Lamar State College - Port Arthur

House Bill 2504

Fall 2017 Course Syllabus

MDCA-1343-01 - Medical Insurance

 
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Faculty Information
SemesterFall 2017
InstructorHarbert, Tonya J
Phone(409) 984-6424
E-mailkeithtj@lamarpa.edu
Department
Business and Technology
Chair:Sheila Guillot
Phone:(409) 984-6381
E-mail:guillsr@lamarpa.edu
Office
Hours:M, W 12-3; T, R 2-3; F 9-11
Building:Madison Monroe Education (MMED)
Room:N/A
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 Number91717
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 Insurance Handbook for the Medical Office, 14th Edition by Marilyn Fordney, Publisher: Elsevier     ISBN: 9780323316255
Workbook for Insurance Handbook for the Medical Office, 14th Edition    by Marilyn Fordney, Publisher: Elsevier 9780323316279
Attendance Policy ATTENDENCE POLICY:
Poor attendance is a leading reason for termination from a job in all areas of employment. With this in mind, the instructor monitors student course activities. In addition, attendance on a regular basis is necessary for proper skill development. A tardy is an absence for attendance purposes.
4 absences = one letter grade drop
6 absences = two letter grade drop
8 absences = automatic failure of class
*Assignment due dates are posted weekly in your course in the calendar, in the announcements, and by e-mail. Check the course and your mylamarpa.edu email SEVERAL times per week.
* I STRONGLY recommend regular participation in this course. PARTICIPATION WILL HELP YOU SUCCEED IN THIS COURSE!!
* Late assignments will be assessed a 30-point penalty. Late work will have a maximum five day submission. After five days late, the work is given a grade of zero.
*Students are responsible for completing all assigned work, including reading assignments, by the required due dates and for being prepared for class.

* See Class Policies on the Begin Here section of course in Blackboard.

