House Bill 2504

Fall 2012 Course Syllabus

MDCA-1343-71 - Medical Insurance

Faculty Information
SemesterFall 2012
InstructorGuillot, Sheila Kaye Rhoden
Phone(409) 984-6381
Business and Technology
Chair:Nancy Cammack
Phone:(409) 984-6378
Hours:MW: 8:30-11:30 a.m.; F: 8:30-10:30 a.m.; TR: 8:15-9:15 a.m.
Building:Student Center (SC)
MyLamarPA Be sure to check your campus E-mail and Course Homepage using MyLamarPA campus web portal ( 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 you academic advisor is by using MyLamarPA.
Course Information
Course Number90306
Course Description Emphasizes medical office coding for payment/reimbursement by patient or third-party.
Course Prerequisites None.
Required Textbooks A Guide to Health Insurance Billing, 3rd edition, by Moisio, ISBN # 978-1-4354-9298-1
Attendance Policy *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
Major Assignments 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 13: Worker's Compensation and Exam 4 (Chapters 11-15)

Week 14: Last class day; post-test
General Education/Core Curriculum Student Learning Outcomes
Communication skills:Students will demonstrate effective written, oral and visual communication.

Critical Thinking Skills:Students will engage in creative and/or innovative thinking, and/or inquiry, analysis, evaluation, synthesis of information, organizing concepts and constructing solutions.

Empirical and Quantitative Skills:Students will demonstrate applications of scientific and mathematical concepts.

Teamwork:Students will demonstrate the ability to work effectively with others to support a shared purpose or goal and consider different points of view.

Social Responsibility:Students will demonstrate intercultural competency and civic knowledge by engaging effectively in local, regional, national and/or global communities.

Personal Responsibility:Students will demonstrate the ability to connect choices, actions and consequences to ethical decision-making.

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.
Facility Policies
  • No food or tobacco products are allowed in the classroom.

  • Only students enrolled in the course are allowed in the classroom, except by special instructor permission.

  • Electronic devices (including but not restricted to cell phones, MP3 players, and laptop computers) shall not be used during examinations unless specifically allowed by the instructor.

  • Use of electronic devices during normal class hours distracts other students, disrupts the class, and wastes valuable time. Instructors have an obligation to reduce such disruptions.

  • Turn your cellphones to vibrate when you enter the classroom.

    •        There will be a comprehensive final exam. All students must take the exam on the scheduled date and time; failure to do so will result in a "0" on the final exam.

    •        EVERY student MUST have a copy of the required textbooks by the second week of class.

    •        The student will still be responsible for any assignments given. Failure to have a text may result in being dropped from the course.

    •        A failure to follow written/oral directions will result in penalties.

    •        Academic dishonesty will result in a zero on any assignment; a second incidence of academic dishonesty on an assignment will result in the student being given an "F" for the course. Academic dishonesty on an exam is automatically an "F" in the course.

    •        Students should keep a record of their grades/average. Instructor(s) will not average grades for students. Instructors do not "drop" grades.

    •        Students must use appropriate e-mail etiquette when corresponding with the instructor; for example, use complete sentences and a full subject line that includes your name and the course name. Do not use emoticons or text message abbreviations in your e-mail.

    •        Voice mail messages should be clearly spoken identifying your name, course name, and any return phone number.

Additional Information •        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.

Important Information
ADA Considerations The Americans with Disabilities Act (ADA) is a federal anti-discrimination statue 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 210D, in the Madison Monroe Building. The phone number is (409) 984-6251.
Copyright Violations 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 Statement 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 programs.

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.
Privacy Notice 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.

A parent or guardian may be given access to information about a student by providing a copy of a filed tax return that shows that the student was listed as a dependent of that parent or guardian. The tax return must be for last complete tax year. Again, this documentation must be submitted to the Registrar’s Office.

A parent or guardian may be given access to information about a student if the student logs on to and sends an email to the Registrar granting permission. The email must specify what information may be given and the name of the person to whom it may be given.

Co-enrollment students are protected by the same privacy laws as adult students.

The Registrar’s office is located in the Student Center room 303B, and can be reached at (409) 984-6165.

College-Level Perspectives This course helps add to the students’ overall collegiate experience in the following ways:

  • Establishing broad and multiple perspectives on the individual in relationship to the larger society and world in which s/he lives, and to understand the responsibilities of living in a culturally and ethnically diversified world.

  • Stimulating a capacity to discuss and reflect upon individual, political, economic, and social aspects of life in order to understand ways in which to be a responsible member of society.

  • Developing a capacity to use knowledge of how technology and science affect their lives.

  • Developing personal values for ethical behavior.

  • Developing the ability to make aesthetic judgments.

  • Using logical reasoning in problem solving.

  • Integrating knowledge and understand the interrelationships of the scholarly disciplines.

Degree Plan Evaluation A Degree Plan Evaluation will help you determine which classes you need to complete your program.

  1. Sign in to your account.

  2. Click on the “My Services” tab.

  3. Click on the “Student” tab.

  4. Click on Student Records.

  5. Click on Degree Evaluation.

  6. Select the term you are planning on registering for (i.e. Summer I, Summer II, Fall, or Spring)

  7. Verify that the Curriculum Information (your MAJOR) is correct

  8. Click on “Generate New Evaluation” at the bottom of the screen.

  9. Click the radio button next to Program

  10. Click on the Generate Request button.

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.

Lamar State College - Port Arthur


Lamar State College - Port Arthur, a member of The Texas State University System, is an open-access, comprehensive public two-year college offering quality and affordable instruction leading to associate degrees and a variety of certificates. The College embraces the premise that education is an ongoing process that enhances career potential, broadens intellectual horizons, and enriches life.

Core Values

  • Shared commitment by faculty, staff and administration to a mission characterized by student learning, diversity, and community involvement

  • General education/core curriculum that develops the values and concepts that allow the student to make a meaningful contribution in the workplace or community

  • Academic and technical programs designed to fulfill our commitment to accommodate students with diverse goals and backgrounds, using a variety of delivery methods, on and off campus

  • Technical education programs that provide for the acquisition of the knowledge, skills and behavior necessary for initial and continued employment

  • Student achievement characterized by attainment of individual goals and measured by successful accomplishments and completion of curriculum

  • Co-curricular opportunities that develop social, financial and civic acuity


Lamar State College - Port Arthur operates in the belief that all individuals should be:

  • treated with dignity and respect;

  • afforded equal opportunity to acquire a complete educational experience;

  • given an opportunity to discover and develop their special aptitudes and insights; and,

  • provided an opportunity to equip themselves for a fulfilling life and responsible citizenship in a world characterized by change.

Copyright ©2011 Lamar State College - Port Arthur. All Rights Reserved.