HLTH 3510R - Revenue Cycle Management and Health Plans

Institution:

Utah Tech University

Subject:

Description:

The course presents the foundational economic principles of health insurance to clarify insurance-related policy and revenue cycle management issues. This course will help students learn the underlying assumptions, facts, and variables that drive decision-making and choices on the payer side. The course will include healthcare reimbursement methodologies and systems, coding and billing compliance, value-based purchasing initiatives, and the revenue cycle and management. It supports knowledge application and data analytics skill-building through real-life scenarios and case studies. **COURSE LEARNING OUTCOMES (CLOs)** At the successful conclusion of this course, students will be able to: At the successful conclusion of this course students will be able to: 1) Explain the public and private sources of health insurance coverage. 2) Describe the factors third-party payers consider when setting premium and reimbursement rates. 3) Describe the various reimbursement methods utilized by third-party payers. 4) Utilize reimbursement methodologies that impact coding and billing compliance, value base purchasing initiatives, and revenue cycle management. Prerequisites: ACCT 2010 Financial Accounting (Grade C or higher). SP

Credits:

3.00

Credit Hours:

Prerequisites:

Corequisites:

Exclusions:

Level:

Instructional Type:

Lecture

Notes:

Additional Information:

Historical Version(s):

Institution Website:

www.utahtech.edu/

Phone Number:

(435) 652-7500

Regional Accreditation:

Northwest Commission on Colleges and Universities

Calendar System:

Semester

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