MDC 203 - Reimbursement Methodologies

3 credit hours - Three hours weekly, one term.
Formerly HIT 222 - Reimbursement Methodologies

Discuss health care reimbursement systems, reimbursement methodologies, and payment processes throughout the health care industry. Examine the complex financial systems within today’s health care environment and provide an understanding of the basics of health insurance, public funding programs, managed care contracting, and how services are paid.

Prerequisite(s): MDC 101 , MDC 103 (formerly HIT 217), and MDC 105 (formerly HIT 218) with a grade of C or better in each course; or permission of the program coordinator.

Corequisite(s): MDC 201 (formerly HIT 221) and MDC 275 (formerly HIT 275).

Note: Typically offered OL; fall and spring terms.

Course Outcomes:

Describe the characteristics of health care reimbursement methods.
Define the terms coding compliance and reimbursement.
Explore the provisions and functioning of health care insurance plans, managed care reimbursement, Medicare and Medicaid.
Compare and contrast specifics of both Inpatient Prospective Payment systems and Outpatient Prospective Payment systems.
Define the components of revenue cycle management.
Define and flowchart the recovery audit contractor process and discuss the components of a chargemaster.