| Instructor Information |
| Instructor |
Toy Thornton-Wyckoff |
| Email |
thorntontn@lamarpa.edu |
| Phone |
(409) 984-6437 |
| Office |
Educational I - Room: 111 |
| Office Hours |
Office Hours: Monday- Tuesday 1:30-2:30 pm, Thurs. 10:30-2:30 pm (By Appointment) Friday 8:30-2:30 pm |
| Additional Contact Information |
Allied Health Administrative Assistant, Donna Wolfe (409) 984-6356 or 1-800-477-5872 |
| Course Information |
| Description |
Overview of third party payment and it's impact on health care. Includes the principles and practices of managed care pharmacy, Medicare and Medicaid, payment plans, reimbursement methods, and formularies.
|
| Required Textbooks |
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.
Medical Insurance for Pharmacy Technicians
ISBN-13: 978-0-07-337416-1
Author(s): Cynthia Newby & Janet Liles McGraw-Hill Publishing
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| Additional Materials/Resources |
N/A
|
| Corequisites/Prerequisites |
None
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| Learning Outcomes |
-
Discuss and compare the benefits of managed care.
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Identify the needs of individuals who are not insurance eligible.
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Describe pricing schedules and demonstrate effective problem-solving skills.
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Communicate with third-party administrators related to coverage and eligibility
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| Program Student Learning Outcomes |
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Identify pharmaceutical drugs, abbreviations, classifications, dosages, side effects, and routes of administration.
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Know the federal and state laws governing the practice of pharmacy.
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Understand the qualifications, operational guidelines, and job duties of a pharmacy technician.
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Apply the skills necessary to process, prepare, label, and maintain records of prescriptions in a community pharmacy.
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Be able to complete pharmaceutical calculations and aseptic technique required for compound and sterile preparations.
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Demonstrate specialized pharmaceutical theory, skills, and concepts.
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| Lecture Topics Outline |
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From Prescription to Paymen
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Medicolegal Issues and the Pharmacy
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Private Insurance Payers and Plans
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Medicare
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Medicaid, TRICARE, CHAMPVA, WCTX and Discount Card
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Claim Preparation and Transmission
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Processing Claims and Reconciling Accounts
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| Major Assignments Schedule |
|
Week 1 |
Course Introduction Syllabus Review |
|
Week 2 |
From Prescription to Payment (Chp.1)
~Chapter Review Assignment
~Discussion Assignment |
Week 3
|
Medicolegal Issues and the Pharmacy (Chp.2)
~Chapter Review Assignment |
Week 4
|
Quiz #1 (Chp.1-2)
Private Insurance Payers and Plans (Chp.3)
~Chapter Review Assignment
~Discussion Assignment |
Week 5
|
Exam #1 (Chp.1-3) |
Week 6
|
Medicare (Chp.4)
~Discussion Assignment |
Week 7
|
Cont’d
Medicare (Chp.4)
~Chapter Review Assignment
~Discussion Assg. (3/18/26) |
|
|
Spring Break |
Week 8
|
Medicaid, TRICARE, CHAMPVA, WCTX and Discount Card Programs (Chp.5) |
Week 9
|
Cont’d
Medicaid, TRICARE, CHAMPVA, WCTX and Discount Card Programs (Chp.5)
~Chapter Review Assignment |
Week 10
|
Quiz #2
Claim Preparation and Transmission (Chp.6)
~Chapter Review Assignment |
Week 11
|
Exam #2 (Chp.4-6) |
Week 12
|
Processing Claims and Reconciling Accounts (Chp.7)
~Chapter Review Assignment |
Week 13
|
Exam #3 (Chp.7) |
Week 14
|
Final Exam Review Day |
Week 15
|
Final Exam |
|
Week 16 |
Final Grade Review Day |
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| Final Exam Date |
May 6, 2026 - 12:00 PM
Through May 6, 2026 - 2:00 PM
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| Grading Scale |
Grade Scale:
100-90 A
80-89 B
75-79 C
74-60 D
59 & Below F
|
Determination of
Final Grade |
1. Quizzes 20%
2. Exams 25%
3. Final Exam 20%
4. Assignments 15%
5. Attendance 10%
6. Discussions 10%
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| Course Policies |
| Instructor Policies |
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NO CELLPHONESare to be in sight during class lectures or labs and must on silent as students will be allowed to use their cell phones during break time. If there is an emergency or situation, please notify your instructor BEFOREclass and you may be allowed to step out of class if need be otherwise Donna Wolfe, AH secretary is available at (409) 984-6366 for emergency contact and will notify the instructor and student.
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All class and or homework assignments, quizzes, exams, and attendance will be used in calculating your course grade.
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No late work will be accepted; a student has 24 hoursto turn in missed assignments due to an excused absence with proper documentation for absence.
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If an exam is missed, the student must have proper documentation for absence and the student’s FINAL EXAM grade will count as the missed exam grade as well as final exam grade with the appropriate percentages.
