HIMA 240: Principles of Health Care Reimbursement Methodologies

Prepare a revenue cycle plan for a community hospital.  Include the following information in your plan:IntroductionEvaluation of clinical data required for payment and reimbursement systems (PPS, DRG, RBRVS, RUGs, VBP, Billing/insurance plans).Explanation of chargemaster and claims management applications and processes.Assess effect on healthcare finance of revenue management (cost reporting, budget variances).Summarize revenue cycle management and reporting processes (CCI, X12N).Evaluation of severity of illness and how it impacts the healthcare payment systems.The format of this plan is like a policy and procedure but is a longer document. Compile your document based on the findings and collection of information for each of the requirements.

 
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