House Bill 2504 Fall 2012 Course Syllabus MDCA-1343-71 - Medical Insurance
Fall 2012 Course Syllabus
MDCA-1343-71 - Medical Insurance
|Instructor||Guillot, Sheila Kaye Rhoden|
|MyLamarPA||Be sure to check your campus E-mail and Course Homepage using MyLamarPA campus web portal (My.LamarPA.edu). When you’ve logged in, click the email icon in the upper right-hand corner to check email, or click on the “My Courses” tab to get to your Course Homepage. Click the link to your course and review the information presented. It is important that you check your email and Course Homepage regularly. You can also access your grades, transcripts, and determine who your academic advisor is by using MyLamarPA.|
|Course Description||Emphasizes medical office coding for payment/reimbursement by patient or third-party.|
|Required Textbooks||A Guide to Health Insurance Billing, 3rd edition, by Moisio, ISBN # 978-1-4354-9298-1|
*Poor attendance is a leading reason for termination from a job in all areas of employment. With this factor in mind, the instructor monitors student attendance. In addition, attendance on a regular basis is necessary for proper skill development.
*Students are responsible for completing all assigned homework and being prepared each week for class.
|Course Grading Scale||90 - 100 = A 80 - 89 = B 70 - 79 = C 60 - 69 = D Below 59 = F|
|Determination of Final Grade||
Exams/Final = 60%
Assignments/Quizzes = 20%
Lab Assignments = 20%
|Final Exam Date||December 11, 2012 - 8:00 AM|
August 27-31 Chapter 1 review exercises (p. 15-17); Chapter 2 review exercises (p. 47-50)
September 3-7 Chapter 3 review exercises (p. 77-82)
September 10-14 Coding ICD-9-CM exercises
September 17-21 Coding ICD-9-CM exercises; Coding challenge p. 162-166
September 24-28 Chapter 5 exercises p. 186-188; Chapter 6 coding exercises
October 1-5 Chapter 6 exercises p. 247-251; Coding exercises
October 8-12 Case study 1-1 & 1-2
October 15-19 Case study 1-3 & 1-4; Review Ch. 8 exer. p. 305-306
October 22-26 Case study 1-5 & 1-6; Review Ch. 9 exercises p. 345-350
October 29-November 2 Case study 1-7 & 1-8; Ch. 10 exer p. 362-363;
Review Chapter 11 exercises 382-384
November 5-9 Case study 1-9 & 1-10; Review Ch.12 exer p. 437-440
November 12-16 Case study 2-1, 2-2, 2-3, & 2-4; Chapter 13 exercises p. 457-460; Chapter 14 exercises p. 491-494
November 19-21 Case study 2-5, 2-6, 2-7
November 26-30 Case study 2-8, 2-9, 2-10
December 3-5 Post-test
|Calendar of Lecture Topics and Major Assignment Due Dates||
Week 1: The Insurance Billing Specialist & Legal Aspects of Insurance Billing
Week 2: Introduction to Health Insurance
Week 3: Exam 1 (Chapters 1-3)
Week 4: International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM)
Week 5: International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) & Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
Week 6: Developing an Insurance Claim
Week 7: Exam 2 (Chapters 4-6)
Week 8: Common CMS-1500 Completion Guidelines & Common UB-04 (CMS-1450) Completion Guidelines
Week 9: Electronic Data Interchange (EDI)& Blue Cross/Blue Shield
Week 10: Exam 3 (Chapters 7-10)
Week 11: Medicare and Medicaid
Week 12: TRICARE and CHAMPVA
Week 13: Worker's Compensation and Exam 4 (Chapters 11-15)
Week 14: Last class day; post-test
|General Education/Core Curriculum Student Learning Outcomes||
|Program Student Learning Outcomes||
PSLO 1: Demonstrates comprehension of content-area reading material.
PSLO 2: Uses medical terminology, jargon, and abbreviations correctly in a healthcare setting.
PSLO 3: Demostrates appropriate professionalism in the healthcare setting.
PSLO 4: Uses medical office software applications.
PSLO 5: Identifies trends in medical insurance, medical laws, and coding systems.
|Course Student Learning Outcomes||
Identifies all main ideas, supporting details, and vocabulary in reading material; demonstrates a full understanding of the reading (PSLO 1)
Defines common terms used to file third party reimbursement forms (PSLO 2)
Bills patients or insurance carriers for visits/procedures (PSLO 4)
Processes medical billing (PSLO 4)
Generates reports (PSLO 4)
Manages activities in medical insurance (PSLO 5)
Demonstrates an understanding of HIPAA guidelines (PSLO 5)
Compares and contrasts insurance plans (PSLO 5)
Codes procedures and bill for services using both electronic and manual methods (PSLO 5)
|Academic Honesty||Academic honesty is expected from all students, and dishonesty in any form will not be tolerated. Please consult the LSC-PA policies (Section IX, subsection A, in the Faculty Handbook) for consequences of academic dishonesty.|
• I will not discuss your grades over the phone or by e-mail. If you want to discuss your grades, you must come to my office, in person.
