Health Information and Information Management
Click on the subdomain titles to examine the range of skills and concepts a student can expect to demonstrate for assessment of this Domain:
- Finance Management and Reimbursement Methodologies
- Healthcare Statistics and Research
- Professional Practice II: Management Level
- Quality Improvement and Performance Management
Finance Management and Reimbursement Methodologies
- The graduate describes and compares contemporary healthcare reimbursement methodologies and systems utilized in the United States.
- The graduate describes and compares sources of operating revenue and facility-wide structures of revenue cycles in healthcare organizations; and calculates rates of federal programs applicable to healthcare organizations.
- The graduate describes major components of the United States healthcare legal and regulatory environments; and evaluates policies and procedures in healthcare organizations to ensure compliance with federal laws and regulations.
- The graduate describes the general factors that influence healthcare pricing and the components of negotiating a managed care contract; and calculates returns on investment for healthcare organizations.
- The graduate describes the functions of financial and managerial accounting; and analyzes financial statements for healthcare organizations.
- The graduate explains the strategic financial process, the components of cost concepts, and decision making and capital formations; and evaluates financial plans for healthcare organizations.
- The graduate explains the management control process and analyzes variances for management use in healthcare organizations.
- The graduate identifies and evaluates code sets associated with various levels of healthcare settings; and articulates procedural and ethical guidelines, rules, and regulations for clinical coding within healthcare organizations.
- The graduate describes key components of private, commercial, and Blue Cross and Blue Shield insurance plans; and evaluates how various insurers use coding in the billing process.
- The graduate evaluates and explains various government-sponsored healthcare programs; and recognizes the impact that government-sponsored healthcare programs have on the healthcare system in the United States.
- The graduate evaluates and explains components and methods of non-Medicare/non-Medicaid government-sponsored healthcare programs; and recognizes the impact that government-sponsored healthcare programs have on the healthcare system in the United States.
- The graduate evaluates and explains the structures and components, and performs payment calculations for outpatient healthcare reimbursement in healthcare organizations.
- The graduate evaluates coding and billing functions and ascertains potential impacts to institutional revenue cycles for healthcare organizations.
- The graduate describes and compares models of pay-for-performance; explains how these models link quality to reimbursement; and evaluates the role of health information management for healthcare organizations.
- The graduate develops a broad knowledge of financial information and organization classification as well as financial decision-making processes in the operations of healthcare organizations.
Healthcare Statistics and Research
- The graduate applies a specific research methodology to solve an organizational problem or add to the body of knowledge in health information management.
- The graduate supports ethical biomedical research in a healthcare organization by applying federal guidelines and adhering to organizational standards that protect human subjects.
- The graduate applies outcomes and effectiveness research strategies in a healthcare organization to impact patient care, organizational processes, and clinical outcomes.
- The graduate applies the components of the research process for the purpose of developing an effective research project and to add to the professional body of knowledge in health informatics.
Professional Practice II: Management Level
- The graduate analyzes how the operational management of a healthcare organization adheres to government regulations, accreditation guidelines, and quality improvement initiatives.
- The graduate applies health informatics and information management skills at the managerial level at a healthcare organization.
- The graduate exemplifies high professional standards, upholds confidentiality requirements, promotes the guidelines of the American Health Information Management Association Code of Ethics, and demonstrates leadership skills as a health informatics professional at a healthcare organization.
Quality Improvement and Performance Management
- The graduate implements quality improvement initiatives in a healthcare environment in order to promote patient-centered care, build effective work teams, and influence organizational change.
- The graduate analyzes the implementation, monitoring, and evaluation of quality improvement projects to ensure they comply with both internal organizational processes and applicable standards established by external agencies.
- The graduate monitors a healthcare organization’s application of standards defined by federal agencies and accrediting bodies to ensure the organization maintains the integrity of achieved quality improvement initiatives.
- The graduate applies human resource development techniques in a health information management department in order to create an environment of productivity, teamwork, and observance of applicable standards and guidelines in the workplace.
- The graduate applies effective methods for staff retention, promotes professional development, counsels employees, and applies disciplinary action in an organization to maintain a productive work environment.
- The graduate enhances professional skills as preparation for assuming supervisory responsibility.