MDCA-1343-01 - Medical Insurance
Lamar State College - Port Arthur
House Bill 2504
Fall 2014 Course Syllabus
Faculty Information | |||||||||||||
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Semester | Fall 2014 | ||||||||||||
Instructor | Champagne, Adriane M. | ||||||||||||
Phone | (409) 984-6416 | ||||||||||||
champagneam@lamarpa.edu | |||||||||||||
Department |
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Office |
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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 Information | |||||||||||||
Course Number | 90611 | ||||||||||||
Course Description | Emphasizes medical office coding procedures for payment and reimbursement by patient or third party payers for ambulatory care settings. | ||||||||||||
Course Prerequisites | None. | ||||||||||||
Required Textbooks | A Guide to Medical Insurance Billing, 4th edition, by Moisio, Delmar Publishing, ISBN: 978-1-285-19359-5 | ||||||||||||
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 daily. In addition, attendance on a regular basis is necessary for proper skill development. Once roll has been taken, a student is considered to be absent. Tardies are considered absences. Do not be late for class. *The instructor reserves the right to drop any student missing more than two weeks of class (4 MWF classes, 4 TR classes). *Quizzes will be given at the beginning of the class period. Students coming in to class late will not be allowed to take quizzes already turned in. A grade of zero will be recorded for the quiz. *Assignments are due at the beginning of each class; student assignment coming in late will be assessed a penalty, even if the student arrives to class late and turns in work. *Students are responsible for completing all assigned homework and for being prepared for each class meeting. This applies even if you were absent for the previous class meeting. |
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Course Grading Scale | 90 - 100 = A 80 - 89 = B 70 - 79 = C 60 - 69 = D Below 59 = F | ||||||||||||
Determination of Final Grade |
Exams/Final 40% Quizzes 10% Assignments 50% |
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Final Exam Date | December 5, 2014 - 2:00 PM | ||||||||||||
Major Assignments |
Week 1: Syllabus; Introduction to Course; Pretest; Chapter 1 The Insurance Billing Specialist; discussion; Week 2: Chapter 2 Legal Aspects of Insurance Billing; Chapter 3 Introduction to Health Insurance; discussion; quiz; exercises Week 3: Exam 1 (Chapters 1-3); Chapter 4 ICD-9-10; discussion; exercises; quiz Week 4: Chapter 5 ICD-9-CM; discussion; exercises; quiz Week 5: Chapter 6 Current Procedural Terminology and Healthcare Common Procedural Coding System; discussion; quiz; exercises Week 6: Chapter 7 Developing and Preparing an Insurance Claim; discussion; quiz; exercises Week 7: Exam 2 (Chapter 4-6); Chapter 8 CMS 1500 Completion Guidelines: Private and Commercial Insurance Claims; quiz; discussion; exercises Week 8: Chapter 9 Electronic Claim Submission; quiz; exercises; discussion Week 9: Chapter 10 Common UB-04 (CMS 1450) Completion Guidelines; quiz; discussion; exercises Week 10: Exam 3 (Chapters 7-9); Chapter 11 Blue Cross/Blue Shield; discussion; quiz; exercises; case studies Week 11: Chapter 12 Medicare; Chapter 13 Medicaid; discussion; quiz; exercises; case studies Week 12: Exam 4 (Chapters 10-12); Chapter 14 Tricare and CHAMPVA; discussion; quiz; exercises; case studies Week 13: Chapter 15 Worker's Compensation; quiz; discussion; exercises; case studies Week 14: Exam 5 (Chapters 13-15); Post-test; case studies Week 15: Final exam review; case studies Week 16: Final Exam (This schedule is subject to change.) |
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Calendar of Lecture Topics and Major Assignment Due Dates |
Week 1: Syllabus; Introduction to Course; Pretest; Chapter 1 The Insurance Billing Specialist; discussion; Week 2: Chapter 2 Legal Aspects of Insurance Billing; Chapter 3 Introduction to Health Insurance; discussion; quiz; exercises Week 3: Exam 1 (Chapters 1-3); Chapter 4 ICD-9-10; discussion; exercises; quiz Week 4: Chapter 5 ICD-9-CM; discussion; exercises; quiz Week 5: Chapter 6 Current Procedural Terminology and Healthcare Common Procedural Coding System; discussion; quiz; exercises Week 6: Chapter 7 Developing and Preparing an Insurance Claim; discussion; quiz; exercises Week 7: Exam 2 (Chapter 4-6); Chapter 8 CMS 1500 Completion Guidelines: Private and Commercial Insurance Claims; quiz; discussion; exercises Week 8: Chapter 9 Electronic Claim Submission; quiz; exercises; discussion Week 9: Chapter 10 Common UB-04 (CMS 1450) Completion Guidelines; quiz; discussion; exercises Week 10: Exam 3 (Chapters 7-9); Chapter 11 Blue Cross/Blue Shield; discussion; quiz; exercises; case studies Week 11: Chapter 12 Medicare; Chapter 13 Medicaid; discussion; quiz; exercises; case studies Week 12: Exam 4 (Chapters 10-12); Chapter 14 Tricare and CHAMPVA; discussion; quiz; exercises; case studies Week 13: Chapter 15 Worker's Compensation; quiz; discussion; exercises; case studies Week 14: Exam 5 (Chapters 13-15); Post-test; case studies Week 15: Final exam review; case studies Week 16: Final Exam (This schedule is subject to change.) |
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General Education/Core Curriculum Student Learning Outcomes |
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Program Student Learning Outcomes |
Alpha: Demonstrates comprehension of content-area reading material by using appropriate reading and vocabulary strategies. 1. Uses medical terminology, jargon, and abbreviations correctly in a healthcare setting. 2. Demonstrates appropriate professionalism in the healthcare setting. 3. Uses medical office software applications. 4. Identifies trends in medical insurance, medical laws, and coding systems. |
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Course Student Learning Outcomes |
1. Identifies all main ideas, supporting details, and vocabulary in reading material; demonstrates a full understanding of the reading. (PSLO 1) Measured by pre- and post-tests 2. Uses medical terminology in context. (PSLO 2)Measured by embedded test questions. 3. Uses medical references as resource tools. (PSLO 2)Measured by embedded test questions. 4. Translates abbreviations and interpret symbols. (PSLO 2)Measured by quiz. 5. Utilizes coding software to correctly code diagnoses and procedures provided. (PSLO 4) Measured by Encoder Pro software assignment. |
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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 |
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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. (*) Homework assignments will be given each week. Not all homework may be graded. (*)LATE WORK is highly discouraged and will incur a 30 point penalty for every day it is late. Due dates are given and enough time is given to complete all work. NO EXCEPTIONS. |
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Important Information | |||||||||||||
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. | ||||||||||||
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. |
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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. |
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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.
The Registrar’s office is located in the Student Center room 303B, and can be reached at (409) 984-6165. |
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College-Level Perspectives |
This course helps add to the students’ overall collegiate experience in the following ways:
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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. |
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HB 2504 | This syllabus is part of LSC-PA’s efforts to comply with Texas House Bill 2504. | ||||||||||||
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Copyright ©2011 Lamar State College - Port Arthur. All Rights Reserved.