Healthcare Reimbursement: An Overview

$15.00

Format: E-course

Duration: Approx 60 min

Instructors: CORAL MED

Learning Credits: 0.25 CEU

*This course was updated on Aug 18, 2025.

Description

This Course explains the phases of the healthcare revenue cycle, stakeholder roles, metrics, compliance integration, and ethics in financial practices.Unit 1.1 provides an overview of healthcare reimbursement models, including fee-for-service, bundled payments, value-based reimbursement, and managed care approaches. Students will learn the fundamental terminology, processes, and compliance requirements that shape healthcare financial performance. The unit emphasizes the role of accurate documentation, payer contracts, and ethical billing practices.

 

By the end of this course the learner will be able to define revenue cycle phases, identify stakeholders, explain KPIs, and apply ethical billing practices.  By the end of this unit, learners will be able to:
1.1.1 Define key concepts of healthcare reimbursement.
1.1.2 Describe traditional and emerging payment models (FFS, DRG/APC, VBR).
1.1.3 Interpret payer contracts and explain their influence on provider revenue.
1.1.4 Analyze the impact of reimbursement models on healthcare operations.
1.1.5 Apply reimbursement formulas to sample case studies.
1.1.6 Evaluate alignment of payment models with compliance requirements.

Upon successful completion, learners will be able to:

  • Explain how reimbursement systems finance healthcare delivery.

  • Differentiate between payment methodologies and identify when each applies.

  • Evaluate how payer mix and contracts affect revenue cycle outcomes.

  • Apply reimbursement calculations to real-world healthcare scenarios.

  • Demonstrate awareness of compliance and ethical considerations in reimbursement

Learners will be able to analyze RCM processes, apply compliance in billing, and evaluate performance using KPIs and metrics.

  • Basic knowledge of healthcare systems and terminology.

  • Recommended completion of Foundations of Healthcare Administration (or equivalent experience).

Follow Coral Plus LMS policies: participation, integrity, respectful conduct, HIPAA/privacy adherence, timely completion of assessments. 1. Participants should register in advance to receive access details. 2. Access links and passwords, if applicable, should be provided securely to registered participants. 3. Participants are encouraged to join the webinar a few minutes early to resolve any technical issues 4. Participants are responsible for ensuring a stable internet connection, compatible devices (computer, tablet, or smartphone), and recommended browsers. 5. A microphone and webcam may be required for interactive sessions. Please test your audio and video settings in advance. 6. The webinar may be recorded for educational purposes. 7. Recorded sessions may be shared with registered participants after the webinar. 8. Please be mindful not to share personal or confidential information during the webinar. 9. A detailed agenda will be provided, and each session will adhere to the schedule to cover all planned topics. 10. Time will be allocated for Q&A sessions and discussions. 11. A helpdesk or contact information for technical support will be provided during the webinar. 12. Common technical issues will be addressed at the beginning of the session. 13. Relevant resources, such as presentation slides or additional reading materials, will be shared after the webinar.

 

  • Healthcare administrators seeking to strengthen their financial literacy.

  • Billing and coding specialists preparing for advanced reimbursement roles.

  • Compliance officers and auditors overseeing revenue cycle practices.

  • Clinicians transitioning into administrative or leadership positions.

  • Students pursuing careers in health information management, finance, or healthcare policy.

 

Revenue cycle specialists, billing/coding teams, practice administrators