HPMT 60203 - Managed Care And Reimbursement Systems

Credit Hours: 3
Contact Hours: 3 Lecture
Provides a comprehensive overview of the strategic and operational aspects of managed health care and health insurance. Examines the historical roots of health insurance and managed care, how payer networks are structured, provider payment methodologies, utilization and quality management, fraud and abuse, special markets for payers, and a review of state and federal regulatory and legal underpinnings.

Prerequisites: admission into MHCA program