Fall 2019 Course Syllabus
Course: HITT-2335- Section: 71 Coding and Reimbursement Methodologies |
Instructor Information | |||||||||||
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Instructor | Tonya Harbert | ||||||||||
keithtj@lamarpa.edu | |||||||||||
Phone | (409) 984-6501 | ||||||||||
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Department |
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Course Information | |||||||||||
Description | Advanced coding techniques with emphasis on case studies, health records, and federal regulations regarding prospective payment systems and methods of reimbursement | ||||||||||
Prerequisites | HITT 1313 Insurance Coding , POFM 2310 Intermediate Medical Coding. | ||||||||||
Learning Outcomes |
1. Identifies all main ideas, supporting details, and vocabulary in reading material; demonstrates a full understanding of the reading. (PSLO ALPHA) Measured by pre- and post-tests. 2. Translates healthcare information and interprets medical symbols. (PSLO 1) Measured by quiz. 3. Analyzes health records to assign principal/secondary diagnoses and procedures (PSLO 2) Measured by embedded test questions and assignment. 4. Assigns reimbursement methodologies (PSLO 2) Measured by assignment. 5. Analyzes health records for documentation requirements (PSLO 3) Measured by assignment. |
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Core Objectives |
* 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. * Personal Responsibility: Students will demonstrate the ability to connect choices, actions and consequences to ethical decision-making. |
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Program Student Learning Outcomes |
Alpha Demonstrates comprehension of content-area reading material by using appropriate reading and vocabulary strategies. 1 Analyzes medical terms, translates healthcare abbreviations, interprets medical symbols, and identifies cells, tissues, organs and systems of the human body. 2 Abstracts and applies correct coding systems and nomenclatures through the use of health records, case studies, and federal regulations regarding methods of reimbursement. 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. 4 Explains governmental health care guidelines, bioethics, and ethics relevant to medical practice. |
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Textbooks |
Comprehensive Health Insurance - 3rd Edition; Pearson; Vines Braceland Rollins Miller ISBN 978-0-13-476103-9 *** This ISBN includes a textbook and student workbook *** |
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Lecture Topics Outline |
Week 1: Chp. 1- Introduction to Professional Billing and Coding Careers Week 2: Chp. 2 - Understanding Managed Care: Insurance Plans; Chp. 3 Understanding Managed Care: Medical Contracts and Ethics Week 3: Chp. 4 - Intro to HIPAA Week 4: Chp. 5 - ICD-10-CM Medical Coding Week 5: Chp. 6 - CPT and POS Coding Week 6: Chp. 7 - Coding Procedures and Services; Chp.8 - HCPCS and Coding Compliance Week 7: Chp. 9 Auditing Week 8: Medical Claims: Chp. 10 Physician Medical Billing; Chp.11 Hospital Medical Billing Week 9: Chp. 12 Medicare Billing Week 10: Chp. 13 Medicaid Billing; Chp.14 Tricare Billing Week 11: Tricare Billing Continued Week 12: Chp 15 EOB & Payment Adjudication Week 13: Chapter 16 Refunds, Follow-ups, and Appeals Week 14: Chapter 17 Workers' Compensation; Post-test Week 15: Last exam; Final Exam Review *** Schedule is Subject to Change *** |
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Major Assignments Schedule |
Week 1: Course introduction; syllabus review; Pre-Test, Chp. 1- Introduction to Professional Billing and Coding Careers Week 2: Chp. 2 - Understanding Managed Care: Insurance Plans; Chp. 3 Understanding Managed Care: Medical Contracts and Ethics Week 3: Chp. 4 - Intro to HIPAA; EXAM 1 (Chp.1-4) Week 4: Chp. 5 - ICD-10-CM Medical Coding Week 5: Chp. 6 - CPT and POS Coding Week 6: Chp. 7 - Coding Procedures and Services; Chp.8 - HCPCS and Coding Compliance Week 7: Chp. 9 Auditing; EXAM 2 (Chp.5-9) Week 8: Medical Claims Chp. 10 Physician Medical Billing; Chp.11 Hospital Medical Billing Week 9: Exam 3 (Chp.10-11); Chp. 12 Medicare Billing Week 10: Chp. 13 Medicaid Billing; Chp.14 Tricare Billing Week 11: Tricare Billing Continued; Exam 4 (Chp.12-14) Week 12: Chp 15 EOB & Payment Adjudication Week 13: Chapter 16 Refunds, Follow-ups, and Appeals Week 14: Chapter 17 Workers' Compensation; Post-test Week 15: Exam 5 (Chapter 15-17) *** Schedule is Subject to Change *** *** Student should be prepared for at least one quiz per week. *** |
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Final Exam Date | December 5, 2019 - 11:00 AM Through December 5, 2019 - 1:00 PM | ||||||||||
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% |
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Course Policies | |||||||||||
Instructor Policies |
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. 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. |
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Attendance 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. Academic Policies * 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 by instructor, will be proctored on campus at a given time and date. Failure to complete will result in a grade of zero. A makeup 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. |
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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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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 the Office for Disability Services Coordinator, Room 231, in the Madison Monroe Building. The phone number is (409) 984-6241. | ||||||||||
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. | ||||||||||
Other | I will not discuss your grades over the phone or by email. If you want to discuss your grades, you must come to my office, in person. | ||||||||||
HB 2504 | This syllabus is part of LSC-PA's efforts to comply with Texas House Bill 2504. |