Health Information Management

This course is designed as an overview to the healthcare delivery system and the health information Management profession. During the course, students will learn about the Health Information profession, the organization of healthcare in the United States, the role of providers, Information Systems related to the health record, filing methods, storage and retention, functions of the health record, content and structure, and data sets for various types of healthcare facilities.

This course reviews the role of the coding professional, the history of classification systems with emphasis on the basic rules and guidelines of the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-10-CM). This course will review the purpose and use the structure and conventions of ICD-10-CM. Detailed study will cover coding procedures in assigning ICD-10-CM codes for diagnosis and procedures with emphasis on coding in the inpatient care setting, coding compliance programs, performance measurement, staff recruiting and retention, and coding for reimbursement.

This course reviews the basic principles, characteristics, and conventions of coding with the current procedural terminology (CPT), nomenclature and introduces the concept of compliance programs including auditing and monitoring, compliance considerations unique to certain healthcare settings, and CMS initiatives to reduce Medicare payment errors and high-risk areas for fraud/abuse enforcement.

This course explores and provides a contemporary look at the principles and practice of insurance and reimbursement processing, including the completion of the claims for inpatient, outpatient, emergency department and office encounters. The students will also explore the structure and purpose of insurance plan options, charge master review, carrier requirements, State and Federal regulations, and healthcare reimbursement methodologies such as payment systems, fee for service, managed care, and global payments.