Cost:

Free for HFMA Members
Buy HFMA Membership to Attend

Audience:

Hospitals and Other Providers
Business Partners
Physicians and Other Practitioners

Career level:

Student
Early Careerist

Recommended for:

Patient Access
Revenue Cycle
Billing
Claims
Managed Care
Patient Financial Services
Physician Practice
Reimbursement

Delivery Method:

Self Study

Advance Preparation:

None

Prerequisites:

None

Course Availability:

18 Months

News | Health Plan Payment and Reimbursement
Hospitals hit by COVID-19 cases face a tight deadline to let HHS know they are interested in new funding that will be distributed next week.
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News | Health Plan Payment and Reimbursement
Provider burdens from health plans’ use of prior authorization continue to mount amid calls to make the process fully automated.
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Blog | Health Plan Payment and Reimbursement
A review of the FY20 appropriations package to fund the federal government and a couple of ideas on lessons that might be applied to future efforts to expand coverage.
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News | Health Plan Payment and Reimbursement
Bonus-based value payment models have proliferated among employer health plans, while risk-based payment and performance on clinical quality indicators have not changed significantly, according to a recently published scorecard.
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Podcast | Health Plan Payment and Reimbursement
America's Health Insurance Plan President and CEO Matt Eyles discusses how health plans view price transparency and other issues facing the industry.
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Course | Overview | Health Plan Payment and Reimbursement

Health Plans - An Overview

Course | Overview | Health Plan Payment and Reimbursement

Health Plans - An Overview

Description

In this course we will address the basic billing rules for major health plans, including an overview of basic billing features and benefits, types of billing rules and minor claim payers and plans.

Estimated course completion time: 30 minutes
After this program, you'll be able to..
  • Recognize the basic features of major government-funded health plans
  • Identify the basic features of other health plans including commercial plans and smaller government-funded plans

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What's your (new) financial persona?

Where do you fit when looking at diversifying future revenue streams: Do you lean toward a defensive position - reverting to your core business; or an offensive position - focusing on growth strategies that will generate new and diversified revenue streams and capture margin? This challenge has taken on a new urgency in a post-COVID-19 economy. In this session, you'll explore potential paths for organizational recovery that depend less on traditional core revenue streams. Rather, you'll be challenged to think about co-owning margins with new partners and solutions, examine what it would take to capture the equivalent NPR from strategic diversification, and create a framework for the future that is metric as well as outcome-based.


Original Live Date: HFMA Digital Annual Conference (6/26/2020)

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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

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Importance of Insurance Verification

In this course we highlight the various types of health insurance that your patients may present at registration. We'll review the fundamentals of Medicare, Medicaid, and third-party liability plans. You'll learn how verifying a patient's insurance eligibility and benefits affect the coordination of benefits process, which determines the primary payer and secondary payer on a claim.


Estimated course completion data: 30 minutes

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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