Tips from our featured course
Hospital Revenue Cycle (HRC)
Target publication date late summer
Case managers in the hospital setting are at the intersection of documenting clinical care and hospital operating revenues. A high performing CM team can improve hospital revenues by several million dollars per year from payers like Aetna, CIGNA and Medicare with highly accurate claims (invoices) to the insurance companies.
Conversely, an underperforming CM team can lose the hospital millions of dollars per year in declining revenues from the same payers. Therefore, we assert that a well educated CM team completing this expanded course can improve the hospital's operating revenues. We encourage case managers to equip themselves with a fiscal power tool in the form of knowledge.
Here's the outline for the expanded Hospital Revenue Cycle course:
Module A: The Significance of Operating Revenues
Module B: The Impact of Revenue Cycle Teams
Module C: Medicare Claims & Reimbursements
Module D: Commercial Claims & Reimbursements
Module E: Medicaid Claims & Reimbursements
Module F: The Uninsured & Medically Indigent
Module G: Denials & Appeals
Module H: Patient Engagement & Cross-Sector Interventions
Heart Failure: Case Managers as Influencers
The quality of member interactions and resulting experiences can influence patient behavior and, as a result, health outcomes.
[Heart Failure, Module G, Transdisciplinary Team]