Revenue Cycle Management (RCM)

  Revenue Cycle Management

COURSE SUMMARY & OBJECTIVES
Revenue Cycle Management aims to improve the patient accounting practices towards error free profitable billing, smart occupancy management, and economic utilization of hospital recourses.

  • Understand internal and external factors within the healthcare setting:
  • Theoretical understanding of Revenue Cycle Management components
  • Practical understanding of Revenue Cycle Management


WHO SHOULD ATTEND:

Healthcare professionals working in hospitals, health centers and insurance companies wanting to understand the Revenue Cycle Management process including without limitation:

  • Admission, reception and customer service
  • Administrative staff including approvals, claims processing, medical coding, rejection analysis and utilization review
  • Finance staff including billing, collection, costing, pricing and experts of actuarial & underwriting departments
  • Medical staff including case management, customer service, HIM, health informatics and physician assistants
  • Managers
  • Senior Executives


COURSE FEE:

USD1,300
(10% discount available for DHA members - please Contact Us for further information)

CONTACT US

For further information, please send your inquiry to ritchel.leonora@tri-c-academy.com.

COURSE OUTLINE:
Level 1: Revenue Cycle Management Conceptual & Process Knowledge
Training duration: 30 hours

1.  Healthcare System Components and Dynamics
2.  Health Insurance Companies
3.  RCM Setup for HCOs
4.  RCM 24 Processes in HCOs
5.  RCM Benchmarking & Quality Improvement
6.  7 Strategic Velocities for Patient-centric & Profitable RCM
7.  Holistic Approach for RCM Clinical Integration


Tri-C Academy RCM Course Certification

  Revenue Cycle Management

DATE AND TIME:

10 x live Webinar Sessions conducted over a 2 week period (*Dubai time/GST).
The next course is scheduled to run on 11 - 23 January 2021.

  Revenue Cycle Management

COURSE SUBJECTS:

Session 1: Healthcare System Components and Dynamics -Dr. Adel Olleik

1.    Healthcare System (HCS) sustainable development goals (SDGs)
2.    HCS Players:
       a)    Providers: Promotion, Prevention, Treatment (Healthcare Organizations- HCOs & Doctors), & Rehabilitation
       b)    Payers: Public, Social Insurance, Private insurance, Mutual fund, Managed Care Practices & HMOs
       c)    Regulators: HCS & universal coverage policies, standardization, coding, pricing, payment systems, & pay for performance (P4P) incentives
3.    HC Power Game
4.    Trends in Healthcare Economics: Cost control & payment systems 
5.    Exercise: describe & criticize a selected HCS
 

Session 2: Health Insurance Companies - Mr. Samer Hanna

1.    Insurance and re-insurance companies overview
2.    Risk pooling & solidarity
3.    Health insurance companies’ services model
       a)    Actuarial studies for risk assessment and underwriting
       b)    Issuance of insurance policies: Eligibility, Tables of benefits, Includes, and Limits
       c)    Provider network and contracts management
       d)    Approvals management
       e)    Claim processing and denials
       f)    Payment and reconciliation
4.    Exercise: describe health insurance companies services from a patient & hospital perspective in a selected country
 

Session 3: RCM Setup for HCOs - Dr. Adel Olleik

1.    Codification of hospital diagnosis & Procedures (ICD & CPT)
2.    Service costing and pricing
3.    Payment systems: fee-for-service, global rates, DRGs.
4.    Exercise 1: Describe codification, pricing, & payment systems in a selected country, & explain benefits of national unification of these practices by regulators
 

Session 4: RCM 24 Steps in HCO's (Part 1) - Dr. Adel Olleik

1.    RCM 24 step from service offering to accounts settlement
2.    Common gaps in every step
3.    RCM step indicators
 

Session 5: RCM 24 Steps in HCO's (Part 2) - Dr. Adel Olleik

1.    RCM 24 step from service offering to accounts settlement
2.    Common gaps in every step
3.    RCM step indicators
 

Session 6: RCM 24 Benchmarking & Quality Improvement - Mr. Samer Hanna

1.    Data Identification & Analysis for Performance Measuring
2.    RCM Staff & Doctors performance dashboards
3.    International benchmarking using HFMA 29 indicators
4.    Integrated quality improvement process for RCM
5.    Exercise1: Case Study, for Identify gaps in RCM in a simulated organization, analyze, design resolutions, and post on Performance Improvement Log (PIL)
6.    Exercise 2: claims scrubbing, and denials analysis of sampled real anonymous claims
 

Session 7: 5 Strategic Veolcities for Patient-centric & Profitable RCM (Part 1) - Dr. Adel Olleik

1.    Governance, organization & competencies for RCM 
2.    Case Management for patient-centric RCM 
3.    Electronic RCM: EMR & ERP Integration 
4.    Revenue budgeting 
5.    Exercise 1: Case Study, for revamping RCM to comply with 7 Strategic velocities
 

Session 8: 5 Strategic Veolcities for Patient-centric & Profitable RCM (Part 2)- Dr. Adel Olleik

6.    Capacity, Utilization & Productivity Management 
7.    Exercise 2: Capacity calculations and optimization, Effective bed occupancy management, & developing performance indicators for doctors & Case Mangers.
 

Session 9: Holistic Approach for RCM Clinical Integration - Dr. Adel Olleik

1.    Clinically- Driven RCM: Clinical pathways, Coding, Costing, Rules engines, Ordering, Approvals, Utilization, Supply chain, & Denials
2.    Doctors’ practice integration: contracts & performance dashboards for Win-Win relations
3.    Interprofessional teams (IPT)& Allied Health System (AHS) integration with RCM
4.    RCM Sustainability: Quantum Leadership & Innovation

Dr. Adel Olleik - MPH, DBA
Gates Group
Dr Adel Olleik

Dr. Olleik has a wide experience in management consultancy, auditing, training and university lecturing. He has lead organizational development interventions in more than 300 organizations across 9 countries, since 2000. In parallel, he mentored 350 master's students and 3000 trainees on organizational development, strategic planning, leadership, governance, financial analysis, and quality improvement.   Dr. Olleik's latest achievement was the innovation of an Organizational Development methodology called 5Ds loop.
Dr. Olleik is the Chairman of Gates Group for management solutions, and a board member at the National Social Security Fund of Lebanon as a government representative.
Dr. Olleik has received a BS degree in environmental health and a Master’s degree in Public Health from AUB. Moreover, he has earned his Doctorate degree in Business Administration from Jean Moulin Lyon 3 University.