Nov 25, 2024  
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2017-2018 Saint Joseph’s College Online [Archived Catalog]

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HIM 320 - Reimbursement Methodologies

Provides an understanding of the fundamental reimbursement concepts and methods of health care systems and describes the role of the manager, health information manager, and personnel.  Strategies for compliance are examined, as well as charge master management, case mix management, payment systems, a variety of payment or insurance plans, as well as the revenue cycle process.

Prerequisites & Notes
HIM 214, HIM 250, HIM 260, and HIM 330

Assignment Overview
12 weekly lessons and a final

Course Learning Objectives
Upon completion of this course, you should be able to do the following:

1.      Manage the use of clinical data that is required in prospective payment systems (PPS) in healthcare delivery.

2.      Manage the use of clinical data that is required in other reimbursement systems in healthcare delivery.

3.      Participate in the selection and development of applications and processes for chargemaster and claims management.

4.      Implement and manage processes for compliance and reporting.

5.      Participate in revenue cycle management.

Credits: 3


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