Diploma in Healthcare Revenue Cycle Management

Advanced Diploma in Healthcare Revenue Cycle Management (Insurance Claims Management, Medical Coding, and Billing)

Comprehensive Program to Master Healthcare Revenue Cycle, Coding, and Billing Practices

Program Overview

The Advanced Diploma in Healthcare Revenue Cycle Management (Insurance Claims Management, Medical Coding, and Billing) at Futureace Healthcare Academy is an in-depth 6-month program designed to equip students with comprehensive knowledge and expertise in medical coding, insurance claims management, and billing practices within the healthcare sector. This program focuses on the complete revenue cycle process, from accurate medical coding to insurance claims processing and reimbursement management.
This course prepares you to handle the entire healthcare revenue cycle efficiently, ensuring timely reimbursement, reduced denials, and compliance with international standards and regulations. With an in-depth exploration of standard medical coding systems, students will be able to optimize billing and claims processes, improving the cash flow and operational efficiency of healthcare organizations.
Ideal for individuals looking to advance their careers in healthcare billing, coding, or revenue cycle management, this advanced diploma provides you with the necessary skills to become a highly proficient professional in the healthcare finance domain.

Program Duration

  • 6 Months (24 Weeks)
  • Weekend & Weekday Batches Available
  • Online & Offline Learning Options

Who Can Enroll?

Eligibility: Plus Two (12th grade) or Above Qualification

Open to:

  • Graduates wishing to specialize in revenue cycle management, insurance claims, medical coding, and billing
  • Healthcare professionals wanting to shift into financial roles
  • Aspirants in medical billing, coding, insurance claims, or hospital administration
  • Anyone interested in medical billing systems, coding, and claims management
Diploma in Healthcare Revenue Cycle Management
Diploma in Healthcare Revenue Cycle Management
Diploma in Healthcare Revenue Cycle Management

Program Modules & Curriculum

Module 1: Introduction to Healthcare Revenue Cycle Management (RCM)

Overview of the Revenue Cycle: Key stages of the revenue cycle from registration to payment
Revenue Cycle Workflow: The seamless flow of data between front-office, coding, billing, and insurance teams
Stakeholders in RCM: Roles of providers, payers, patients, and billing departments
Revenue Cycle Metrics and KPIs: Identifying inefficiencies and improving cash flow

Module 2: Medical Coding Fundamentals

Introduction to Medical Coding: Overview and importance of accurate coding in the revenue cycle
ICD-10-CM (International Classification of Diseases): Understanding and applying diagnostic codes
CPT (Current Procedural Terminology) Codes: How to code medical procedures and services
HCPCS (Healthcare Common Procedure Coding System): Coding for services, equipment, and procedures
Coding Compliance: Understanding coding rules, audits, and preventing fraud
Practical Application: Hands-on exercises with real-world coding examples

Module 3: Medical Billing and Claims Management

The Billing Process: Step-by-step process of creating and submitting claims
Understanding Insurance Claims: Claims forms (CMS-1500, UB-04), payer types, and processing
Insurance Verifications: Confirming patient insurance details, eligibility, and benefits
Insurance Claims Lifecycle: How claims are initiated, processed, and paid
Handling Denied Claims: Analyzing reasons for denials, correcting claims, and resubmitting
Third-Party Payer Communication: How to interact effectively with insurance companies

Module 4: Healthcare Reimbursement Systems and Payment Models

Reimbursement Models: Fee-for-service, bundled payments, and capitation models
Government and Private Insurance: Understanding Medicare, Medicaid, private insurance policies, and healthcare exchanges
Understanding Payments and Adjustments: Payment schedules, underpayments, overpayments, and adjustments
Denial and Appeal Management: How to handle and prevent denials, initiate appeals, and optimize reimbursement
Payment Processing Best Practices: Ensuring accuracy and timely payments

Module 5: Healthcare Finance and Compliance Regulations

Healthcare Financial Regulations: HIPAA, OIG, and other compliance laws for medical billing and coding
Risk Management and Fraud Prevention: Identifying and preventing billing fraud, abuse, and overbilling
Revenue Cycle Audits: Performing internal audits, ensuring coding accuracy, and reducing fraud
Coding Compliance and Legal Aspects: Adhering to coding rules and avoiding legal issues
Financial Reporting and Analysis: Monitoring and reporting revenue cycle performance

Module 6: Payment Reconciliation and Collections Process

Reconciliation Procedures: How to compare insurance payments with billed amounts and adjust discrepancies
Managing Denied Claims: Steps to resolve and prevent denied claims, using claims data for improvements
Patient Financial Services: Managing patient billing, payment plans, and collections
Account Receivables and Collections: Effective techniques for collecting overdue payments
Bad Debt Management: Strategies for minimizing write-offs and improving collections

Module 7: Denial Management and Optimization

Understanding Denial Reasons: Common causes of claim denials and how to resolve them
Denial Prevention: Key practices for preventing claim rejections
Denial Management Systems: Using denial management software and analytics to track and reduce denials
Effective Appeals Process: How to successfully challenge denied claims
Denial Analytics and Reporting: Using data to identify trends and improve claims acceptance

Module 8: Future Trends in Medical Coding and Billing

Technological Advances in Medical Coding: The role of AI and automation in simplifying coding and billing
Telemedicine and Billing: Billing for telehealth services and the nuances of telemedicine claims
Global Coding Standards: International coding practices and their influence on billing systems
Emerging Healthcare Payment Models: Understanding the shift to value-based payments and its impact on RCM
The Future of Healthcare Revenue Cycle: Predictions on how technology, AI, and evolving regulations will shape the industry

Key Takeaways & Skills Acquired

  • Master the complete revenue cycle process: From coding and billing to reimbursement and collection
  • Specialized knowledge in ICD-10, CPT, and HCPCS codes for accurate and efficient medical coding
  • In-depth understanding of insurance claims submission, management, and denial prevention
  • Hands-on experience with medical coding software, billing systems, and insurance claims platforms
  • Proficiency in handling complex reimbursement models, patient billing systems, and collections processes

Career Opportunities After Completion

Upon successful completion of the Advanced Diploma in Healthcare Revenue Cycle Management (Insurance Claims Management, Medical Coding, and Billing), graduates can pursue roles such as:

  • Revenue Cycle Manager
  • Medical Billing Specialist
  • Medical Coder
  • Insurance Claims Analyst
  • Healthcare Financial Analyst
  • Claims Auditor
  • Patient Financial Services Coordinator

Why Choose Futureace Healthcare Academy?

  1. Industry-Aligned Curriculum: Designed by experts with extensive experience in healthcare finance and operations
  2. Practical Training: Real-life case studies, hands-on practice, and software simulations
  3. Career-Oriented: Placement assistance, mock interviews, and industry networking opportunities
  4. Accredited Certification recognized by leading healthcare organizations
  5. Flexible Learning Options: Online and offline classes to suit different learning preferences
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98956 23801

Headquarters Address

Futureace coporate office, Opp Lulu India Head Office, NH17 Service Road, Nethaji Nagar, Edapally 682024.

Campus Address

Cochin Public School Road, Thrikkakara, Kochi - 21
(Monday - Saturday)
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