The healthcare industry is continually evolving, with financial management becoming an increasingly critical part of its operations. Revenue Cycle Management (RCM) is a key aspect of this process, ensuring that healthcare providers are paid accurately and promptly for the services they deliver. The OSHAA 30-Hours Diploma in Revenue Cycle Management (RCM) in Healthcare is designed to equip professionals with the skills and knowledge required to manage the complexities of the healthcare revenue cycle efficiently.
Revenue Cycle Management (RCM) in healthcare refers to the financial process that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of balances. This process involves a series of steps designed to ensure that healthcare providers receive the appropriate reimbursement for services rendered.
The OSHAA 30-Hours Diploma in Revenue Cycle Management in Healthcare offers professionals the essential knowledge and skills required to manage the complexities of the healthcare revenue cycle. With a focus on improving accuracy, efficiency, and compliance, this course prepares participants to navigate the challenges of healthcare billing and reimbursement, ensuring that organizations remain financially viable while continuing to deliver high-quality patient care.
OSHAA 30-Hours Diploma in Revenue Cycle Management (RCM) in Healthcare
Study Units
Learning Outcomes
Introduction to Revenue Cycle Management (RCM) (3 Hours)
- Understand the key components of Revenue Cycle Management (RCM) in healthcare.
- Learn the importance of an efficient revenue cycle in maintaining financial health for healthcare organisations.
- Identify the stages of the revenue cycle and the roles involved in each stage.
Patient Registration and Insurance Verification (3 Hours)
- Learn the process of accurate patient registration and its impact on the revenue cycle.
- Understand how to verify patient insurance coverage and eligibility to avoid claim denials.
- Gain knowledge of the best practices for collecting patient information and ensuring accurate data entry.
Medical Coding and Billing (4 Hours)
- Understand the role of medical coding in healthcare billing, including ICD-10 and CPT codes.
- Learn how to accurately assign medical codes for diagnoses, procedures, and services provided.
- Gain an understanding of billing processes and how proper coding ensures correct reimbursement.
Claims Submission and Follow-Up (4 Hours)
- Learn the steps involved in submitting accurate insurance claims to ensure timely reimbursement.
- Understand the process of following up on claims to track payments and resolve issues.
- Gain skills in handling claim rejections and resubmitting claims when necessary.
Payment Posting and Adjustments (3 Hours)
- Understand how to post payments to patient accounts and ensure accuracy in financial records.
- Learn the process of making necessary adjustments to patient accounts for payments, write-offs, and other changes.
- Gain an understanding of how accurate payment posting impacts the overall revenue cycle.
Denial Management and Resolution (4 Hours)
- Learn the common reasons for claim denials and how to address them effectively.
- Understand the steps to dispute or appeal denied claims, ensuring proper reimbursement.
- Develop strategies for proactive denial prevention and improve cash flow by reducing denials.
Compliance and Regulatory Requirements (4 Hours)
- Gain knowledge of the key regulations governing the revenue cycle, including HIPAA and CMS guidelines.
- Understand how to maintain compliance with healthcare billing and coding standards.
- Learn how to identify and prevent compliance violations that could lead to financial or legal penalties.
Financial Reporting and Analysis (5 Hours)
- Learn how to generate and interpret financial reports related to the revenue cycle.
- Gain skills in analysing revenue cycle data to identify trends, inefficiencies, and areas for improvement.
- Understand how financial reporting contributes to decision-making and the financial health of healthcare organisations.
- Comprehensive Knowledge of RCM: Gain a thorough understanding of the entire revenue cycle process, from patient registration to final payment, equipping you with essential skills to manage healthcare financial operations effectively.
- Enhanced Career Prospects: This diploma enhances your qualifications, making you a valuable asset to healthcare organisations by demonstrating your expertise in managing the complexities of healthcare billing and reimbursement.
- Increased Efficiency in Healthcare Operations: Learn how to streamline billing, coding, and claims processes, ultimately improving the efficiency of revenue cycle operations and reducing errors or delays in payment.
- Practical Skills in Medical Coding and Billing: Gain hands-on experience in medical coding and billing practices, including the use of ICD-10 and CPT codes, and learn how to ensure accurate reimbursement for healthcare services.
- Expertise in Denial Management: Learn how to effectively manage and resolve denied claims, reducing the likelihood of financial losses and improving cash flow for healthcare providers.
- Up-to-Date Knowledge of Compliance and Regulations: Understand the legal and regulatory requirements in healthcare finance, including HIPAA and CMS guidelines, ensuring that your practice or organisation remains compliant and avoids penalties.
- Improved Financial Reporting and Analysis: Learn how to generate and interpret financial reports, providing insights that support better decision-making and financial planning within healthcare organisations.
- Boosted Professional Credibility: This recognised qualification enhances your professional credibility in the healthcare industry, making you stand out in roles related to healthcare finance, administration, and revenue cycle management.
- Increased Job Security: With the growing need for skilled professionals in healthcare finance, this diploma strengthens your job security by expanding your qualifications and skill set, making you indispensable to employers.
- Global Opportunities: The course provides globally relevant knowledge, allowing you to work in revenue cycle management roles across different healthcare systems, both locally and internationally.
- Healthcare Administrators: Professionals managing the operational and financial aspects of healthcare facilities who want to improve their understanding of revenue cycle management.
- Medical Billing and Coding Specialists: Individuals working in medical billing or coding who wish to enhance their expertise in the billing process, medical coding systems, and reimbursement procedures.
- Revenue Cycle Managers: Those already overseeing the revenue cycle in healthcare organisations who want to refine their skills and gain in-depth knowledge of best practices for managing the entire process efficiently.
- Medical Office Staff: Staff members involved in patient registration, insurance verification, or payment processing who seek to improve their understanding of the full revenue cycle and streamline operations.
- Financial Analysts and Healthcare Consultants: Professionals in healthcare finance or consulting who want to expand their knowledge of healthcare revenue cycle management and its impact on organisational financial health.
- Healthcare Providers and Practitioners: Doctors, nurses, or allied health professionals who want to gain a better understanding of the revenue cycle and how it affects the financial sustainability of their practice or institution.
- Students and Career Changers: Individuals interested in starting a career in healthcare administration, medical billing, or revenue cycle management, seeking to acquire the necessary skills and knowledge to enter the field.
- Compliance Officers: Professionals ensuring that healthcare organisations adhere to industry regulations and standards who wish to deepen their understanding of compliance within the context of revenue cycle management.
- Anyone Interested in Healthcare Financial Management: Anyone looking to understand the financial workings behind healthcare organisations and develop skills in revenue cycle management to support better operational performance and financial health.
