Course Syllabus
Instructor Information
|
Instructor Info |
Course Length and Schedule |
|
Julian Kiler; kilerj@faculy.laccd.edu Adjunct Faculty, Adult Ed, LA Pierce College Cell: 951-234-7041 |
10/4/21– 10/30/21 On M, W, Fr; from 5:30 - 8.30 Total of 12 meeting = 36hours
|
General Information
This class will be fully synchronous or online live learning. This class is not meant to be a self-paced class. First, you will need to learn how to use LMS - learning management system to find materials, take quizzes and exams, and submit completed works electronically. You should do your work in this course with a high priority and complete reading assignments, group discussions, and exams on time. Any delay or neglect of class assignments will affect your course performance and course grade.
Description
In this non-credit course, students will be introduced to the medical insurance, medical office billing, and the procedural Coding CPT as well as the diagnostic coding ICD-10-CM. This course will provide an overview of daily medical office billing procedures and processes required for successful reimbursement. Topics include insurance eligibility/ verification, diagnosis & procedure coding posting, charge entry, claim submissions, and payment posting.
Student Learning Outcome
- Students will be prepared with the groundwork for understanding medical insurance, coding, and reimbursement to make sure that the Physician's time and all procedures are appropriately billed
- Students will be able to explain insurance eligibility, coverage, and procedures to the patients
- Students will be familiar and able to operate the Basic Medical Billing Coding practice management software.
Expectations and Goals
On completion of this course, the student will be able to describe the 'why,' 'what' and 'how' the daily medical office billing procedures processed in the clinic, including the operation of the Medical Billing practice management software. Students will also be able to apply the skills and qualifications that are necessary to assist Physicians in successful reimbursement.
Methodology
- Students are to read each chapter before class starts
- Class time will be devoted to discussing content, presenting enrichment materials, answering student questions, and engaging in additional learning activities.
- There will be an interactive MindTap practices and discussions based on the real life clinical scenario practices.
- Assignments will be:
- Case study questions and discussion at the Forum Discussion assignments
- Quizzes covering all the chapters; timed with 2 attempts
- Final Exam (100 questions, one attempt only; for 120 minutes)
Study materials
1. Required textbook
Comprehensive Medical Assisting, 6th edition, Wilburta Q Lindh et al., Delmar Cengage, 2019 - UNIT 5: chapter 16-20
- Chapter 16: Medical Insurance
- Chapter 17: Medical Coding
- Chapter 18: Daily Financial Practice
- Chapter 19: Billing and Collections
- Chapter 20: Accounting Practices
2. Additional materials to supplement the textbook will be performed during the live lecture
- Introduction to the Billing Coding practice management software (MOSS Medical Office Simulation software 3.0)
- Interactive exercise and practice on the software skills (MOSS and Billing Harris Tracker software) – optional, if we have an extra time!
Course Outline and Schedule
Mon, 10/4/21
|
Mod 1 (Ch. 16) Medical Insurance
|
|
Wednesday, 10/6/21
|
Mod 1 (Ch. 16) Medical Insurance
|
|
Friday, 10/8/21
|
Mod 1 (Ch. 16) Medical Insurance
|
2. In-class assignments + discussions 3. Competency Assessment a. Applying Managed Care Policies and Procedures b. Screening for Insurance c. Obtaining Referrals and Authorizations d. Computing the Medicare Fee Schedule
|
Monday, 10/11/21
|
Mod 2 (Ch. 17) Medical Coding |
|
Wednesday, 10/13/21
|
Mod 2 (Ch. 17) Medical Coding |
|
Friday, 10/15/21
|
Mod 2 (Ch. 17) Medical Coding |
2. In-class assignments + discussions 3. Competency Assessment a. Coding with Current Procedural Terminology b. Coding with International Classification of Diseases, 10th c. Applying Third-Party Guidelines d. Completing a Medicare CMS-1500 (02-12) Claim Form |
Monday, 10/18/21
|
Mod 3 (Ch. 18) Daily Financial Practice |
|
Wednesday, 10/20/21
|
Mod 3 (Ch. 18) Daily Financial Practice |
|
Friday, 10/22/21
|
Mod 3 (Ch. 18) Daily Financial Practice |
