Fall 2020 Course Syllabus
Course: HITT-2335- Section: 72
Coding and Reimbursement Methodologies
|COVID 19 Information||The Lamar State College Port Arthur (LSCPA) Student Code of Conduct COVID 19 Policy requires students who have been exposed to COVID 19 or diagnosed with COVID 19 to report their condition on the COVID 19 Notification Form (available via a link on the Student Code of Conduct COVID19 webpage). This information will be provided to the Dean of Student Services. In addition, this policy requires all students to wear face coverings in compliance with the criteria included in the policy. For more information please refer to the COVID 19 link on the LSCPA website.|
|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.|
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.
* 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.
|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.
Textbook Purchasing Statement: A student attending Lamar State College Port Arthur is not under any obligation to purchase a textbook from the college-affiliated bookstore. The same textbook may also be available from an independent retailer, including an online retailer.
Comprehensive Health Insurance (Textbook & Workbook Bundle) - 3rd Edition; Pearson; Vines Braceland Rollins Miller ISBN 978-0-13-476103-9
*** This ISBN includes a textbook and student workbook ***
SECTION I: A CAREER IN HEALTH CARE
1. Introduction to Professional Billing and Coding Careers
SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND CARRIER
2. Understanding Managed Care: Insurance Plans
3. Understanding Managed Care: Medical Contracts and Ethics
4. Introduction to the Health Insurance Portability and Accountability Act (HIPAA)
SECTION III: MEDICAL CODING
5. ICD-10-CM Medical Coding
6. Introduction to CPT and Place of Service Coding
7. Coding Procedures and Services
8. HCPCS and Coding Compliance
SECTION IV: MEDICAL CLAIMS
10. Physician Medical Billing
11. Hospital Medical Billing
SECTION V: GOVERNMENT MEDICAL BILLING
12. Medicare Medical Billing
13. Medicaid Medical Billing
14. TRICARE Medical Billing
SECTION VI: ACCOUNTS RECEIVABLE
15. Explanation of Benefits and Payment Adjudication
16. Refunds, Follow-Up, and Appeals
SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM
17. Workers' Compensation
Week 1 Aug 24 - 28 Introduction video; Orientation video; Review Syllabus; Video & Syllabus Quiz; Pre-test; Chapter 1
Week 2 Aug 31 - Sept 4 Chapter 2; Discussion Board(s)/Virtual Meeting
Week 3 Sept 7 - 11 Sept 7: Labor Day HolidayŚno classes, offices closed; Chapter 3-4; Discusson Board(s)/Virtual Meeting
Week 4 Sept 14 - 18 Chapter 5; Discussion Board(s)/Virtual Meeting; EXAM 1 (Chp 1-4)
Week 5 Sept 21 - 25 Chapter 6 -7; Discussion Board(s)/Virtual Meeting
Week 6 Sept 28 - Oct 2 Chapter 8-9; Discussion Board(s)
Week 7 Oct 5 - 9 Chapter 10; Discussion Board(s)/Virtual Meeting; EXAM 2 (Chp 5-9)
Week 8 Oct 12 - 16 Chapter 11; Discussion Board(s)/Virtual Meeting
Week 9 Oct 19 - 23 Chapter 12; Discussion Board(s): EXAM 3 (Chp 10-11)
Week 10 Oct 26 - 30 Chapter 13; Discussion Board(s)/Virtual Meeting
Week 11 Nov 2 - 6 Chapter 14; Discussion Board(s)
Week 12 Nov 9 - 11 Chapter 15; Discussion Board(s)/Virtual Meeting; EXAM 4 (Chp 12-14)
Week 13 Nov 16 - 20 Chapter 16; Discussion Board(s)/Virtual Meeting
Week 14 Nov 23 - 27 Nov 27: Thanksgiving; Chapter 17; Discussion Board(s); EXAM 5 (Chp 15-16)
Week 15 Nov 30 - Dec 2 Discussion Board(s)/Virtual Meeting; Dec 2: Last Class Day
Dec 3 - 4 COMPREHENSIVE FINAL EXAM (Chp. 1-17)
|Final Exam Date||December 3, 2020 - 8:00 AM Through December 4, 2020 - 11:59 PM|
|Grading Scale||90 - 100=A 80 - 89=B 70 - 79=C 60 - 69=D Below 59 = F|
EXAMS = 45
Assignments/ Quizzes = 45%
FINAL EXAM 10%
ASSESSMENT METHODS & GRADING POLICY
* Students should keep a record of their grades/average. Instructor(s) will not average grades for students. The instructor will not drop grades.
* Each module focuses on specific learning outcomes. However, some activities in the course may be used to enhance learning and may not be graded. Student learning will be assessed with assignments, quizzes, discussions, exams, etc. throughout the course.
