Note: Self-Study courses are available for 60 days from the first time you login to your course.
For practice administrators seeking to improve their financial management skills, the revenue cycle is a good place to start
This course is a module of the full Financial Management Boot Camp course.
MGMA Cost Survey data have consistently shown that the practices with the highest net revenues are usually the most profitable. Revenue cycle initiatives have the biggest impact on the bottom line. In this course we cover types of payers and reimbursement methodologies, the basics of the billing and collection process and the leading indicators and analyzing revenue cycle performance.
A medical practice’s revenue cycle also demands attention because it is complicated. In most industries, when a business sends a bill, it expects that the customer will pay 100 percent of the amount billed. This is not the case for much of the health care industry.
Medical practices normally bill numerous insurance companies and government payers, each of whom reimburses the practice according to their own negotiated or government-mandated fee schedules. The practice must submit bills (or claims) to the payers in a standardized format, in compliance with government regulations and payer policies. Payers may refuse to pay some of the claims for various reasons, such as incomplete or incorrect information, late filing, or that the services were 'not medically necessary.'
Insured patients are often liable for portions of their bills in the form of co-payments, coinsurance or deductibles. A growing number of uninsured patients and higher-deductible health plans have resulted in practices needing to collect more of their fees from patients.
While collecting from insurance companies can present challenges, patients often have financial problems or conflicting priorities that also make collecting fees difficult.
Practices need to ensure that their billing staff or billing company work on denials and past-due claims to get paid for its services.
Learning objectives
- Explain the various reimbursement methodologies payers use to reimburse the practice
- List the types of payers who reimburse practices for their services and the basic traits of those payers
- Understand the basics of billing, including charge capture and the role of coding in getting paid
- Implement strategies to overcome the major obstacles to collecting from payers and patients
- Analyze your practice’s revenue cycle performance using key indicators
Who should participate
- Those studying for the ACMPE certification exams
- Those new to practice management
- Those in practice management without a financial background who want to improve their financial skills
Career level
Credit hours
- 5 credit hours as assigned by ACMPE
Prerequisites
- Knowledge of accounting principles
System Requirements
- A personal computer with a Pentium processor with either speakers or headphones
- Internet connection with a minimum speed of 56K baud dial-up (DSL, cable or T1 connection is recommended for viewing necessary archived lectures), Internet Explorer or Mozilla Firefox as well as Adobe Flash Player and Adobe Acrobat Reader
- A computer with speakers or headphones is necessary for audio sections
- Note: The MGMA online platform uses “frames” and may not be compatible with software for those who are sight-impaired
What's different about online courses?
Taking a course on the computer can be both different from and similar to a traditional classroom experience. The learning process is the same, but an online course provides immediate resources.
Facilitators and students maintain their traditional roles. The facilitator places lessons and materials online for you to use – you set your own pace. The instructor is available to have a conversation with you, but won’t be online at the same time.
You interact with the course content on the screen, just as though you were in a classroom, and have discussions with classmates on an online discussion board.
You can ask questions or reply to others' questions or responses at any time. You will have exercises to complete on your own. And, as with classroom-based courses, you will have a multiple-choice assessment at the end of each week to gauge your comprehension and progress.
How are the courses formatted?
Generally, online courses follow this weekly format:
- Overview – Learning objectives are explained
- Readings and resources – Read from your textbook and other online materials
- Content – The main topic is presented
- Case studies – Examples illustrating the main topic are provided, based on either small or large group practices
- Practice activities – An assignment related to the main content is given
- Assessment – Complete a multiple-choice exam
- Summary – The week’s content is reviewed, which prepares you for the following week
- Discussion – Participate in a facilitator-led discussion board to get your questions answered and see how your peers apply the information
How does working online add to your education experience?
Online courses provide these convenient features:
- Search – Search for course content
- Notes – Take notes you can save for reference
- Calendar – Review scheduled tasks from the facilitator
- Chat – Talk directly to one or all class participants
- Discussion board – Ask questions and discuss course topics in an open forum with facilitator and classmates
- E-mail – Communicate with the facilitator or any course participant
- Location – View your progress relative to each week’s content
- Assessment – Complete 10-15 multiple-choice questions (not graded) at the end of each week (you can retake the assessment as often as you like)
- Bookmark – Save your place if you need to leave the course and pick up later
How the self-study course works
You will receive textbooks (if applicable) a few days before the start of the course, the course URL and a user name and a password to log in. On the first day, you will be able to log in and proceed through the material week by week or to complete only the weeks most important to you.
There is also a free Webcast recorded by the course facilitator. This recording provides you with important introductory information. If you have questions during this self-study course a facilitator will answer your e-mails once a week. You will have two months to complete the course.
MGMA Online Course - Transfer Policy
If there are unexpected demands on your time or you are not able to complete the course within the six weeks, MGMA strongly recommends you transfer into another course.
Your transfer request must be received within the first two weeks of the course. After that time, you will be charged a $100 administrative fee after two weeks have passed.
Transfer requests by telephone are not valid.
All transfer requests must be submitted in writing to the:
MGMA Learning & Networking Center
Attention: John Crawford
104 Inverness Terrace East
Englewood, CO 80112-5306
Letters may be faxed to 303.784.6099
Cancellation Policy
All registration cancellations must be received by MGMA no later than 48 hours prior to the start of each program and are subject to a $100 processing fee per course.
- No credit or partial or full refund will be made for failure to attend after this date
- Cancellations by telephone will not be accepted
- No credit is available for text materials sent (when applicable)
- All cancellations must be submitted in writing to:
MGMA Service Center
104 Inverness Terrace East
Englewood, CO 80112
Cancellation letters may also be faxed to 303.784.6110
If for any reason, MGMA must cancel one of its programs or turn you away due to limited attendance your registration fee will be refunded in full. However, you are responsible for your own airline and hotel reservations. MGMA cannot be held accountable for any cancellation charges caused by program cancellation or attendance limitations.
Please call the MGMA Service Center toll-free at 877.275.6462, ext. 1888, if you need to send someone in your place. If the new attendee has a different MGMA membership status, the registration fee will be adjusted accordingly.
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