HITS 230 - Reimbursement Methodologies

This courses focuses on the history, rationale,,and methodology of the systems used by third-party,payers to determine the reimbursement health care,providers will receive. Reimbursement concepts,include fee-for-service, managed care, capitation,systems, Diagnosis-Related Groups (DRGs), Resource,Based Relative Value Scale (RBRVS), Ambulatory,Payment Classifications (APCs), and related,concepts. The use of the charge description,master (charge master) in reimbursement will be,discussed. The importance of compliance with,regulations and the related issues of fraud and,abuse will also be addressed.
Prerequisites: HITS-220
Credits: 3