Healthcare Coding, Billing and Reimbursement: An Overview
Tuesday, Feb. 26, 2019
10:00 AM - 11:30 AM
Where Event is Online Event Website
Event Type: Webcast/Webinar
Industry: Human Resources
Many people work with various aspects of healthcare coding and billing but may not understand how providers generate their claim data, how they report the data to payors, and how payors use that information to reimburse providers. This webinar provides a high-level overview of all major aspects of healthcare coding, billing, and reimbursement.
We discuss key data elements of the two major claim forms (CMS-1500 and UB04) and how that information tells the story of the patientís encounter with the provider. We review the major coding systems including CPT, HCPCS, ICD-9, ICD-10, DRG, and APC, and examine how codes in each system are assigned and the purpose of each system. We review the typical process flow for how a provider submits a claim and gets reimbursed. We discuss the fundamentals of physician and hospital reimbursement, including a brief conversation of relative value units (RVUs) are and how they are used to reimburse providers. We discuss commonly used methods to reimburse hospitals, including per diems, per stay, DRGs, and APCs. Finally, we review common pitfalls that analysts encounter when working with healthcare claims data sets and how to be on the watch for them.
Netzealous LLC - MentorHealth
Phone: (800) 385-1607