Course Description
Comprehensive study of the healthcare revenue cycle from patient registration through final payment. Covers charge capture, coding, claims submission, denials management, collections, and analytics. Emphasis on optimizing revenue cycle performance and managing payer relationships.
Credit Hours
3 credits (3 lecture)
Prerequisites
Healthcare Finance course or industry experience
Student Learning Outcomes
- Analyze end-to-end revenue cycle processes and identify improvement opportunities
- Evaluate coding accuracy and compliance programs
- Design denials prevention and management strategies
- Optimize patient access and registration workflows
- Implement revenue cycle analytics and reporting
- Manage payer contracts and fee schedule negotiations
Course Topics
- Revenue Cycle Overview: Front-End, Mid-Cycle, Back-End
- Patient Access: Scheduling, Registration, Eligibility, Authorization
- Charge Capture and CDM Management
- Medical Coding: ICD-10, CPT, HCPCS, DRG
- Claims Management: Electronic Submission, Clearinghouses
- Denials Management: Prevention, Appeals, Root Cause Analysis
- Patient Collections: Estimates, Payment Plans, Bad Debt
- Revenue Cycle Analytics: KPIs, Dashboards, Benchmarking
Required Textbooks
- HFMA: Revenue Cycle Management (current edition)
- Case studies and simulation exercises (provided)
Evaluation Methods
Revenue Cycle Improvement Project (35%), Case Studies (25%), Simulation (20%), Exams (20%)