Reimbursement and Coding
The reimbursement environment for pharmaceuticals and healthcare services is extremely complex. This course helps team members understand the various processes and systems used in the industry.
After completing this course, participants will be able to
- Describe the basic structure of both Medicare and commercial healthcare coverage
- Provide an overview of coding and billing systems and their respective roles in reimbursement
- Healthcare Common Procedure Coding System (HCPCS)
- Level I—Current Procedural Terminology (CPT)
- Level II—HCPCS National Codes
- International Classification of Diseases (ICD-9)
- National Drug Codes (NDCs)
- Diagnosis-Related Groups (DRG s)
- Ambulatory Procedure Classifications (APCs)
- Explain prospective payment systems
- Describe key distinctions in reimbursement systemsbased on the site of care
- Identify major trends in reimbursement and coverage of specialty drugs, such as the transition to ASP-based reimbursement and the rise of e-prescribing
Download the course learning objectives
Our e-courses are only available for group and corporate-wide licenses. Pricing is based on the estimated number of users. Please contact us to learn more about incorporating Managed Markets Excellence® into your corporate training program. We can also develop custom training solutions to meet your specific training needs.
