Reimbursement Methodologies & Compliance

This course provides an in-depth understanding of the structure and function of the US Healthcare Reimbursement system, including the various types of payors, payment methodologies and compliance strategies.
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A UC San Diego Extended Studies course (MEDC-X400.21) within the Medical Coding certificate. It explains the three types of US payors (commercial, federal, managed care), the payment methodologies linked to each, the insurance billing process from claim to payment determination, and the laws and agencies governing claims compliance.

What you’ll learn:

  • Commercial, federal and managed care insurance plans
  • Payment methodologies by payor type
  • The insurance billing process from claims submission to payment
  • Claims compliance legislation and enforcing agencies

Details:
Type: Course
Format: Online
Language: English
Start: No open session listed – contact the department
Price: $475
Provider: UC San Diego – Division of Extended Studies
Instructor(s): Jessica Ciccone
Contact: unexhealthcare@ucsd.edu

Course details
Level Intermediate
Any device (online)
Basic info

This course provides an in-depth understanding of the structure and function of the US Healthcare Reimbursement system, including the various types of payors, payment methodologies and compliance strategies.

Intended audience

Medical coding and billing students and professionals