* Due dates are posted each week for course work.
* Instructions and grading information will be posted on the course site for each assignment.
* Instructor will not drop grades.
* Late assignments are accepted for 2 days after the due date with -30 point deduction.
* After the second day, assignments are closed and will be unavailable to view and complete. The assignment will receive a grade of zero (0).
* Quizzes may be given throughout the semester. If a student misses a quiz, the grade is recorded as a zero (0). After quizzes are closed and unavailable to view, you cannot make-up a quiz.
* NO MAKE-UP EXAMS. If a student should miss an exam, at the end of the semester, the instructor will average all exam grades [including the zero(s)] to replace the zero for the missed exam. (The final exam will not be calculated in this average.)
EXAMPLE: 4 test grades: 100, 100, 0, 80 = 280; 280/4= 70; 70 will go in the place of the zero.; Test grades are now 100, 100, 70,80
* THE FINAL EXAM ACCOUNTS FOR 10% OF THE COURSE AVERAGE. The FINAL EXAM will be comprehensive. 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.
* Academic dishonesty will result in a zero on any academic work or exam in question; a second incidence of academic dishonesty on any academic work or exam in question will result in the student being given an "F" for the course.
* 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.
* Assignments and due dates are posted weekly in your course. Check your calendar; check the announcements; check your email; and check the To-Do List.
* Students are responsible for being prepared for class. The student is responsible for completing all assigned homework, including reading assignments, and doing so by required due dates.
* STUDENTS ARE RESPONSIBLE FOR COMPLETING ALL ASSIGNED READING. Read over chapters PRIOR to class even if reading was not assigned.
* STUDENTS ARE EXPECTED TO FOLLOW WRITTEN and/or ORAL INSTRUCTIONS. It is important to follow all directions. A failure to follow written and/or oral instructions will result in penalties.
*** DO NOT WAIT UNTIL THE LAST MINUTE TO COMPLETE CLASSWORK AND EXAMS. ***
* COMPUTER FAILURE AND LACK OF INTERNET ACCESS ARE NOT ACCEPTABLE EXCUSES FOR MISSED ASSIGNMENTS, PROJECTS, QUIZZES, EXAMS, ETC.
* We cannot control weather conditions, power outages, etc. Students should complete classwork as soon as possible so due dates are not missed.
* PLEASE.... Do NOT wait until the last weeks of class to discuss your grades with your instructor.
* If you are having issues with the class, the material covered, or have any other issues, please contact the instructor as soon as possible.
* If you would like to discuss your grades, contact the instructor to meet in person. (Instructor will speak to the student only.)
* Research has shown a cause and effect relationship between attendance and college success. Students with more than three absences from the course will receive an academic penalty.
* 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 course activity weekly.
* Class participation is required. It is important to be active within the course.
* Students are expected to log in to Blackboard a minimum of three times per week.
* Students are expected to check e-mail a minimum of three times per week.
|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.|
|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.|
|MyLSCPA||Be sure to check your campus E-mail and Course Homepage using MyLSCPA 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 MyLSCPA.|
METHODS OF PRESENTATION:
Several methods of presentation may 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)
The student is required to have all required software, e-books, key codes, etc. needed for class to complete required readings, work, etc.
Reliable Internet access is required for all online courses. You may use the open lab provided in the Gates Memorial Library.
COMPUTER FAILURE AND LACK OF INTERNET ACCESS ARE NOT ACCEPTABLE EXCUSES FOR MISSED ASSIGNMENTS, PROJECTS, QUIZZES, EXAMS, ETC.
* If a student decides to withdraw, he or she should also verify that the withdrawal is submitted before the final withdrawal date.
* It is the responsibility of each student to ensure that his or her name is removed from the roll should he or she decide to withdraw from the class.
* The student is also strongly encouraged to retain their copy of the withdrawal form for their records.
* The student is required to turn in any equipment or items that belong to the department. Failure to do so may compromise their standing with LSCPA.
* State law permits students to withdraw from no more than six courses during their entire undergraduate career at Texas public colleges or universities. With certain exceptions, all course withdrawals automatically count towards this limit. Details regarding this policy can be found in the LSCPA college catalog.
E-Mail/Voice Mail Etiquette:
* Students must use appropriate e-mail etiquette when corresponding with instructor; for example, complete sentences and a full subject line with your name/course name.
* Voice mail messages should be clearly spoken identifying student's name, course, and any return phone number.
*Exceptions and/or changes may be made to information in this syllabus at the instructors discretion.
|HB 2504||This syllabus is part of LSC-PA's efforts to comply with Texas House Bill 2504.|