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Fundamentals of Revenue Cycle Management in Healthcare Organizations: Approval phase
About This Course
Content
COMMUNITY
Schedule
Introduction
Fundamentals of Revenue Cycle Management in Healthcare Organizations: Approval phase
Pre - Quiz
Unit 1 Introduction to the Approval Phase of RCM
Introduction to the Approval Phase of RCM
What is RCM and Why is It Important?
RCM Workflow and Key Components 1
RCM Workflow and Key Components 2
Signifivanace of the Approval Phase and related challanges
Unit 2 Insurance Policies, Terminologies, and Processes
Insurance Policies, Terminologies, and Processes
Introduction to Insurance Terminology
Brief on Policy Terms and Conditions
Tables of Benefits (TOB) and Coverage Limits
Unit 3 Managing Exclusions and Addressing Regulatory Challenges
Items of Exclusions in Insurance Policies
Exclusions for corpse repatriation to home country & Concept of hospitals
Understanding Policy-Specific Benefits and Limitations
Unit 4 Approval Processes and Workflow Optimization
Pre-Approval and Eligibility Check Processes
Understanding Approval Process and Workflow
Approval Request Validation
Unit 5 KPIs and Performance Evaluation in the Approval Process
Importance of accurate UCAF data completion for rejection free process
The standard medical disclosure form (H.Q)
Key performance indicators HCP / Payer side
Final Quiz
Post-Test
Evaluation
