Healthcare Operations and Technology

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Healthcare Operations and Technology

An overview of healthcare domain, and IT systems like Electronic Health Record (EHR), Electronic Medical Record (EMR), Personal Health Record (PHR), Practice Management System (PMS), Health Information Exchange (HIE) and health insurance.

Course Description

You should consider this course if...
– You work in a technology role (like BA, PM, QA, or as a Developer) but have limited or no understanding of the industry domain and core business concepts.
– You know BA, PM, QA, or IT concepts but want to focus on the Healthcare Domain and require domain knowledge and related systems
– You want to specialize as a BA, PM, QA, or as a Developer in the Healthcare industry.

Are there any course prerequisites?
While there are no formal prerequisites, we recommend this program for students currently working as a BA, PM, QA or as a Developer to gain the most from the covered subject matter.

$150
Self paced learning ?

$400
Instructor lead online ?

The best 360 degree deep dive of the healthcare world

Project documentation, resume toolkit and interview prep e-book included with course

Techno-functional architecture of key healthcare systems explained

Real project documentation from healthcare projects

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Course Curriculum

1. Health care overview — 3 hour: – What is health insurance
– What are different components of health insurance
– What is a provider, payer and national provider identifier
2. Claims process overview — 3 hours: – Claims process overview
– Claims management process
– Various elements of claims
– Claims settlement
– Compliance for claims
3. Electronic Data Interchange (EDI) transactions - part 1 — 3 hours: – 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
4. Electronic Data Interchange (EDI) transactions - part 2 — 3 hours: – 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
5. Facets overview — 3 hours: – Facets functional models
– Facets data model
– Pricing workflow
– DRG processing
– Government healthcare reforms
– HIPAA compliance at work
6. Coordination of benefits & third party liability— 3 hours: – What is coordination of benefits (COB)?
– What is third party liability (TPL)?
– What are rules of COB and TPL?
7. Medicare and Medicaid — 2 hours: – How does Medicare and Medicaid work?
– HIPAA privacy
Government reforms
– Electronic medical record (EMR) & Health information exchange (HIE)
8. Overview of various IT systems required in health care — 2 hours: – 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)

Total Time: 22 hours

Course Reviews

Riddhi Rawal

I could not have asked for a better or more detailed course on the healthcare industry and I.T systems. As a BA I now feel like my scope for projects in the industry is much broader.

Riddhi Rawal

COMPLEMENTARY PRODUCTS

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YOU CAN CHOOSE ANY FROM BUSINESS ANALYSIS / QUALITY ASSURANCE / PROJECT MANAGEMENT

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