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Master Certificate in Reimbursement Policy Analysis
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Course Details
- Introduction to Healthcare Reimbursement Systems
- Foundations of Medical Billing and Coding
- Understanding ICD-10-CM and ICD-10-PCS Coding
- Advanced CPT and HCPCS Level II Coding Standards
- Overview of Medicare Part A and Part B
- Medicaid Program Structure and Eligibility
- Commercial Payer Contracts and Negotiations
- Principles of Reimbursement Policy Analysis
- Fee-for-Service vs. Value-Based Payment Models
- Relative Value Scale (RVS) and RVU Calculations
- Prospective Payment Systems (PPS) Overview
- Diagnosis-Related Groups (DRGs) Methodology
- Ambulatory Payment Classifications (APCs)
- Outpatient Prospective Payment System (OPPS)
- Inpatient Prospective Payment System (IPPS)
- Home Health Prospective Payment System (HH PPS)
- Hospital Outpatient Quality Reporting (OQR)
- Compliance and Fraud Prevention Strategies
- Medical Necessity and Documentation Standards
- Claim Adjudication and Denial Management
- Appeals Process and Regulatory Compliance
- Healthcare Data Analytics for Reimbursement
- Electronic Health Records (EHR) Integration
- Telehealth Reimbursement Policies and Trends
- Bundled Payments and Episode-Based Care
- Accountable Care Organizations (ACOs) and Reimbursement
- International Reimbursement Models Comparison
- Financial Impact of Policy Changes on Providers
- Strategic Planning for Revenue Cycle Optimization
- Capstone Project in Reimbursement Policy Analysis
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Entry Requirements
- Basic understanding of the subject matter
- Proficiency in English language
- Computer and internet access
- Basic computer skills
- Dedication to complete the course
No prior formal qualifications required. Course designed for accessibility.
Course Status
This course provides practical knowledge and skills for professional development. It is:
- Not accredited by a recognized body
- Not regulated by an authorized institution
- Complementary to formal qualifications
You'll receive a certificate of completion upon successfully finishing the course.
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