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 frame work
Explain how the chargemaster fits into over revenue integrity functions
Review requirements and issues associated with provider-based status
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
Review concepts of pricing different services
Exemplify Critical Access Hospital cost-based reimbursement, including Method I and II, and as well as appeal strategies to protect revenue