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Apr 16, 2024
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TCC Catalog 2018-19 [ARCHIVED CATALOG]
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HIM2272 Reimbursement Methodology3 credit hour(s)
Prerequisite(s): grade of C or better in HIM2222C and HIM2253C .
This course introduces current health insurance programs for reimbursement in inpatient and outpatient prospective payment systems. Topics covered include group and individual insurances, health maintenance organizations, preferred provider organizations and government-sponsored medical insurance programs. Discussion will include diagnosis-related groups (DRGs) and ambulatory payment classifications (APCs). Students will complete uniform bill (UB) and Centers for Medicare and Medicaid Services (CMS) forms for reimbursement. Students will perform quality reviews for code and documentation assignments. Contact: 3 hours.
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