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Department of Health Informatics

Health Information Management

BINF3301 - Classification & Reimbursement Systems

Course Description

This web-based course provides in depth coverage of reimbursement methodologies used throughout the healthcare industry as well as preparing the student to assess compliance with regulatory guidelines. Also including is an overview of classification systems such as the International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and the Health Care Common Procedure Coding System (HCPCS) and clinical terminologies as they apply to these systems.

Credits/Modes of Instruction

Credits: 3

Canvas enhanced course for all online activities
Lecture presented as MS PowerPoint Presentations
Assignments/Projects
Textbook activities
Posted discussions via Canvas learning system
Videos

Prerequisites

None. This course is open to all medical, dental, public health and health related professions
students. Students must have access to the internet.

Course Goals and Outcomes:

Goals

This course introduces the students to the classification systems from the management perspective. Elementary coding activities prepare the student for the technical aspects; reading assignments and discussions prepare the students to be effective users of coded data.

Outcomes

Upon completion of this course, the student will be able to:
List and describe the uses of various classification systems including ICD and CPT.
Demonstrate the correct use of basic coding conventions pertaining to ICD and CPT.
Describe the claims process utilized in various health care settings.
List and describe the various reimbursement systems utilized in health care settings.
Explain severity of illness systems, present methods of data collection and uses of collected data.
Describe the Revenue Cycle, including the major departments involved in revenue cycle management, and the elements necessary for compliance and appropriate reimbursement.
Explain the uses of and management issues related to the Charge Description Master.
Explain the elements of insurance billing in various health care settings.
Demonstrate methods used to measure and maintain compliance with standards of coding.