Midlands Technical College MED 134 Medical Assisting Financial Management - Hybrid Health Sciences Medical Assisting Sum mer

Transcription

1 Midlands Technical College MED 134 Medical Assisting Financial Management - Hybrid Health Sciences Medical Assisting Sum mer Catalog Course Description: This course is the study of the daily financial practices, insurance coding, billing and collections, and accounting principles in the medical office environment. Prerequisite(s): MED 103, MED 104, MED 109 Credit Hours: 1.5 Lecture hours 0.5 Lab Hours 3 Contact hours Departmental Website: D2L Brightspace Login Page Instructor: Office: Telephone: FAX: E- mail: Campus Mailbox: Administrative Specialist: Program Director: Ms. Fran Smith Sherri Dykes Textbook(s): Practice Management and EHR : A Total Patient Encounter for Medisoft Clinical with Connect Plus Access Card by Sanderson ISBN: General Education Core Competency Statement: Upon completion of the medical assisting certificate program the student will be able to: 1. Demonstrate competence in clinical procedures 2. Demonstrate competence in administrative procedures 3. Demonstrate competence in basic medical laboratory procedures 4. Provide competent patient care Course Objectives: Upon successful completion of this course, the student will be able to: 1. Evaluate the basic components of the reimbursement cycle, including the role that coders play in reimbursement 2. Analyze the process of developing an insurance claim from a coding perspective 3. Evaluate the reimbursement processes required to be consistent with CMS payment systems 4. Analyze the Medicare payment system to successfully complete a claim 5. Analyze Medicaid, TRICARE, and workers compensation payment systems to successfully complete a claim Compare commercial insurance plans to successfully complete a claim Course Outcomes and Competencies: Intended Course Outcome #1: Demonstrate competence in administrative procedures.

2 Course Competency (Performance Measure): Students will demonstrate overall knowledge of reimbursement methodologies utilized in physician offices and other outpatient clinical facilities Performance Measurement Instrument and Success Criteria: Successful completions of CMS 1500 claim form and comprehensive final exam. CAAHEP Competencies Evaluated in this course: VII. Managed Care/Insurance 1. Apply both managed care policies and procedures 2. Apply third party guidelines 3. Complete insurance claim forms 4. Obtain precertification, including documentation 5. Obtain preauthorization, including documentation Course Attendance: The quality of your learning experience in this class is determined in large by your active participation in the learning process. Therefore, it is important that you make every effort to attend every class. Students are expected to attend all classes and are responsible for class work, homework, lecture notes, reading assignments, etc., whether or not you are present. This is a hybrid course and attendance will be monitored each week online and on- campus (lab attendance). The length of time you spend online, frequency and resources assessed will be monitored by the instructor. You must log- in to the course a minimum of twice a week to answer discussion questions and complete weekly assignments and assessments. Example: If you login once a week, then you will receive one absence for that week. If you do not login at all during a week, you will receive two absences for that week. Some chapter tests will be administered online and others will be administered on campus. The final exam will be administered on campus. To be successful in this course you must log- in and review assignments and participate in online class discussion There is no such thing as an "excused absence". On certain occasions, circumstances may arise, such as illness, personal issues or transportation problems that prevent you from attending class. In light of that, the maximum number of absences (no matter what the reason is - such as illness, out of town, etc.) allowed is twice the number of meeting times per week. Maximum of Two (2) absences for this course Students should not be late to class. Students who come in late interfere with the class presentation and disturb the other students in the class. Likewise, students should not leave in the middle of class or before class is dismissed. If you arrive after the roll has been taken, you will be marked absent. It is YOUR responsibility to see the instructor after class on THAT DAY so your absence can be changed to a tardy. Three tardies will be counted as one absence. Missing more than 10 minutes of class, (late arrival or early exit), will constitute an absence. The student is responsible for keeping up with the number of classes missed. Absences will be counted beginning with the first day of class Additional items to consider: A. Incompletes are awarded only under extenuating circumstances, such as hospitalization, and require the permission of the instructor. All requests must be properly documented. Normally, the course work must be completed no later than the end of the following term. B. The instructor is not required to permit makeup work after the fact and may assign a grade of 0. Submitting makeup work for grades may be permitted at the discretion of the instructor provided you make arrangements with your instructor prior to the due date of the assignment in question. C. You are responsible for making sure all work reaches the instructor. All assignments should be submitted directly to the instructor; if assignments are submitted in any other way, they must be clearly labeled with the instructor s name.