1. MOSS 3.0: posting copayment, insurance payment, posting a denial, and posting adjustment 2. In-class assignments + discussions 3. Competency Assessment a) Recording/Posting Patient Charges, Payments, and Adjustments b) Processing Credit Balances and Refunds c) Preparing a Deposit d) Recording a Nonsufficient Funds Check e) Reconciling a Bank Statement f) Establishing and Maintaining a Petty Cash Fund
|
Monday, 10/25/21
|
Mod 4 (Ch. 19) Billing and Collections |
|
Wednesday, 10/27/21
|
Mod 4 (Ch. 19) Billing and Collections |
|
Friday, 10/29/21
|
Mod 5 (Ch. 20) Accounting Practices |
|
Quizzes and Examinations
|
· The quizzes will be posted on Canvas. This homework will have no time limitation, two attempts, auto-graded (the highest score). Students will be able to evaluate or review the feedback after each attempt. |
|||
Evaluation Methods |
|||
|
30% |
Attendance and punctuality |
||
|
30% |
Quizzes |
||
|
20 |
Case Study Forum Discussions |
||
|
20% |
Final Exam |
||
Grading |
|||
|
75-100 |
PASS |
|
|
|
70-74 |
Satisfactory PASS |
|
|
|
less than 70 |
NO PASS |
|
|
Code of Conduct/Expectations/Behavior
EXPECTATIONS OF THE STUDENTS
- Log into the course daily. Come to class and be involved. Attendance grade contributes 30% of the total grade.
- Expect to spend about five hours per week working on this course (besides class time).
- Prepare to the best of your ability for every aspect of this course.
- Learning through collaboration (defined as working with or receiving assistance from another) is an effective tool used in this class and in your future employment. When I expect you to collaborate, I'll make it very clear in the assignment instructions. All other work in this class is to be done independently.
- All examinations will be done online. You are required to take these tests independently. It is considered cheating if you get assistance from anyone else either in the class or elsewhere.
EXPECTATIONS TO THE INSTRUCTOR
If we all live up to our academic responsibilities, this course will be meaningful for all who participate. Please feel free to discuss these points with me at any time during the course this semester.
- I will prepare and review course materials to be as current and accurate as possible.
- I will be available to answer questions or issues that may arise for you during this course. Expect a 24-hour turnaround time for response to emails.
- I will try to the best of my ability to prepare you for the exams and other assessments in this course.
- I will utilize fair and honest evaluation techniques for each assignment required for this course.
- To the best of my ability, make this a valid and worthwhile learning experience.
- I will do my best to address the needs of a diverse range of learning styles in this course.
- I will make every effort to follow QA - quality learning and teaching best practices.
ABSENCE and TARDINESS
Students may be absent from class a maximum of the total number of hours that the class meets in one week. Any absences beyond that amount of time may be made up only at the discretion of the instructor. If the absences cannot be made up satisfactorily, then the student will be dismissed from the course. Students are expected to arrive on time. Three late arrivals of 5 Minutes or more will be counted as one absence. Being on time is very important in this class. Stop coming to the class does not mean that you are automatically dropped. It is your responsibility to officially withdraw from the course if you decide to do so.
Academic Dishonesty
Students will be expected to follow the LACCD student code of conduct as it relates to student dishonesty (Board Rule 9803.28) as follows: "Violations of academic integrity of any type by a student provides grounds for disciplinary action by the instructor or College. Violations of Academic Integrity include, but are not limited to, the following actions: cheating on an exam, plagiarism, working together on an assignment, paper or project when the instructor has specifically stated students should not do so, submitting the same term paper to more than one instructor, or allowing another individual to assume one's identity for the purpose of enhancing one's grade. For more information on the Standards of Student Conduct, refer to the college catalog. Also, students are strongly advised to carefully read the Student Academic Integrity Policy Statement from the Los Angeles Pierce College 2017 – 2018 General Catalog.
