Master Revenue Cycle Management | Learn Insurance Verification, Claim Submission, A/R, Charge Entry, Reporting and So On
What you will learn
You will gain an understanding of the 16 steps involved in Revenue Cycle Management in Healthcare.
You’ll learn how to explain and clear up financial transactions in medical billing, including pre-registration and insurance verification.
You will Learn what makes up a high performance pre-registration unit and what information is needed during patient registration.
You will discover how to verify a patient’s insurance coverage and the financial responsibility of the patient in medical billing.
You’ll learn about the three categories of CPT along with an overview of ICD-10-CM and HCPS.
You will discover the definition, five step process, and best practices for charging in medical billing.
You will learn what is included in a medical claim, how to submit a claim in 4 steps, and what happens after submission.
You’ll Know about the KPIs that needs to be tracked to maintain healthy accounts in medical billing.
You will learn how to improve the efficiency of your A/R process by automation.
You will discover the six steps of an effective denial management process, master best practices, and devise strategies to effectively manage denials.
you will actively engage with supplemental materials, course notes, and quizzes in each section of thisto measure and enhance your understanding in RCM.
You’ll utilize the RCM Course audiobook provided in the resource section of each unit to deepen your understanding and complement your learning experience.
You will receive tutor support & communicate with tutor through inbox.
You will obtain a Certificate of Completion in Revenue Cycle Management (RCM) in Medical Billing 2024।
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- Course Overview
- This accredited course provides an immersive journey into the strategic core of healthcare finance: Revenue Cycle Management. It’s designed to equip you with a holistic understanding of how healthcare providers maximize legitimate reimbursements while ensuring operational efficiency and patient satisfaction.
- Delve into the intricate sequence of administrative and clinical functions that span from a patient’s initial appointment scheduling through to the final payment collection, offering a comprehensive perspective on the financial health of medical practices and facilities.
- Gain insights into the critical interplay between patient registration, service delivery, coding accuracy, billing processes, and payment reconciliation, all framed within the context of regulatory compliance and payer requirements.
- Understand the lifecycle of a medical claim, identifying key touchpoints where optimization can significantly reduce financial leakage and accelerate revenue capture for healthcare organizations.
- Requirements / Prerequisites
- A foundational understanding of basic office administration or general healthcare processes is beneficial but not strictly required.
- No prior experience in medical billing or coding is necessary, making this course accessible for motivated beginners.
- A strong aptitude for detail, analytical thinking, and problem-solving will greatly enhance your learning experience.
- Proficiency in basic computer operations and internet usage is expected for navigating course materials and relevant online tools.
- A high school diploma or equivalent is generally recommended.
- Skills Covered / Tools Used
- Develop expertise in financial data analysis, enabling you to track key performance indicators (KPIs) and identify areas for revenue enhancement.
- Cultivate precision in medical documentation review and charge reconciliation to minimize errors and audit risks.
- Master effective communication strategies for interacting with patients regarding financial obligations and liaising with insurance payers to resolve complex billing inquiries.
- Gain familiarity with the functional aspects of generic Electronic Health Record (EHR) and Practice Management (PM) systems, understanding their role in facilitating RCM workflows.
- Acquire systematic approaches to managing accounts receivable, including follow-up procedures and denial management strategies to ensure timely and complete payments.
- Learn to interpret and apply diverse payer-specific guidelines and governmental regulations to maintain compliance and avoid costly penalties.
- Develop capabilities in producing and interpreting RCM reports, allowing for data-driven decision-making and continuous process improvement within a healthcare setting.
- Benefits / Outcomes
- Position yourself for a rewarding career in the rapidly expanding and stable field of healthcare administration and medical finance.
- Achieve an accredited qualification, signifying a recognized standard of competence and enhancing your professional credibility with potential employers.
- Contribute directly to the financial sustainability and success of healthcare providers, playing a vital role in their ability to deliver quality patient care.
- Develop a robust skill set that is highly transferable across various healthcare settings, including hospitals, clinics, and specialized medical practices.
- Empower yourself with the knowledge to troubleshoot common billing issues, reduce claim rejections, and optimize collection rates for any medical entity.
- Unlock opportunities for career advancement into roles such as RCM Specialist, Billing Coordinator, Claims Analyst, or Financial Counselor.
- PROS
- High Demand Career: The need for skilled RCM professionals continues to grow with the complexity of healthcare finance.
- Impactful Role: Directly contributes to the operational and financial viability of healthcare organizations.
- Career Stability: Healthcare is an evergreen industry, offering long-term career prospects.
- Accredited Certification: Provides a verifiable credential that validates your expertise and commitment.
- Diverse Pathways: Opens doors to various specializations within the revenue cycle, from front-end patient services to back-end collections.
- CONS
- Continuous Learning Required: The dynamic nature of healthcare regulations and coding standards necessitates ongoing education and adaptation.
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