HITM2264 - Revenue Cycle Management

Competencies

1. Identify the components of the revenue cycle.
2. Demonstrate proficiency in completing patient encounter financial documents.
3. Assess the accuracy of chargemaster and encounter forms.
4. Validate Diagnosis Related Groups (DRGs) assignments.
5. Solve claims denials.
6. Determine the impact of the appeals process and discharged not final billed (DNFB) on facility reimbursement.
7. Perform revenue cycle audits and reporting.
8. Manage the revenue cycle audit process.
9. Define utilization management in healthcare.
10. Summarize regulatory requirements and reimbursement methodologies.