Discrimination
Faculty and students are expected to follow the following district policy with the goal of keeping the campus free of discrimination of any kind. 9803.21 Discriminatory Behavior: Behavior while on a college campus or at a college-sponsored function, inconsistent with the District's Non-discrimination Policy, which requires that all programs and activities of the Los Angeles Community College District be operated in a manner which is free of "Prohibited Discrimination," defined as discrimination or harassment in violation of state or federal law on the basis of actual or perceived ethnic group identification, race, color, national origin, ancestry, religion, creed, sex (including gender-based sexual harassment), pregnancy, marital status, cancer-related medical condition of an employee, sexual orientation, age, physical or mental disability, or veteran status.
Students with Disabilities
Students with disabilities are encouraged to contact Disabled Student Programs & Services (DSPS) to find out what services and accommodations are available. In general, the recording of the lectures is
not allowed unless the student can provide a letter from the DSPS office indicating the need for
recording the lectures.
Add/Drop Policy
If you do not log in and complete all coursework during the first week, you will be dropped from this course by the instructor. It is essential that you stay on track in an online course, so you don’t fall behind. Students are responsible for knowing the Pierce College policy, procedures, and schedule for dropping or adding classes
Syllabus Subject to Change
The data provided in this document is for information and initial planning only. Therefore, schedules, as well as topics covered, and any dates are subject to change based on the material covered and unexpected circumstances as well as relevance to the class and learning objectives.
Course Outline and Schedule
Mon, 10/4/21
|
Mod 1 (Ch. 16) Medical Insurance
|
|
Wednesday, 10/6/21
|
Mod 1 (Ch. 16) Medical Insurance
|
|
Friday, 7/2/20
|
Mod 1 (Ch. 16) Medical Insurance
|
2. In-class assignments + discussions 3. Competency Assessment a. Applying Managed Care Policies and Procedures b. Screening for Insurance c. Obtaining Referrals and Authorizations d. Computing the Medicare Fee Schedule
|
Tuesday, 7/7/20 Independence Day holiday: 7/3/20
|
Mod 2 (Ch. 17) Medical Coding |
|
Wednesday, 7/8/20
|
Mod 2 (Ch. 17) Medical Coding |
|
Thursday, 7/9/20
|
Mod 2 (Ch. 17) Medical Coding |
2. In-class assignments + discussions 3. Competency Assessment a. Coding with Current Procedural Terminology b. Coding with International Classification of Diseases, 10th c. Applying Third-Party Guidelines d. Completing a Medicare CMS-1500 (02-12) Claim Form |
Thursday, 7/9/20
|
Mod 3 (Ch. 18) Daily Financial Practice |
|
Friday, 7/10/20
|
Mod 3 (Ch. 18) Daily Financial Practice |
|
Tuesday, 7/14/20
|
Mod 3 (Ch. 18) Daily Financial Practice |
1. MOSS 3.0: posting copayment, insurance payment, posting a denial, and posting adjustment 2. In-class assignments + discussions 3. Competency Assessment a) Recording/Posting Patient Charges, Payments, and Adjustments b) Processing Credit Balances and Refunds c) Preparing a Deposit d) Recording a Nonsufficient Funds Check e) Reconciling a Bank Statement f) Establishing and Maintaining a Petty Cash Fund
|
Wednesday, 7/15/20
|
Mod 4 (Ch. 19) Billing and Collections |
|
Thursday, 7/16/20
|
Mod 4 (Ch. 19) Billing and Collections |
|
Friday, 7/17/20
|
Mod 5 (Ch. 20) Accounting Practices |
|
Tuesday, 7/21/20
|
Last Day: Review and Final Exam
|
Quizzes and Examinations
|
· Two homework/ quizzes will be posted on Canvas. This homework will have no time limitation, two attempts, auto-graded (the highest score). Students will be able to evaluate or review the feedback after each attempt. |
|||
Evaluation Methods |
|||
|
20% |
Attendance and punctuality |
||
|
20% |
In-class participation, contribution, and quality of questions asked |
||
|
40% |
Homework/ Quizzes |
||
|
20% |
Final Exam |
||
Grading |
|||
|
75-100 |
PASS |
|
|
|
70-74 |
Satisfactory PASS |
|
|
|
less than 70 |
NO PASS |
|
|
Code of Conduct/Expectations/Behavior
EXPECTATIONS OF THE STUDENTS
- Log into the course daily. Come to class. Other
- Expect to spend about five hours per week working on this course (besides class time).
