Syllabus for Medical Front Office Customized Job Skills Training
AHE 105 – Insurance Billing and Coding, Medisoft and Medical Terminology – Fall Quarter 2007
Class begins –October 1, 2007
Class Ends – December 14, 2007
Student Coordinator/Instructor: Jennifer Evans Office location: Aviation Building
Office phone number: 206-768-6646
Cell phone number: 206-228-7561
Email: jevans@sccd.ctc.edu
Office hours: Due to schedule, by appointment only
Program hours: 9:00-4:30 Monday through Thursday and 9:00-1:00 on Friday
AHE 105 Class Hours:
Monday and Wednesday 10:00 – 12:30 and 1:00-4:30 Lunch is from 12:30-1:00
Go to www.medoffice.blogspot.com for copies of policies.
Absenteeism:
All absences must be called into either office or cell number before the start of class or emailed to Jennifer Evans Coordinator/Instructor.
Accommodations:
If you have a documented disability and are in need of support services or accommodations, please contact Disability Support Services in the Robert Smith Building, Room RS 12 (763-5137) for assistance in developing a plan to address your academic needs.
Course Description:
AHE 105 develops vocabulary skills of pronunciation, meaning, and spelling of common medical terms. Students will acquire a vocabulary of common medical terms by learning to identify root forms, prefixes, suffixes, combining forms and abbreviations for medical terms, medical procedures and therapeutic interventions used in medicine.
This course also provides a foundation in the principles and practices of medical billing and insurance processing, using ICD-9, CPT codes and HCPCS codes, to complete insurance forms, and medical record information and appropriate patient paperwork. This course also utilizes MediSoft for electronic billing and coding management. Work will be completed hands-on in both classroom and lab setting.
Prerequisites: A keyboarding score of 35 wpm or better, or by Coordinator approval. Students must be able to read and understand college level text and follow both written and oral instructions. If a student is in need of tutoring due to a documented learning or physical disability, please contact Special Student Services and the Instructor.
Required texts and materials:
Insurance Handbook for the Medical Office and Workbook, Marilyn T. Fordney; Saunders; 2006
Patient Billing – Using MediSoft Advanced 4th Edition, Susan Sanderson; Glencoe, 2003
Mastering Healthcare Terminology, Betsy Shiland; Mosby; 2004
Outline of topics in AHE 105 Introduction to Medical Insurance, Coding, MediSoft and Medical Terminology
Medical Insurance, Billing and Coding
1. Career and Professionalism
Roles and Responsibilities
Confidentiality
Liability
2. Patient Scheduling
Check in patients
The steps in scheduling patient appointments
Determine urgency of appointment.
Handling cancellations.
Understand the appointment matrix.
3. Basics of Medical Insurance
Understand the types of reimbursement.
Knowledge of insurance vocabulary.
Be familiar with insurance forms and how to complete them.
Medicare and Medicaid basics
Insurance abuse and fraud implications
Documents and the Insurance Claim Cycle.
The reimbursement cycle
Types of office documents in insurance
4. Medical Insurance Coding
Vocabulary of coding
Be familiar with ICD-9CM codes and CPT codes.
Be familiar with how to complete the HFCA-1500 form.
Seriousness of coding errors
Confidentiality
5. Coding Procedures
Evaluation and Management
Anesthesia, surgery and radiology
Pathology/Laboratory and Medicine
6. Claim Submission
Billing cycle.
Legal ramifications of overdue accounts.
Aging accounts.
Truth in Lending
Data Storage
Auditing
7. CMS 1500 forms Completion and Submission
8. Managed Care and Private Insurance
9. Government Insurance Programs
a. Medicaid
b. Medicare
c. TRICARE and CHAMPVA
d. Worker’s Comp and Disability Programs
10. Billing and Collections
11. Tracking Reimbursement
12. Medical Practice Simulations
13. Insurance Software Challenge
MediSoft
Work with Medisoft software and be able to navigate through the various databases with confidence.
