HM 270 Healthcare Revenue Cycle 2

Lecture Hours: 4
Credits: 4

Builds on skills learned in HM 170 while learning how to trace delinquent claims, appeal denied claims and complete a CMS-1500 Claim Form to streamline billing procedures by completing case studies.

Prerequisite: Enrolled in Healthcare certificate program, completion of HM 170; or consent of instructor. You must earn grades of “C” or better in all required courses in order to progress to the next term.
Maximum number of credits course can be taken for: 4

Student Learning Outcomes:

Explain the claims adjudication process.
Interpret a remittance advice.
Assess how appeals, post payment audits and overpayments might affect the claims process.
Explain the structure of a financial policy.
Describe the processes and methods used to collect outstanding balances.
Complete case studies to increase proficiency.

Content Outline

Claim Follow-up
- Payments Appeals and Secondary Claims
- Primary Case Studies
- Secondary Case Studies
Payment Processing
- Patient Billing and Collections
Hospital Services
- Hospital Billing and Reimbursement