Topics covered include revenue cycle basics, cost analysis and payer contracts, patient access, documentation and charge capture, record completion and coding, claims management, and an overview of how charges become revenue.

Revenue cycle management is a complex element of healthcare. This course culminates the study of revenue cycle management with a hands-on application of health insurance billing and revenue cycle process.