Enter and edit new patient records.
Input and edit patient cases.
Enter insurance information.
Input data based on codes and information from the superbill.
Make deposits from patients and insurance companies.
Apply payments to patient accounts.
Print receipts.
Print reports.
Schedule appointments on the computer.
11. Reschedule.
12. Search for appointment dates.
13. Print appointment reports.
Medical Terminology
Understand connotations of Greek and Latin prefixes, suffixes, and combining forms.
Identify plural forms.
Know abbreviations.
Use a medical dictionary and other reference sources proficiently.
Pronounce words correctly.
Importance of correct spelling and pronouncing of terms.
Have a working knowledge of the body system and the applicable medical terms.
Know common medical terms associated with the integumentary system, musculoskeletal system, gastrointestinal system, urinary system, male and female reproductive systems, blood, lymphatic and immune systems, cardiovascular system, respiratory system, nervous system, mental and behavioral health, eyes and ears, endocrine systems and oncology, as well as diagnoses, procedures, pathology, surgical, and pharmacology areas.
Identify and use appropriate medical terms and Medical Abbreviations in other medically related paperwork
SSCC STUDENT LEARNING OUTCOMES are the knowledge and abilities every student graduating with a certificate or degree from South Seattle Community College will have. Students will achieve these outcomes as well as the specific curriculum outcomes for their academic or technical area of study.
Communication
Read and listen actively to learn and communicate
Speak and write effectively for personal, academic, and career purposes
Computation
Use arithmetic and other basic mathematical operations as required by program of study
Apply quantitative skills for personal, academic, and career purposes
Identify, interpret, and utilize higher level mathematical and cognitive skills (for those students who choose to move beyond the minimum requirements as stated above)
Human Relations
Use social interactive skills to work in groups effectively
Recognize the diversity of cultural influences and values
Critical Thinking and Problem-Solving
º Think critically in evaluating information, solving problems, and making decisions
Technology
Select and use appropriate technological tools for personal, academic, and career tasks.
Personal Responsibility
Be motivated and able to continue learning and adapt to change
Value one's own skills, abilities, ideas, and art
Take pride in one's work
Manage personal health and safety
Be aware of civic and environmental issues
Information Literacy
Access and evaluate information from a variety of sources and contexts, including technology
Use information to achieve personal, academic, and career goals, as well as to participate in a democratic society.
Grading and evaluations
Grading is based on the following grading system for all insurance forms: Each form related assignment will have a number grade of 0-100 based on the amount of errors per medical form or document.
0 errors = 100
1 error = 90
2 errors = 80
3 errors = 70
4 errors = 60
5 errors = 50
6 errors = 40
7 errors = 30
8 errors = 20
9 errors = 10
10 errors = no credit
Attendance is 33.3% of your overall grade, Quizzes, projects/portfolios and exams equal 33.3% of your overall grade. All homework and in class assignments equal 33.3% of your overall grade.
Quizzes and Exams may be given on either computer or on paper. There will be NO late tests given.
Homework will be reduced by 20 points if turned on 1 day late. After that, it will NOT be accepted.
§ Medical Terminology homework consists of the exercises within each chapter. The Medical Terminology Chapter Review questions are NOT part of the homework and will be discussed separately.
§ Medical Insurance homework consists of the Self Study review questions (50 points per chapter), Critical Thinking, and Assignments (100 points per chapter) at the end of each chapter. The Exercise Exchanges and Billing Breaks are graded separately and according to the amount of errors per document.
Medical Terminology and Medical Insurance homework questions are worth 50 points per chapter. For medical terminology, if you would like and additional 25 extra points per chapter, you may type both the question and answer for all of the study questions. This format serves the purpose to assist you with studying.
A final grade of 75% (2.0) or below is unacceptable and will result in a non-passing grade for this class. A non-passing grade for any class will result in not passing the Medical Office program.
Timeline for class assignments
Please refer to the tentative timeline for specific details. This document will be given separately.
