Categories KSA Overview Objectives Learning Outcomes Curriculum Course Overview Explore the evolution of the DRGs from their historical roots through to AR-DRG V9.0 (as used in KSA) Discuss key concepts of data collection and methodologies, including the role of quality documentation, clinical coding and DRG allocation through comparative case studies Evaluate different healthcare funding models with particular attention to Accountable Care Organizations, healthcare financing reforms, and the road to Value-based healthcare Introduce continuous analysis activities and audit programs to support the transformation Objectives By the end of this course, participants will be able to: Explain the AR-DRG and its role in healthcare by understanding the sources of information required to identify the appropriate AR-DRGs. Identify the differences between nomenclatures, terminologies, and classifications, and explain their individual and collective value. Discuss the importance of clinical documentation and accurate clinical coding in ensuring the integrity of healthcare data. Recognize the drivers of AR-DRGs and their impact on patient complexity levels and resource allocation. Define and use appropriate terminology associated with AR-DRGs in an ABF/M funding environment. Benefit from the value of DRGs in an insurance funding model to optimize funding and reimbursement strategies. Gain knowledge in implementing continuous analysis and audit for ongoing improvement in clinical documentation and coding practices. Learning Outcomes Upon completion of this course, participants will be able to: Accurately explain the AR-DRG system and its role in healthcare, including how to identify appropriate AR-DRGs based on medical data. Differentiate between nomenclatures, terminologies, and classifications, and understand their value in clinical coding and documentation. Understand and emphasize the significance of clinical documentation and accurate clinical coding in ensuring quality and compliance. Recognize the key drivers of AR-DRGs and their effect on patient complexity, healthcare resource utilization, and reimbursement. Use appropriate terminology associated with AR-DRGs within the context of ABF/M funding models. Identify how DRGs contribute to an insurance funding model and understand the financial impact on healthcare services. Implement continuous analysis and audit practices to maintain and improve clinical documentation and coding accuracy. Curriculum Course Structure Module # Module Name M1 Introduction to DRGs M2 Nomenclatures, Classifications, and Terminologies M3 Coding, Documentation, and DRGs M4 DRGs and Healthcare Funding M5 Casemix and Calculation M6 Analysis and Audit Module Features Audiovisual Lecture: A comprehensive presentation of the content delivered online. Explanation of Section-Specific Guidelines: Detailed breakdown of medical terminology, key concepts, and relevant applications. Case Studies: Real-world scenarios to demonstrate the practical use of medical terminology and reinforce learning. Practical Exercises: Hands-on practice to assign medical terms, enhancing understanding and application. Knowledge Checks: Quizzes or assessments to review key concepts and ensure mastery of the material.