BA HEALTH CARE


BA HEALTH CARE

BA Healthcare Domain Course Content:
• Business Analysis Basics
• Definition: Business Problem, Project Work and Operational;
• Introduction to project Team;
• Do’s & don’ts of BA?
• Requirement Gathering versus Elicitation
• Types of Requirements: with– EXAMPLES
• Business Analysis Deliverable: BRD & Business Process flows
• Requirements (using waterfall and Agile model)
• Data Flow Diagrams
• Current Process Flow, Future Process flows
• Business Analysis Deliverable Part 2: Use cases
• Use Cases
• User Scenarios
• User Stories
• Healthcare Introduction
• Overview
• Medicare vs Medicaid
• Payer vs Provider
• Business Analysis Tools & Healthcare Tools
• HPQC- ALM
• Visual Use Case or similar tools
• MS-VISIO
• FACETS Overview
• EMR & EHR System Overview
• Lab Book & LIMS
• Healthcare mandates and Acronyms
• Healthcare in USA
• Healthcare reform and other mandates
• Jobs in the healthcare industry MCD, MCR, MMIS, HIX
• Health Insurance Concepts: Premium, Deductible, Co-pay, Co-insurance, Exclusions, OOPMax, EHBs, Capitation versus FFS, In-network, OON, Prior-Auth, Pre-cert, EOB, EOP etc.
• Common terms in healthcare interview.
• Types of Insurance & Healthcare Insurance Exchange (HIX)
• HIX and HUB Overview
• State-run HIX vs Federal HIX
• Functions of the exchange – eligibility, enrollment, benefit- plan management, risk, re-insurance & risk
• EDI & Claims
• What are EDI transactions, different types, ANSI, ASCX12, EDIX12
• HIPAA EDI 837, 834, 835, 820, 270, 271, 277, 278
• EDI implementation guides vs Companion guides
• EDI transaction parts – loops, segments, delimiters
• Claims lifecycle from billing to payment
• Revenue Cycle Management
• ICD Overview
• CPT Coding
• Modifiers
• Unlisted Codes
• HCPC National Level II Codes
• CPT Coding with Manual
• ICD History
• Why ICD codes?
• ICD Codes – What does it tell us?
• Use of ICD codes
• Anatomy and Terminology for Coders
• Advanced Anatomy and Terminology for Coders
• Coding for the Non-Coder Preparation Analyzer
• Anatomy and Terminology Essentials from an ICD-10-CM Perspective
• Anatomy and Terminology Essentials from an ICD-10-PCS Perspective
• General Equivalence Mappings (GEMs)
• ICD 10 Implementation phases
• ICD-10 Release Timeliness
• ICD-10 Impact to Payer
• Provider Sector
• EMR/EHR
• EMR Implementation Projects
• LIMS/Lab book projects
• Revenue Cycle Management Projects
• JAD Session
• JAD Session –hand on experience
• Resume Preparation
• Resume Review
• Resume Preparation Tips
• Sample Resumes
• Interview Preparation:
• Mock Interviews
• Interview Preparation Tips
• Sample Interview Questions
• How to clear an Interview