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If a quiz is missed, you will be allowed to make up the quiz with the proper documentation for absence at a scheduled time per instructor or program director, and a different quiz may be given with the zero being replaced with the quiz grade upon completion.
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In class activities and participation will include assessments of videos, games, group presentations, EVERYONE is expected to stay engaged as this apart of your class grade.
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Complete any and all required readings, assignments, discussions as directed by the instructor.
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Keep copies of ALLpaperwork, including syllabus, handouts, and assignments.
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Participate actively by reviewing course material, interacting with classmates, and responding promptly in communication with your instructor via school email or by appointment.
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No gradeswill be discussed over the phone, as you can make an appointment with your instructor or program coordinator.
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If you have a complaint about this course which you cannot resolve through discussion with the instructor, please contact Heather Breaux, Chair Allied Health Department phone: 409-984-6365
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The following materials are officially PROHIBTED in the classroom meetings for this course: food, drink, or tobacco. This policy agrees with the official college policy; breaks will be given.
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The instructor expects that students to illustrate mature behavior with respect to being responsible for your own actions and being respectful of others. Failure to comply may result in removal from the classroom or the program.
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Students should ALWAYS use their LSCPA email account to send messages to instructors and leave an office voicemail.
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| Attendance Policy |
Attendance Policy:
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All students are expected to attend class DAILY. A no call, no showwill result in a zerofor class work/homework assignment, class participation, etc. for the day of absence and cannotbe made up.
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A student who is absent from class more than 3 days (3 times) within the semester may be at risk of being dropped from the program by the Program Coordinator.
1st Warning- verbal with record of conference
2nd Warning- written with record of conference
3rd Warning- written and meeting with Program Coordinator and Allied Health Director
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Late arrivalto class is disruptive, the classroom door is closed at the time class starts, any student arriving at that time will be considered LATE andwill not be allowed to enter the classroom, the student then should wait until break time to enter. Material that has been taught willNOT be retaught as students should follow up with their group or partner for class work.
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Students who arrive after a quiz or exam starts, but before it ends, may take the quiz or exam but will have a deduction of 5 points and no additional time will be given.
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It is the student's responsibility to notify the instructor of any absence. If unable to reach the instructor in the office, please leave a voicemail AND emailusing the student's campus email. Absences must be followed up with proper documentation for student records.
*At any time while a student in the Pharmacy Technology Program, two final counseling notes are grounds for immediate dismissal.
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| Additional Information |
|
| Institutional Policies |
| MyLSCPA |
Be sure to check your campus email and Course Homepage using MyLSCPA campus web portal. You can also access your grades, transcripts, academic advisors, degree progress, and other services through
MyLSCPA.
|
| Academic Honesty |
Academic honesty is expected from all students, and dishonesty in any form will not be tolerated. Please consult the LSCPA policies (Academic Dishonesty section in the Student Handbook) for consequences of academic dishonesty.
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| 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
Disability Services Coordinator, Room 117, in the Student Sucess Center. The phone number is (409) 984-6241.
|
| COVID 19 Information |
The Lamar State College Port Arthur (LSCPA) Student Code of Conduct COVID 19 Policy requires students who have been diagnosed with COVID 19 to report their condition directly to their local health department. Students should also contact their course faculty to report their quarantine status. In addition, this policy requires all students to wear face coverings when directly exposed to COVID 19 in compliance with the criteria included in the policy. For more information please refer to the COVID 19 link on the LSCPA website.
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| 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. Use of electronic devices is prohibited.
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| HB 2504 |
This syllabus is part of LSCPA's efforts to comply with Texas House Bill 2504.
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| Mandatory Reporting of Child Abuse and Neglect |
As per Texas law and LSCPA policy, all LSCPA employees, including faculty, are required to report allegations or disclosures of child abuse or neglect to the designated authorities, which may include a local or state law enforcement agency or the Texas Department of Family Protective Services. For more information about mandatory reporting requirements, see
LSCPA's Policy and Procedure Manual.
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| Title IX and Sexual Misconduct |
LSCPA is committed to establishing and maintaining an environment that is free from all forms of sex discrimination, including sexual harassment, sexual violence, and other forms of sexual misconduct. All LSCPA employees, including faculty, have the responsibility to report disclosures of sexual misconduct, including sexual harassment, sexual assault (including rape and acquaintance rape), domestic violence, dating violence, relationship violence, or stalking, to LSCPA's Title IX Coordinator, whose role is to coordinate the college's response to sexual misconduct. For more information about Title IX protections, faculty reporting responsibilities, options for confidential reporting, and the resources available for support visit LSCPA's Title IX website.
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| Clery Act Crime Reporting |
For more information about the Clery Act and crime reporting, see the Annual Security & Fire Safety Report and the Campus Security website.
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| Grievance / Complaint / Concern |
If you have a grievance, complaint, or concern about this course that has not been resolved through discussion with the Instructor, please consult the Department Chair.
|
| Department Information |
| Allied Health |
| Chair: | Shirley MacNeill |
| Email: | macneisb@lamarpa.edu |
| Phone: | (409) 984-6365 |
|
