The purpose of this course is to expose the
student to contemporary prospective payment systems used by the U.S. government
and other key health plans that comprise most patients' source of payment for
healthcare services. Reimbursement systems from a variety of healthcare settings
are presented to round out the student's experience in preparation for
employment as a coding professional in a variety of settings.
Coding Basics is a self-paced program which will cover the foundational
concepts in the coding and billing profession. Coding professionals abstract
clinical data from health records and assign appropriate medical codes. These
codes are used for reimbursement, planning, and research. Comprehensive training
in inpatient and outpatient coding is provided, along with the necessary
background courses in health record content, medical terminology, and disease
At the end of this course, students will be
- Explain prospective payments and their
implications for coding.
- Define the basic language associated with
- Analyze various reimbursement methodologies
including: MS-DRGs, RUGs, OASIS, APCs, and RBRVS.
- Differentiate various prospective payment
systems and identify the applicable healthcare setting.
- Recognize the importance of correct clinical
coding and compliance.
- Distinguish between the various types of
voluntary healthcare insurance plans.
- Understand the creation and maintenance of
federal insurance programs.
- Understand the concept and history of
- List types of managed care health
- Identify the benefits and non-benefits of
federal programs such as Medicare and Medicaid.
- Outline the process of revenue cycle
- Identify current quality trends in health
You must complete each item found on the main
course page to successfully complete this course. Completion is identified with
a green check mark symbol.
Each lesson has an associated lesson-level
quiz provided for review. You may take the quizzes as many times as you like.
However, note that you must achieve a score of 70% or higher on each quiz for it
to mark as complete.
Unlike the quizzes, you
allowed to take the Final Exam once, and you must
complete it with a score of 70% or higher to successfully
complete the course.
- Principles of Healthcare Reimbursement, 5th edition Casto and