AHE 105 – Insurance Billing and Coding, Medisoft and Medical Terminology – Fall Quarter 2007
Class begins –October 1, 2007
Class Ends – December 14, 2007
Student Coordinator/Instructor: Jennifer Evans Office location: Aviation Building
Office phone number: 206-768-6646
Cell phone number: 206-228-7561
Email: jevans@sccd.ctc.edu
Office hours: Due to schedule, by appointment only
Program hours: 9:00-4:30 Monday through Thursday and 9:00-1:00 on Friday
AHE 105 Class Hours:
Monday and Wednesday 10:00 – 12:30 and 1:00-4:30 Lunch is from 12:30-1:00
Go to www.medoffice.blogspot.com for copies of policies.
Absenteeism:
All absences must be called into either office or cell number before the start of class or emailed to Jennifer Evans Coordinator/Instructor.
Accommodations:
If you have a documented disability and are in need of support services or accommodations, please contact Disability Support Services in the Robert Smith Building, Room RS 12 (763-5137) for assistance in developing a plan to address your academic needs.
Course Description:
AHE 105 develops vocabulary skills of pronunciation, meaning, and spelling of common medical terms. Students will acquire a vocabulary of common medical terms by learning to identify root forms, prefixes, suffixes, combining forms and abbreviations for medical terms, medical procedures and therapeutic interventions used in medicine.
This course also provides a foundation in the principles and practices of medical billing and insurance processing, using ICD-9, CPT codes and HCPCS codes, to complete insurance forms, and medical record information and appropriate patient paperwork. This course also utilizes MediSoft for electronic billing and coding management. Work will be completed hands-on in both classroom and lab setting.
Prerequisites: A keyboarding score of 35 wpm or better, or by Coordinator approval. Students must be able to read and understand college level text and follow both written and oral instructions. If a student is in need of tutoring due to a documented learning or physical disability, please contact Special Student Services and the Instructor.
Required texts and materials:
Insurance Handbook for the Medical Office and Workbook, Marilyn T. Fordney; Saunders; 2006
Patient Billing – Using MediSoft Advanced 4th Edition, Susan Sanderson; Glencoe, 2003
Mastering Healthcare Terminology, Betsy Shiland; Mosby; 2004
Outline of topics in AHE 105 Introduction to Medical Insurance, Coding, MediSoft and Medical Terminology
Medical Insurance, Billing and Coding
1. Career and Professionalism
Roles and Responsibilities
Confidentiality
Liability
2. Patient Scheduling
Check in patients
The steps in scheduling patient appointments
Determine urgency of appointment.
Handling cancellations.
Understand the appointment matrix.
3. Basics of Medical Insurance
Understand the types of reimbursement.
Knowledge of insurance vocabulary.
Be familiar with insurance forms and how to complete them.
Medicare and Medicaid basics
Insurance abuse and fraud implications
Documents and the Insurance Claim Cycle.
The reimbursement cycle
Types of office documents in insurance
4. Medical Insurance Coding
Vocabulary of coding
Be familiar with ICD-9CM codes and CPT codes.
Be familiar with how to complete the HFCA-1500 form.
Seriousness of coding errors
Confidentiality
5. Coding Procedures
Evaluation and Management
Anesthesia, surgery and radiology
Pathology/Laboratory and Medicine
6. Claim Submission
Billing cycle.
Legal ramifications of overdue accounts.
Aging accounts.
Truth in Lending
Data Storage
Auditing
7. CMS 1500 forms Completion and Submission
8. Managed Care and Private Insurance
9. Government Insurance Programs
a. Medicaid
b. Medicare
c. TRICARE and CHAMPVA
d. Worker’s Comp and Disability Programs
10. Billing and Collections
11. Tracking Reimbursement
12. Medical Practice Simulations
13. Insurance Software Challenge
MediSoft
Work with Medisoft software and be able to navigate through the various databases with confidence.
Enter and edit new patient records.
Input and edit patient cases.
Enter insurance information.
