The healthcare reimbursement system is complex. Ensuring appropriate reimbursement for services is a key part of any organization’s revenue cycle.
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Learn to navigate the 'ins and outs' of reimbursement for outpatient services. Fundamentals of Reimbursement: Outpatient Services will help Coders, Clinical Documentation Improvement Specialists and other key actors in the hospital revenue cycle understand the complexities of the healthcare reimbursement system and their role in ensuring accurate and appropriate reimbursement for services. -
Accurate and appropriate reimbursement for services is essential to the financial health of hospitals. Learn to navigate the 'ins and outs' of reimbursement for hospital inpatient services with Fundamentals of Reimbursement: Inpatient Services. Essential training for Coders, Clinical Documentation Improvement Specialists and other key actors in the hospital revenue cycle.
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This two-course bundle will help Coders, Clinical Documentation Improvement Specialists and other key actors in the hospital revenue cycle understand the complexities of the healthcare reimbursement system and their role in ensuring accurate and appropriate reimbursement for both inpatient and outpatient services.
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Understanding the proper application of modifiers is essential to correct and complete CPT coding of professional fee services. CPT® and HCPCS: Modifiers covers commonly used CPT and HCPCS Level II modifiers and provides examples of how these modifiers are used in reporting physician and other provider services. -
Medical Necessity determines if a health care service is reasonable, necessary, and appropriate based on clinical standards of care. It's a key factor in determining eligibility for reimbursement. Nationally-recognized coding authority, Kim Huey, MJ, CHC, CPC-M, CPC, CCS-P, PCS, CPCO, COC, walks you through what you need to know to ensure your documentation and coding will meet requirements for medical necessity.
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The National Correct Coding Initiative, developed by CMS, outlines correct coding policy as well as bundling edits; however understanding the policies, identifying under what circumstances procedures can be coded together, and which modifiers are appropriate can seem overwhelming. Join nationally recognized CPT coding authority Kim Huey, MJ, CHC, CPC-M, CPC, CCS-P, PCS, CPCO, COC, for an overview of the NCCI ePolicy manual followed by a detailed review of the edits and modifiers to ensure your coding is appropriate and defensible. -
IPPS: FY 2027 Updates: Final Rule examines the changes to the Inpatient Prospective Payment System (IPPS) for FY 2027, helping coding and CDI professionals prepare for coding, MS-DRG, reimbursement, and payment policy changes. The course reviews MS-DRG revisions, ICD-10-CM/PCS updates, payment initiatives, and quality reporting changes. -
Selecting the Principal Diagnosis, by nationally-recognized clinical documentation authority, Cynthia Tang, RHIA, CCS, provides in-depth instruction on accurately determining principal diagnosis and resultant DRG assignment. This online course is helpful for CDI Professionals and Coders. -
OPPS: 2026 Updates covers the significant changes in the Final Rule for the Outpatient Prospective Payment System (OPPS) for services provided January 1, 2026 or later. This online, on-demand course covers both coding changes and provides insight into the underlying issues driving the changes. -
MPFS: 2026 Updates covers the significant changes to the Medicare Physician Fee Schedule (MPFS) for services provided January 1, 2026 or later. This online, on-demand course covers both changes to MPFS and provides insight into the underlying issues driving the changes.