ACADEMIC POLICY
* Quizzes may 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.
* Exams cannot be completed using a mobile device.
* If an exam is missed, the lowest exam grade will be counted for the missed exam not to exceed 100%. If you miss more than one exam, those exams will be given a grade of zero.
* Make-up exams, if approved, will be proctored on campus at a given time and date. Failure to complete will result in a grade of zero. If approved to make-up an exam, the exam will be subject to a 30 point penalty.
* There will be a comprehensive final exam. ALL STUDENTS MUST TAKE THE FINAL EXAM ON THE SCHEDULED DATE AND TIME, and failure to do so will result in a ZERO on the final exam. THERE ARE NO MAKE-UPS FOR MISSED FINAL EXAMS – IT WILL BE GIVEN A GRADE OF ZERO.
* 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 textbook may result in a drop in grade.
* Students are responsible for completing all assigned reading and assignments given.
* A failure to follow oral and/or written instructions will result in penalties.
Students should keep a record of their grades/average. Instructor will not average grades for students.
* INSTRUCTOR WILL NOT DROP GRADES
* Extra credit may be assigned at the discretion of the instructor.
* Do NOT wait until the last weeks of class to discuss your grades with your instructor. If you are having issues with the class, materials or are having any other issues, please contact the instructor as soon as possible.
Course Grading Scale  90 - 100=A    80 - 89=B    70 - 79=C     60 - 69=D    Below 59 = F
Determination of Final Grade Exams/Final Exam = 60%
Assignments/Quizzes = 40%
Final Exam Date December 14, 2017 - 12:00 AM   Through  December 14, 2017 - 1:00 PM
Major Assignments Week 1: Online Orientation, Introduction to Class, Pre-Test, Chapter 1 Role of an Insurance Billing Specialist
Week 2: Chapter 2 Compliance, Privacy, Fraud, and Abuse in Insurance Billing, Chapter 3 Basics of Health Insurance
Week 3: Chapter 4 Medical Documentation and the Electronic Health Record, Exam Review
Week 4: EXAM; Chapter 5 Diagnostic Coding
Week 5: Chapter 6 Procedural Coding; Chapter 7 The Paper Claim CMS-1500
Week 6: Chapter 8 The Electronic Claim, Chapter 9 Receiving Payments and Insurance Problem Solving, Exam Review
Week 7: EXAM; Chapter 10 Office and Insurance Collection Strategies
Week 8: Chapter 11 The Blue Plans, Private Insurance, and Managed Care Plans; Chapter 12 Medicare
Week 9: Chapter 13 Medicaid and Other State Programs; Exam Review
Week 10: Chapter 14 TRICARE and Veterans' Health Care; Chapter 15 Workers' Compensation; Chapter 16 Disability Income Insurance and Disability Benefit Programs
Week 11: Exam Review, Thanksgiving Break 11/23-11/24
Week 12: EXAM; Post-Test; Chapter 17 Hospital Billing
Week 13: Final Exam Review
Week 14: FINAL EXAM
Calendar of Lecture Topics and Major Assignment Due Dates Week 1: Online Orientation, Introduction to Class, Pre-Test, Chapter 1 Role of an Insurance Billing Specialist
Week 2: Chapter 2 Compliance, Privacy, Fraud, and Abuse in Insurance Billing, Chapter 3 Basics of Health Insurance
Week 3: Chapter 4 Medical Documentation and the Electronic Health Record, Exam Review
Week 4: EXAM; Chapter 5 Diagnostic Coding
Week 5: Chapter 6 Procedural Coding; Chapter 7 The Paper Claim CMS-1500
Week 6: Chapter 8 The Electronic Claim, Chapter 9 Receiving Payments and Insurance Problem Solving, Exam Review
Week 7: EXAM; Chapter 10 Office and Insurance Collection Strategies
Week 8: Chapter 11 The Blue Plans, Private Insurance, and Managed Care Plans; Chapter 12 Medicare
Week 9: Chapter 13 Medicaid and Other State Programs; Exam Review
Week 10: Chapter 14 TRICARE and Veterans' Health Care; Chapter 15 Workers' Compensation; Chapter 16 Disability Income Insurance and Disability Benefit Programs
Week 11: Exam Review, Thanksgiving Break 11/23-11/24
Week 12: EXAM; Post-Test; Chapter 17 Hospital Billing
Week 13: Final Exam Review
Week 14: FINAL EXAM
*** Schedule Subject to Changes ***
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 Alpha: Demonstrates comprehension of content-area reading material by using appropriate reading and vocabulary strategies.
PSLO 1: Analyzes medical terms, translates healthcare abbreviations, interprets medical symbols, and identifies cells, tissues, organs and systems of the human body.
PSLO 2: Abstracts and applies correct coding systems and nomenclatures through the use of health records, case studies, and federal regulations regarding methods of reimbursement.
PSLO 3: Utilizes medical software applications and the Internet, creates manual and electronic claim forms, creates and maintains database; and analyzes content of health records for documentation requirements.
PSLO 4: Explains governmental health care guidelines, bioethics, and ethics relevant to medical practice.
Course Student Learning Outcomes CSLO ALPHA: Identifies all main ideas, supporting details, and vocabulary in reading material; demonstrates a full understanding of the reading. (PSLO ALPHA: Measured by pre/post-test)
CSLO 1: Defines terms relevant to reimbursement forms (PSLO 1: Measured by quiz)
CSLO 2: Applies correct coding systems through case studies (PSLO 2: Measured by assignment)
CSLO 3: Codes procedures and bills for services using both electronic & manual methods PSLO 3: Measured by assignment)
CSLO 4: Compares and contrasts insurance plans (PSLO 4: Measured by exam)
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.
Additional Information     For all coding classes: When coding books are necessary for assignments, the books will need to be checked out with your instructor. Books must be returned at the end of the semester. If books are not returned, a hold will be put on student records with a monetary fee.

For ONLINE CLASSES: ONLINE CLASS POLICIES in addition to the above policies:

METHODS OF PRESENTATION:
Several methods of presentation will be used in class and may include any of the following:
Lecture (through PowerPoint slides, interactive notes, video, or audio sources)
Computer Assisted Learning (publisher websites)
Lab Exercises
Internet

ASSESSMENT METHODS & GRADING POLICY
Specific instructions and grading information will be posted on the course site for each assignment.
Each module in the course will focus on specific learning outcomes.
Some activities in the course are simply to enhance learning, and will not be graded.
Student learning will be assessed with assignments/quizzes throughout the course.
Due dates are posted each week for course work. If work is submitted late it will be assessed a penalty of 30 points off.
Late work will have a maximum five day submission. After five days late, the work is given a grade of zero.

SOFTWARE REQUIREMENTS:
If you are in a course that is using a specific software, you MUST have the software available to you either on your home computer or you must use the open lab provided in the Gates Library.
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, EXAMS, ETC.

*** DO NOT WAIT UNTIL THE LAST MINUTE TO COMPLETE CLASSWORK AND EXAMS. ***
We can't control weather conditions, power outages, etc. Students should complete classwork as soon as possible so due dates aren't missed.

* * Do NOT wait until the last weeks of class to discuss your grades with your instructor. If you are having issues with the class, materials or are having any other issues, please contact the instructor as soon as possible.
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.
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 My.LamarPA.edu 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 my.lamarpa.edu 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

Mission

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

Principles

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.

 
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