Welcome to the Revenue Cycle, Billing, and Coding in Ambulatory Healthcare Management course! In this course, you will explore the essential aspects of revenue cycle management in ambulatory healthcare settings. Designed for those with little to no background in healthcare, this course provides you with a comprehensive understanding of the revenue cycle process, including registration, insurance, billing and coding basics, denials management, collections, and price transparency.
By the end of this course, you will have a comprehensive understanding of the revenue cycle billing and coding process in ambulatory healthcare management. Start your journey to acquire the knowledge and skills needed to navigate the complexities of registration, insurance, billing and coding, denials management, collections, and price transparency in the revenue cycle.
Overview
Syllabus
- Registration
- During the first module, we will focus on the crucial step of patient registration in the revenue cycle. You will learn about the importance of accurate and complete patient information, including demographics, insurance details, and consent forms. We will discuss the registration process, data collection methods, and strategies for ensuring data accuracy and integrity.
- Insurance
- In this module, we will delve into the complexities of insurance in the revenue cycle. You will gain knowledge of different types of insurance, such as commercial insurance and federal insurance programs (e.g., Medicare and Medicaid). We will explore the insurance verification process, eligibility criteria, and common challenges in dealing with insurance providers.
- Basics of Billing and Coding
- The third module will focus on the fundamentals of billing and coding in the revenue cycle. You will learn about the Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD) codes, and Healthcare Common Procedure Coding System (HCPCS) codes. We will discuss the importance of accurate coding for proper reimbursement and explore coding guidelines and conventions.
- Denials, Collections, Estimates and Price Transparency
- The final module of the course will cover denials management, collections, estimates, and price transparency in the revenue cycle. You will understand the common reasons for claim denials and learn strategies for appealing denials and minimizing their occurrence. We will discuss effective collections processes, including patient billing and payment options. Additionally, we will explore the importance of providing cost estimates and promoting price transparency to enhance patient satisfaction and financial accountability.
Taught by
Maura McGuire, MD, CPC, FACP and Michelle J. Campbell
