Administrative Healthcare Data and SAS(R)

  • Tuition USD $1,650
  • Reviews star_rate star_rate star_rate star_rate star_half 1115 Ratings
  • Course Code BHCDA94
  • Duration 2 days
  • Available Formats Classroom

This industry-specific course focuses on the payer side of the industry: the origin, content, management, and use of administrative healthcare data. During the course, students become acquainted with the providers, payers, and users of the U.S. healthcare system. This course is a hands-on programming course, but rather, it explores the business of medical claims data, health plan members, and service providers. As a supplement to this course, programmers should consider also registering for Administrative Healthcare Data and SAS®: Hands-On Programming Workshop, a one-day course that focuses on programming methods and techniques that are useful in the healthcare industry. The two courses are offered on contiguous days.

Skills Gained

  • Recognize the different origins, content, and uses of administrative healthcare data.
  • Understand the intricacies of national claims coding structures.
  • Be aware of evolving issues that face industry payers.

Who Can Benefit

  • Analysts and programmers who need to understand and work with administrative healthcare data

Prerequisites

  • Experience with SAS software, programming, or the healthcare industry is required.

Course Details

U.S. Healthcare System

  • A "30-thousand-foot" view of the industry.
  • Payment systems, payers, and providers.

Healthcare Data Origins

  • Professional and ancillary claims (CMS-1500 claim form).
  • Facility claims (CMS-1450 claim form).
  • Prescription drug data.
  • 837 electronic claims.

Medical Claim Codes

  • Diagnosis codes.
  • Procedure codes.
  • Billing codes.
  • Drug codes.
  • Laboratory codes.
  • Others.

Post-adjudication Data

  • Administrative healthcare data.
  • Data structures, types, and organizations.
  • Data validation and accuracy issues.

The Business of Healthcare Data

  • Business rule development.
  • Available industry rules/guidelines.

Member Files

  • Complexity and use of membership information.
  • Rate setting.
  • Uses of enrollment and eligibility data.

Provider Data

  • Basic structure of provider files.
  • National Provider Registry.
  • Uses of provider data.

Evolving Industry Concepts

  • Brief overview of HIPAA.
  • National identifiers.
  • Public data sources.
  • Industry futures.

HEDIS

  • Understanding the what and why of performance measurement.
  • Overview of several measures.
  • Recommended data structures.

Fraud and Abuse

  • Understanding a major healthcare industry issue.
  • Measuring and detecting fraud.

Looking Ahead - What to Consider Next

When does class start/end?

Classes begin promptly at 9:00 am, and typically end at 5:00 pm.

Does the course schedule include a Lunchbreak?

Lunch is normally an hour long and begins at noon. Coffee, tea, hot chocolate and juice are available all day in the kitchen. Fruit, muffins and bagels are served each morning. There are numerous restaurants near each of our centers, and some popular ones are indicated on the Area Map in the Student Welcome Handbooks - these can be picked up in the lobby or requested from one of our ExitCertified staff.

How can someone reach me during class?

If someone should need to contact you while you are in class, please have them call the center telephone number and leave a message with the receptionist.

What languages are used to deliver training?

Most courses are conducted in English, unless otherwise specified. Some courses will have the word "FRENCH" marked in red beside the scheduled date(s) indicating the language of instruction.

What does GTR stand for?

GTR stands for Guaranteed to Run; if you see a course with this status, it means this event is confirmed to run. View our GTR page to see our full list of Guaranteed to Run courses.

Does ExitCertified deliver group training?

Yes, we provide training for groups, individuals and private on sites. View our group training page for more information.

Does ExitCertified deliver group training?

Yes, we provide training for groups, individuals, and private on sites. View our group training page for more information.

Lab infraestructure is very suitable and works pretty good help to understand better the concepts exposed during the training.

Very organized and provides a ton of information both in class and for self study. I highly recommend ExitCertified for AWS training.

One of the best organized and thoughtful learning sessions I've attended, thank you!

Great training that provided pro-tips a plenty that were immediately put to use.

The course was very thorough and the instructor ensured that all the students were on the same page.

0 options available

There are currently no scheduled dates for this course. If you are interested in this course, request a course date with the links above. We can also contact you when the course is scheduled in your area.

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