About this course
The second part of the module introduces the basics of Managed Care contracts risk, reimbursement, and quality. This module is divided into 5 sessions, each section ends with a quiz to test the learners understanding. Quizzes are not graded. The model ends with a comprehensive test. A minimum grade of 80% is required to pass the model.
Objectives
- Introduce the basics of Medicare contracts with commercial payers.
- Define ICD-10, CPT and HCPCS coding systems and how they are used in Managed Care.
- Discuss Risk Adjustment Factors: RAF, HCC, HEDIS, MIPS and NCOA.
- Explain the role of assessment surveys in Managed Care: HOS, CAHPS.
- Outline the role of quality measurements play in Managed Care by summarizing the Five Star Rating.
Who is this course for
The target audiences are nurses and case managers interested in or working in the field of remote care. The course is approved by the California Board of Nursing for 2 CE’s.
Instant Access
$30.00
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