HIT 290 - Reimbursement Methods

Credits: 3
Lecture Hours: 2
Lab Hours: 2
Practicum Hours: 0
Work Experience: 0
Course Type: Voc/Tech

This introduction to health insurance and reimbursement studies payment systems for all types of healthcare systems and managed care. Changing trends in the reimbursement of healthcare services are reviewed. Topics include prospective payment systems, charge master maintenance, DRGs, APCs, ASC Groups, RBRVs, third-party payers, EOB, Quality Improvement Organizations, managed care/capitation and compliance. Students practice completing claim forms for a variety of medical scenarios and learn the importance of accurate coding and medical necessity to ensure proper reimbursement.
Prerequisite: All first year HIT courses (HIT 120, HIT 125, HIT 162, HIT 360, HIT 450, HIT 520)