Feb 01, 2023  
2022-2023 Lane Community College Catalog 
2022-2023 Lane Community College Catalog
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HIM 222 - Reimbursement Methodologies

4 Credit(s)

This course will provide the student with a comprehensive overview of billing for facility services using the ICD-10-CM, CPT and HCPCS codes to complete UB-04 claim forms. The course will familiarize the student with health records and how documentation translates to the basics of medical coding, billing, insurance, and proper reimbursement. The course also discusses the various reimbursement methodologies affecting facilities and provides an introduction to coding classification systems and the payer and healthcare system in the United States.

Learning Outcomes
Upon successful completion of this course, students will be able to:
1. Apply knowledge of the methods of healthcare reimbursement
2. Understand Clinical Coding and Coding Compliance
3. Describe Voluntary Healthcare Insurance Plans
4. Understand the key concepts of Government-Sponsored Healthcare Programs
5. Understand the key concepts of Managed Care Plans
6. Understand the Medicare-Medicaid Prospective Payment System for Inpatients
7. Differentiate between the non-acute Medicare/Medicaid reimbursement systems for ambulatory, other, and prospective payment systems for Post-Acute Care
8. Demonstrate the important role of Revenue Cycle Management and Value-Based Purchasing in healthcare reimbursement

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