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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
HFMA's Chad Mulvany says given the Trump administration’s focus on transparency, it’s possible the Transparency in Coverage final rule could be released prior to the election.
Blog | Medicare Payment and Reimbursement
HFMA's Chad Mulvany offers insight on key areas of the Inpatient Prospective Payment Service final rule, including market-based MS-DRG weights, Uncompensated Care DSH and Medicare bad debt requirements.
News | Medicare Payment and Reimbursement
In the FY21 IPPS final rule, CMS expanded controversial negotiated-price reporting requirements.
Podcast | Medicare Payment and Reimbursement
Rich Daly interviews Rep. Suzan Delbene about the Value in Health Care Act, proposed legislation that would make a series of hospital-supported changes to value-based programs operated by Medicare. Andrew Renda of Humana talks about how the...
News | Medicare Payment and Reimbursement
The CY21 OPPS proposed rule would eliminate the inpatient-only list of services over three years while increasing the number of ASC-eligible procedures, and also would increase 340B payment cuts and overhaul the hospital star-rating system.
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 | Update | Legal and Regulatory Compliance

How to accelerate financial results of a specialty pharmacy service

Prepare your organization now for the proposed CY21 changes to the ambulatory surgery center (ASC) payment system and the hospital outpatient payment system (OPPS) CY21. Find out what changes are proposed for implementation on January 1, 2021, for ASCs and hospital leaders will not want to keep a close watch on ASC and OPPS developments as more services migrate from one setting to another.

Topics include proposed 2021 changes to:

  • APC groupings
  • OPPS changes to drugs, biological, and radiopharmaceuticals
  • OPPS for packaging
  • Inpatient Only List
  • ASCs
  • Hospital outpatient and ASC quality requirements
  • Additional changes to other policy areas

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 | Coding

Health Information Management (HIM) and Coding

At the end of this course, you will be able to identify the responsibility of Health Information Management (HIM) in the revenue cycle.

Estimated course completion time: 2 hours