Certificates in This course guarantee that you will learn what the Health insurance cycle and Revenue cycle management what every role is in the cycle and how to get the highest revenue with the lowest cost.
1 - Patient Access:
• Entry to healthcare services under insurance plans.
Involves patient-provider interactions within the health insurance context.
2 - Case Management:
• Collaborative process for complex medical conditions.
Enhances patient outcomes and healthcare efficiency.
3 - Clinical Documentation:
• Creation and maintenance of accurate patient records.
Foundation for revenue cycle, impacting billing and claims processing.
4 - Medical Coding:
• Transforms healthcare services into recognized codes.
Critical for health insurance and revenue cycle management.
5 - Charges and Reimbursement:
• Fees for healthcare services.
Reimbursement is payment for services rendered by providers.
6 - Claim Management:
• Submission, processing, and adjudication of healthcare claims.
Crucial for revenue cycle management and provider reimbursement.