- Prepare to the best of your ability for every aspect of this course.
- Learning through collaboration (defined as working with or receiving assistance from another) is an effective tool used in this class and in your future employment. When I expect you to collaborate, I'll make it very clear in the assignment instructions. All other work in this class is to be done independently.
- All examinations will be done online. You are required to take these tests independently. It is considered cheating if you get assistance from anyone else either in the class or elsewhere.
EXPECTATIONS TO THE INSTRUCTOR
If we all live up to our academic responsibilities, this course will be meaningful for all who participate. Please feel free to discuss these points with me at any time during the course this semester.
- I will prepare and review course materials to be as current and accurate as possible.
- I will be available to answer questions or issues that may arise for you during this course. Expect a 24-hour turnaround time for response to emails.
- I will try to the best of my ability to prepare you for the exams and other assessments in this course.
- I will utilize fair and honest evaluation techniques for each assignment required for this course.
- To the best of my ability, make this a valid and worthwhile learning experience.
- I will do my best to address the needs of a diverse range of learning styles in this course.
- I will make every effort to follow QA - quality learning and teaching best practices.
ABSENCE and TARDINESS
Students may be absent from class a maximum of the total number of hours that the class meets in one week. Any absences beyond that amount of time may be made up only at the discretion of the instructor. If the absences cannot be made up satisfactorily, then the student will be dismissed from the course. Students are expected to arrive on time. Three late arrivals of 5 Minutes or more will be counted as one absence. Being on time is very important in this class. Stop coming to the class does not mean that you are automatically dropped. It is your responsibility to officially withdraw from the course if you decide to do so.
Academic Dishonesty
Students will be expected to follow the LACCD student code of conduct as it relates to student dishonesty (Board Rule 9803.28) as follows: "Violations of academic integrity of any type by a student provides grounds for disciplinary action by the instructor or College. Violations of Academic Integrity include, but are not limited to, the following actions: cheating on an exam, plagiarism, working together on an assignment, paper or project when the instructor has specifically stated students should not do so, submitting the same term paper to more than one instructor, or allowing another individual to assume one's identity for the purpose of enhancing one's grade. For more information on the Standards of Student Conduct, refer to the college catalog. Also, students are strongly advised to carefully read the Student Academic Integrity Policy Statement from the Los Angeles Pierce College 2017 – 2018 General Catalog.
Discrimination
Faculty and students are expected to follow the following district policy with the goal of keeping the campus free of discrimination of any kind. 9803.21 Discriminatory Behavior: Behavior while on a college campus or at a college-sponsored function, inconsistent with the District's Non-discrimination Policy, which requires that all programs and activities of the Los Angeles Community College District be operated in a manner which is free of "Prohibited Discrimination," defined as discrimination or harassment in violation of state or federal law on the basis of actual or perceived ethnic group identification, race, color, national origin, ancestry, religion, creed, sex (including gender-based sexual harassment), pregnancy, marital status, cancer-related medical condition of an employee, sexual orientation, age, physical or mental disability, or veteran status.
Students with Disabilities
Students with disabilities are encouraged to contact Disabled Student Programs & Services (DSPS) to find out what services and accommodations are available. In general, the recording of the lectures is
not allowed unless the student can provide a letter from the DSPS office indicating the need for
recording the lectures.
Add/Drop Policy
If you do not log in and complete all coursework during the first week, you will be dropped from this course by the instructor. It is essential that you stay on track in an online course, so you don’t fall behind. Students are responsible for knowing the Pierce College policy, procedures, and schedule for dropping or adding classes
Syllabus Subject to Change
The data provided in this document is for information and initial planning only. Therefore, schedules, as well as topics covered, and any dates are subject to change based on the material covered and unexpected circumstances as well as relevance to the class and learning objectives.
Course Summary:
| Date | Details | Due |
|---|---|---|