FUNDAMENTALS OF RCM

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Tailored for
beginners

RCM knowledge covered
from A to Z

Improved job prospects
in RCM

Based on ICD-10
& SBS

Course Summary

Fundamentals of Healthcare Revenue Cycle Management is an online course to help  you understand the basics of healthcare RCM. It navigates the learner from “What is RCM to  Healthcare RCM, global trends and best practice to regional insights and the scope of CDI  (Clinical Documentation Improvement) in RCM.

This course provides a complete overview of different departments or units  of RCM and the RCM process flow from patient registration to end billing. This modular  course covers RCM learning from an international perspective and is not confined to any  one country standards. We have included various roles of RCM in our course; that serve  as a source of knowledge and also helps you identify a suitable RCM model for improved  revenues and financial outcomes.

By the end of this course, you will be able to:

  • Comprehend different versions of codes available in any RCM practice and recognise the  differences in various versions of coding in respect to the country’s Healthcare Billing  System.
  • Gain 360 degrees understanding of RCM concepts and principles ranging from coding  to insurance protocols to billing regulations and compliance; in addition to claim  submissions, insurance denials, and reconciliations.
  • Become aware of Revenue Cycle Management (RCM) concepts to maximize the billing  potential leading to increased revenues and improved financial results.
  • Identify the structure and organization of the International Statistical Classification of Diseases and Related Health Problems – Tenth Revision – Australian Modification (ICD-10-AM), Saudi Billing System (SBS), ICD-10-CM, CPT and Canadian Coding Methodologies
  • Apply the conventions and instructions found in ICD-10-CM, ICD-10-AM, SBS, CPT
  • Determine diagnosis and procedure codes for ambulatory cases

Introduction to Revenue  Cycle Management (RCM)

General RCM cycle with key  functions of departments

Different versions of medical coding adopted by various countries will be discussed

General insurance protocols are highlighted to enable participants  have a sound knowledge about the basic insurance standards a country should follow. This module is explained using UAE  Insurance protocols as a standard model.
Billing regulations along with compliance are explained which form  the major part of the RCM cycle. This module highlights the U.S billing methods and compliance as the standards.

The final step in RCM cycle after a claim generation. This module is explained with respect to Canadian standards.