Fundamentals Of Revenue Cycle Management (RCM)

The Fundamentals of Healthcare Revenue Cycle Management course is designed to provide a comprehensive understanding of healthcare RCM. This course explores the entire RCM process, from patient registration through to end billing. It covers global trends and best practices, offering regional insights and emphasizing the importance of Clinical Documentation Improvement (CDI) in optimizing RCM processes. The course is intended for individuals new to the field of healthcare finance or those seeking to strengthen their knowledge and skills in managing the financial aspects of healthcare organizations. With an international perspective, this course prepares learners to understand the various departments and units within RCM and how they contribute to the overall revenue cycle, improving financial outcomes.

Clinical Documentation Integrity Course
Categories
UAE

Course Overview

This modular online course offers a deep dive into healthcare RCM, covering its global practices, regional differences, and key concepts like CDI. The course provides insights into the key roles and responsibilities in RCM, helping learners identify the most effective RCM models for improved revenue management and financial performance.

Objectives

By the end of the entire course; you will be able to:

  • Comprehend different versions of codes available in any RCM practice and recognise the differences in various versions of coding in respect to the country’s Healthcare Billing System.
  • Gain 360 degrees understanding of RCM concepts and principles ranging from coding to insurance protocols to billing regulations and compliance; in addition to claim submissions, insurance denials, and reconciliations.
  • Become aware of Revenue Cycle Management (RCM) concepts to maximize the billing potential leading to increased revenues and improved financial results.

Learning Outcomes

Participants will be able to:

  • Understand the key components and processes involved in the healthcare revenue cycle.
  • Identify the different coding systems used in RCM and understand how they vary across regions and healthcare systems.
  • Analyze the impact of clinical documentation improvement (CDI) on revenue cycle management and financial outcomes.
  • Apply best practices in coding, billing, and compliance to ensure accuracy and efficiency in revenue cycle processes.
  • Navigate through the steps of claim submission, denial management, resubmission, and reconciliation to enhance revenue collection.
  • Assess the role of various departments involved in the revenue cycle and how they contribute to overall financial success in healthcare settings.
  • Recognize the significance of global trends and regional insights in shaping healthcare RCM practices.

Curriculum Overview

Course Duration: 10 hours

Introduction to Revenue Cycle Management (RCM)

  • General RCM cycle with key functions of departments

Module 1: Coding Concepts

  • Different versions of medical coding adopted by various countries will be discussed

Module 2: Demystifying Insurance Concepts

  • General insurance protocols are highlighted to enable participants to have sound knowledge about the basic insurance standards a country should follow. This module is explained using UAE Insurance protocols as a standard model.

Module 3: Billing Regulations and Compliance

  • Billing regulations along with compliance are explained which form the major part of the RCM cycle. This module highlights the U.S billing methods and compliance as the standards.

Module 4: Claim Submissions, Insurance Denials, Resubmissions, Reconciliations

  • The final step in RCM cycle after a claim generation. This module is explained with respect to Canadian standards.

Module Features

  • Audiovisual lectures (face-to-face or online)
  • Practice coding scenarios with instructor feedback
  • Module assessments