• If you are in an online course that requires specific software, you also MUST have a copy of the software available either on your own computer or you must make arrangements to use the open lab provided on campus. Do not sign up to take an online course if you do not have the correct software.
• Reliable Internet access is required for all online courses and many traditional courses.
• Computer failure and lack of Internet access are not acceptable excuses for missed assignments, projects, quizzes, or exams. DO NOT wait until the "last minute" to complete class work or exams.
• Students are responsible for all readings that are assigned, including textbook readings and lecture notes.
• Assignments/Projects will be assigned weekly and will have a specific due date.
• Quizzes will be given periodically throughout the semester.
• Exams/Finals--all exams and the final are closed-book, closed-notes and are made up primarily of multiple-choice questions. Tests must be completed in the allotted time frame.
• For each assignment, students must complete the entire lesson (file) on their own. Students are never allowed to use anyone's USB or file but their own, or work together. Students should never lend their file to another student nor should a student have any other students work in their possession for any reason. If a student uses another student's files, both students are considered guilty of cheating. IF caught cheating, the students will get a "0" on the assignment. If a second incidence occurs, both students will be given a final grade of "F" for the course.
• While this is an online course, the student will be required to communicate with the instructor and complete course work on a weekly basis. Students are expected to read announcements posted on Blackboard and check their MyLamar e-mail account on a regular basis.
|ADA Considerations||The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Special Populations Coordinator, Room 231, in the Madison Monroe Building. The phone number is (409) 984-6241.|
Some material in this course may be copyrighted. They may be used only for instructional purposes this semester,
by students enrolled in this course. These materials are being used fairly and legally.
No one may distribute or share these copyrighted materials in any medium or format with anyone outside this class,
including publishing essays with copyrighted material, uploading copyrighted material to Facebook or YouTube, or
painting or performing copyrighted material for public display.
Copyright violation is not the same thing as plagiarism. Plagiarism is intellectual dishonesty. Offenses of plagiarism result in lower grades or failing scores, and professors and the college strictly enforce plagiarism rules. There is never any acceptable use of plagiarism. Copyright violation is a legal offense, punishable by large fines and penalties.
Copyrighted material can be used if permission from the material’s creator is obtained, or if its use meets the standards of fair use in an educational setting. For example, a student can quote a line from Shakespeare’s Hamlet in a report without violating copyright but still be guilty of plagiarism if the quotation is not properly documented.
If you are in doubt about what material can be freely used, ask your professor or contact the Dean of Library Services, at (409) 984-6216.
Assessment is a process by which LSCPA can help you learn better and gauge the level of progress you have made to
attain knowledge, skills, beliefs, and values. It also helps your professors understand how to improve teaching
and testing methods in your classes, and it helps each department understand and improve degree and certificate
Periodically LSC-PA will collect assessment data for research and reporting purposes, including statistical data and sometimes copies of your work. Be assured that all material the college uses for assessment purposes will be kept confidential. To ensure anonymity, your name will be removed from any material we use for assessment purposes, including video-recorded performances, speeches, and projects.
If you object to allowing LSC-PA to use your material for assessment purposes, submit a letter stating so to your professor by the 12th class day. You will still be required to participate in whatever assessments are being done; we just won’t use your data.
What’s the difference between assessment and grades? The grades you get on papers, projects, speeches, and assignments are specific types of focused assessment. LSC-PA’s assessment efforts include class grades, surveys, standardized tests, and other tools.
Federal privacy laws apply to college students. This means that college employees, including instructors, cannot
divulge information to third parties, including parents and legal guardians of students. Even if the students are
minors, information about their college work cannot be shared with anyone except in very limited circumstances.
Anyone requesting information about a student should be referred to the Registrar. Instructors will be notified in writing by that Office about what information may be released and to whom.
Please remember that releasing private information about a student, however innocuous it may seem, can be a violation of federal law, with very serious consequences.
Circumstances under which information may be released:
An adult student may submit, to the Registrar, a handwritten, signed note granting permission for release of
information. The note must specify what information may be divulged, and it must specify the name of the person
to whom the information may be given.
The Registrar’s office is located in the Student Center room 303B, and can be reached at (409) 984-6165.
This course helps add to the students’ overall collegiate experience in the following ways:
|Degree Plan Evaluation||
A Degree Plan Evaluation will help you determine which classes you need to complete your program.
All of the classes that you have taken that apply to your declared major will be listed on the right. If you have a class that still needs to be completed, a “NO” will be listed on the right next to the required class.
|HB 2504||This syllabus is part of LSC-PA’s efforts to comply with Texas House Bill 2504.|
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