3 You are responsible for all material and announcements presented, whether you are present or absent. Withdrawal Should the maximum allowable absences be exceeded prior to midterm, a "W" will be submitted to the registrar to be recorded on the student's transcript. Should the maximum allowable absences be exceeded after midterm, "W" will be submitted to the registrar if the student was passing the course at the time of withdrawal OR a "WF" will be submitted if the student was failing the course at the time of withdrawal. No Shows: If you register for a course and decide not to attend for any reason, you must complete a drop form and process it through the student Records Office. You will not be automatically purged for non- attendance. If you d not submit a drop form, you will be responsible for course tuition and fees. By not officially dropping the course, you will incur a bill with the college that can only be addressed through the College s Finance Office. The college s refund policy and dates are posted each semester. Effective Spring 2015, the Student Ombudsman s office will no longer be the initial point of contact for requesting No Shows to be processed. Students who incur bill must contact the Finance Office. Administrative Drop Requests: student requesting an Administrative Drop resulting from medical event, death of family member, and other extenuating circumstances experienced while enrolled at Midlands Technical College should be directed to the Student Ombudsman s office. Our policy dictates a request must be made n later than 30 days after the affected term. Supporting documentation is required and must be received before the request can be processed. Once the request form is received along with supporting documentation, it takes approximately three weeks for processing. As a result of an approved Administrative Drop Request, the student may be granted a refund of tuition and fees. Military Withdrawal According to College Procedure , students having to withdraw from college because of Military Deployment (active duty personnel) while enrolled must complete a withdrawal form and submit to the Records Office along with a copy of military orders. Disabilities Statement The staff of Counseling and Career Services works to ensure that all educational programming and services are accessible to otherwise qualified students with disabilities. If you have a concern regarding the accessibility of websites, instructional materials, online courses and other electronic or information technology please contact Counseling and Career Services It is the student's responsibility to self- disclose as a student with a disability and to request accommodations prior to beginning a program or course. Please contact the staff of Counseling and Career Services at (AC) or (BC) or via at if you have any questions or concerns. D2L Brightspace Help: Online Learning Support Help Desk: Technical questions related to the operation and use of D2L Brightspace can be answered from our Support Help Desk A response will be provided within one business day. To login: use your MTC e- mail account username and password. (Student Username Example: georgeasmith) (Faculty Username Example: smithg) D2L Brightspace Assistance: Technical questions related to the operation and use of D2L Brightspace can also be answered by leaving a voic at (803) , or ing A response will be provided within one business day.

4 MyMTC Help For MyMTC log- in issues please call Academic Dishonesty For more information about academic dishonesty, see the Academic Affairs Student Guidelines and Expectations attached. If you are suspected of cheating, your instructor will inform you. You may explain or refute the allegation. If your instructor still thinks the charges are founded, you will be referred to the Office of the AVP, SDS. Documentation is submitted to the Office of the AVP, SDS, by the instructor. You will then meet with either Dr. Holloway or Mr. Hayden. After the meeting, you will receive a letter with the sanction grade of zero (0) and any other sanctions deemed appropriate. You have the right to file an appeal. Once the hearing and the notice of the right to appeal have been completed, the instructor will be notified to apply the sanction grade of zero (0). Course Requirements: Mastering the content of this course requires regular attendance in class, consistent study of text material and class notes, and preparation of homework assignments. Students are expected to BE PREPARED FOR and PARTICIPATE in every class meeting. Students are expected to have all assignments completed by the due date. You are in college. You will be treated and respected as an adult. It is a violation of the MTC Student Code to interfere with the learning process in the classroom. Courteous, attentive behavior is expected at all times. Disruptive behavior in any form will not be tolerated. Students engaged in such behavior will be dismissed from class and subject to disciplinary procedures. It is expected that all beepers and cellular telephones will be turned off or set to the silent mode during class. You may not receive or place telephone calls during class. No electronic devises will be (including, but not limited to I- pods, MP3 players, etc) will be permitted in class. A Laptop computer is allowed only if the student uses it to take notes during class. Be on time! It is inconsiderate to your classmates and disruptive to the class to arrive late. Students are expected to be in their seats ready to start class at the beginning of the class. Leaving during class should only be in case of an emergency. If you know you must leave early, please let the instructor know ahead of time. Prior to each class, the student should review the previously covered material of the last class period. Additionally, the next chapter should be reviewed, in depth, for complete understanding and class participation. Course Grading: In addition to the grading criteria above, students must also receive a Pass grade on ALL competencies taught in this course. Students who do not Pass all competencies check- offs WILL NOT PASS THE COURSE EVEN IF THEY HAVE PASSED ALL OF THE WRITTEN ASSESSMENTS. Requests to miss a test must be made in writing (via e- mail) and approved prior to the test. NO MORE THAN TWO QUIZZES AND TWO COMPETENCY CHECK- OFFS CAN BE MADE UP. Any student arriving 5 minutes after the start of the test/exam will be denied entrance AND MAY RECEIVE A GRADE OF ZERO AT THE INSTRUCTOR S DISCRETION. Homework: You must hand write the questions that you missed on the exam and find the correct answer, write the correct answer, the page number and section you found your answer. If you received 100% on the exam, you will automatically get the homework points. This must be turned in by the next class session. This is worth a possibility of 10 points.

5 CAAHEP Required Competency Checklist Grading: Each Job Skill should be removed from the Workbook and kept in a notebook, when completed, submit to instructor with the Competency Evaluation Checklist for evaluation. These checklists are designed with simplicity in mind to help students perform each step of the exercise satisfactorily, and then to be used by the instructor to evaluate each step. Other job skills will be completed using Practice Fusion Electronic Medical Records Software. STUDENT MUST PASS ALL OF THE CAAHEP COMPETENCIES BELOW IN ADDITION TO A PASSING AVERAGE ON WRITTEN ASSESSMENTS TO SUCCESSFULLY PASS THE COURSE. FOR EXAMPLE: IF THE STUDENT HAS AN AVERAGE OF 95 ON ALL WRITTEN ASSESSMENTs AND FAIL ONE COMPETENCY LISTED BELOW, THE STUDENT HAS FAILED THE COURSE. STUDENTS WILL BE GIVEN A SECOND ATTEMPT IF UNSUCCESSFUL WITH THE FIRST ATTEMPT (second attempts will start at 90%). IF THE COMPETENCY IS NOT PASSED BY THE SECOND ATTEMPT, NO MORE ATTEMPTS WILL BE GRANTED AND THE STUDENT HAS FAILED THE COURSE. PLEASE NOTE: Should change become necessary, the instructor reserves the right to adjust the requirements, pace, or scheduling of this course. Any change will be announced in class before it becomes effective. Grading Scale: A Superior Work B Good Work C Average Work 0-74 F Unsatisfactory Work