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Hospitals and Other Providers
Physicians and Other Practitioners

Career level:

Experienced Professional
Early Careerist

Recommended for:

Patient Accounts
Patient Financial Services
Physician Practice
Revenue Cycle

Delivery Method:

Self Study

Advance Preparation:




Course Availability:

18 Months

Blog | Medicare Payment and Reimbursement
Recommendations from healthcare economists for savings to preserve Part A Trust Fund focus more on taxes and less on providers.
Blog | Medicare Payment and Reimbursement
HFMA's Chad Mulvany explains why a small percentage point increase in the uninsured rate could significantly impact the UC DSH dollars available to safety net hospitals at a time when they are financially struggling due to COVID-19.
News | Medicare Payment and Reimbursement
Federal assistance programs should stabilize hospital cash through the summer, when Medicare repayments will create major financial pressure.
News | Medicare Payment and Reimbursement
CMS wants hospitals to start reporting median health plan payment rates and may use the information to help determine Medicare rate changes.
News | Medicare Payment and Reimbursement
The federal government has begun to release financial assistance targeted to rural hospitals as they struggle with cash shortfalls amid the shutdown of elective procedures.
Course | Intermediate | Medicare Payment and Reimbursement

Compliance: Reimbursement Issues

Course | Intermediate | Medicare Payment and Reimbursement

Compliance: Reimbursement Issues


This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Prospective Payment System (IPPS) and discusses specific instances in which a hospital may receive additional payments under the IPPS.

Estimated course completion time: 1 hour
After this program, you'll be able to..
  • Identify the general structure of a prospective payment system
  • Recognize the statutory history behind the implementation of the prospective payment system
  • Identify which Medicare programs are reimbursed using a prospective payment system
  • Recognize the physician fee schedule
  • Recognize the DMEPOS fee schedule
  • Recognize the clinical laboratory fee schedule
  • Identify the steps necessary to determine payment under the IPPS
  • Identify which services are not included in payment made under the IPPS
  • Recognize the purpose of an outlier payment and identify when an outlier payment may be made
  • Recognize the purpose of a disproportionate share adjustment and when such an adjustment may be made
  • Identify indirect medical education (IME) and recognize when an IME adjustment may be made

Related Courses | Medicare Payment and Reimbursement

On Demand Webinar | Overview | Coronavirus

Patient care in crisis: How to launch, code and bill telehealth services (Spring 2020 Virtual Conference On-demand)

Due to the coronavirus/COVID-19 crisis, physicians and health leaders are under tremendous pressure to meet the demands of patient care while stabilizing operational and financial health. This session will showcase a telehealth demonstration and discuss how providers can implement telehealth quickly and efficiently.

Original live session date: 4/9/2020

Course | Advanced | Payment Trends

Healthcare Finance: The Big Picture

Next to national defense, the healthcare industry in the United States is one of the largest sectors of the economy. Currently making up almost 20 percent of the nation's gross domestic product, health care in the U.S. will be a significant factor in the national economy for the foreseeable future.

Estimated course completion time: 1 hour and 30 minutes

Course | Basic | Medicare Payment and Reimbursement


In this course we will address scheduling processes, including

  • Patient identification
  • Requested service
  • Medical necessity screening
  • Medicare Advance Beneficiary Notice of Noncoverage processing
  • Patient instructions
  • Scheduler instructions
  • Order requirements
Estimated course completion time: 30 minutes

Course | Basic | Billing and Collections

Cash Posting and Electronic Remittance - Advice and Fund Transfers

In this course we review internal controls for cash handling and posting, electronic funds transfer and electronic remittance advices.

Estimated course completion time: 30 minutes