HITC 155 - Reimbursement Methodologies

Institution:

Raritan Valley Community College

Subject:

Description:

Prerequisites: HITC 152 - Basic Coding ICD-9-CM, HITC 154 - Basic CPT-4 Coding. This course provides students the opportunity to learn the history, rationale, and methodology of the systems used by third-party payers to determine the reimbursement that health care providers will receive. Reimbursement concepts include fee-for-service, managed care, capitation systems, Diagnosis-Related Groups (DRGs), Resource Based Relative Value Scale (RBRVS), Ambulatory Payment Classifications (APCs), and related concepts. The use of the charge description master (chargemaster) in reimbursement will be discussed. The importance of compliance with regulations and the related issues of fraud and abuse will also be addressed.

Credits:

3.00

Credit Hours:

Prerequisites:

Corequisites:

Exclusions:

Level:

Instructional Type:

Lecture

Notes:

Additional Information:

Historical Version(s):

Institution Website:

www.raritanval.edu

Phone Number:

(908) 526-1200

Regional Accreditation:

Middle States Association of Colleges and Schools

Calendar System:

Semester

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