Input data based on codes and information from the superbill.
Make deposits from patients and insurance companies.
Apply payments to patient accounts.
Print receipts.
Print reports.
Schedule appointments on the computer.
11. Reschedule.
12. Search for appointment dates.
13. Print appointment reports.
Medical Terminology
Understand connotations of Greek and Latin prefixes, suffixes, and combining forms.
Identify plural forms.
Know abbreviations.
Use a medical dictionary and other reference sources proficiently.
Pronounce words correctly.
Importance of correct spelling and pronouncing of terms.
Have a working knowledge of the body system and the applicable medical terms.
Know common medical terms associated with the integumentary system, musculoskeletal system, gastrointestinal system, urinary system, male and female reproductive systems, blood, lymphatic and immune systems, cardiovascular system, respiratory system, nervous system, mental and behavioral health, eyes and ears, endocrine systems and oncology, as well as diagnoses, procedures, pathology, surgical, and pharmacology areas.
Identify and use appropriate medical terms and Medical Abbreviations in other medically related paperwork
SSCC STUDENT LEARNING OUTCOMES are the knowledge and abilities every student graduating with a certificate or degree from South Seattle Community College will have. Students will achieve these outcomes as well as the specific curriculum outcomes for their academic or technical area of study.
Communication
Read and listen actively to learn and communicate
Speak and write effectively for personal, academic, and career purposes
Computation
Use arithmetic and other basic mathematical operations as required by program of study
Apply quantitative skills for personal, academic, and career purposes
Identify, interpret, and utilize higher level mathematical and cognitive skills (for those students who choose to move beyond the minimum requirements as stated above)
Human Relations
Use social interactive skills to work in groups effectively
Recognize the diversity of cultural influences and values
Critical Thinking and Problem-Solving
º Think critically in evaluating information, solving problems, and making decisions
Technology
Select and use appropriate technological tools for personal, academic, and career tasks.
Personal Responsibility
Be motivated and able to continue learning and adapt to change
Value one's own skills, abilities, ideas, and art
Take pride in one's work
Manage personal health and safety
Be aware of civic and environmental issues
Information Literacy
Access and evaluate information from a variety of sources and contexts, including technology
Use information to achieve personal, academic, and career goals, as well as to participate in a democratic society.
Grading and evaluations
Grading is based on the following grading system for all insurance forms: Each form related assignment will have a number grade of 0-100 based on the amount of errors per medical form or document.
0 errors = 100
1 error = 90
2 errors = 80
3 errors = 70
4 errors = 60
5 errors = 50
6 errors = 40
7 errors = 30
8 errors = 20
9 errors = 10
10 errors = no credit
Attendance is 33.3% of your overall grade, Quizzes, projects/portfolios and exams equal 33.3% of your overall grade. All homework and in class assignments equal 33.3% of your overall grade.
Quizzes and Exams may be given on either computer or on paper. There will be NO late tests given.
Homework will be reduced by 20 points if turned on 1 day late. After that, it will NOT be accepted.
§ Medical Terminology homework consists of the exercises within each chapter. The Medical Terminology Chapter Review questions are NOT part of the homework and will be discussed separately.
§ Medical Insurance homework consists of the Self Study review questions (50 points per chapter), Critical Thinking, and Assignments (100 points per chapter) at the end of each chapter. The Exercise Exchanges and Billing Breaks are graded separately and according to the amount of errors per document.
Medical Terminology and Medical Insurance homework questions are worth 50 points per chapter. For medical terminology, if you would like and additional 25 extra points per chapter, you may type both the question and answer for all of the study questions. This format serves the purpose to assist you with studying.
A final grade of 75% (2.0) or below is unacceptable and will result in a non-passing grade for this class. A non-passing grade for any class will result in not passing the Medical Office program.
Timeline for class assignments
Please refer to the tentative timeline for specific details. This document will be given separately.
Labels: AHE 105 Syllabus
posted by Tieyah @ 2:42 PM
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