Course Provider
Learning Objectives
Equip hospital, payer and other healthcare specialists with effective and efficient strategies to obtain and maintain overall revenue integrity for both governmental and non-governmental payers
Gain a working understanding of revenue integrity principles associated with eligibility, coverage, coding, billing and payment using fee-for-service Medicare requirements as a framework
Explain standard charge description master (CDM) elements, design and relationship to the general ledger and revenue cycle processes of coding and billing
Review claim requirements and specific issues of CDM set-up and maintenance by revenue code with associated cost reporting principles
Exemplify outpatient and inpatient hospital prospective payment systems reimbursement and rate setting methodologies as well as appeal strategies to protect revenue