Healthcare Domain

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# Topic What will be taught Time Required (Hours)
1 Overview of various IT systems required in health care - Various types of I.T operations in healthcare
- Electronic health record (EHR)
- Electronic Medical Record (EMR)
- Personal Health Record (PHR)
- Practice Management systems (PMS)
- Health Information Exchange (HIE)		 3
2 Health insurance overview - What is health insurance
- What are different components of health insurance
- What are different components of health insurance
- What is a provider, payer and national provider identifier		 3
3 Claims process overview - Claims process overview
- Claims management process
- Various elements of claims
- Claims settlement
- Compliance for claims		 3
4 Electronic Data Interchange (EDI) transactions - part 1 - What is electronic data exchange?
- 837 EDI claim
- 835 Remittance
- 270/271 Eligibility and benefits
- 278 authorization
- 820 premium payments
- Edits and validation
- Reports and acknowledgement		 3
5 Electronic Data Interchange (EDI) transactions - part 2 - ICD 9 vs ICD 10
- 4010 vs solo conversion
- DRG (Diagnoses related group), Current procedural terminology (CPT) & Healthcare common procedure coding system (HCPS)
- TR3 companion guide		 3
6 Facets overview - Facets functional models
- Facets data model
- Pricing workflow
- DRG processing
- Government healthcare reforms
- HIPAA compliance at work		 3
7 Coordination of benefits & third party liability What is coordination of benefits (COB)?
- What is third party liability (TPL)?
- What are rules of COB and TPL?		 3
8 Medicare and Medicaid - How does Medicare and Medicaid work?
- HIPAA privacy
Government reforms
- Electronic medical record (EMR) & Health information exchange (HIE)		 3

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Total Time: 24 Hours