This course provides an understanding of the healthcare reimbursement methodologies and issues including PPS, DRGs, APCs, ASC Groups and applicable state and federal regulations related to HIPAA mandated electronic claims transaction and UB-04 claims processing. Requirements for payers and Quality Improvement Organizations (QIO) are discussed. Included is an introduction to regulatory compliance, revenue cycle and Charge Description Master (CDM) maintenance. This course will help prepare the student to pursue a multifunctional career path in areas dealing with health information management, healthcare claim and reimbursement in physician offices and/or acute care facilities.

Prerequisites: HINFO-AS program plan and CGS 2545C. Corequisite: HIM 2253C.
Terms Offered: Spring
Credits: 3.00

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Each course offered by Seminole State is listed alphabetically and organized by the course prefix, catalog number and description. The courses in this catalog are identified by prefixes and numbers that were assigned by Florida's Statewide Course Numbering System, a system used by all public postsecondary institutions in Florida and 32 non-public institutions. Seminole State controls the description, credit and content of its own courses.