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Distance Education · Health Sciences · Health Information - HITT


Advanced Medical Billing and Reimbursement
HITT-2340

  • Spring 2019
  • Section N01 CRN-24416
  • 3 Credits
  • 01/14/2019 to 05/09/2019
  • Modified 01/11/2019

Meeting Times


  • Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, 12:00 AM to 11:59 PM

Course may be accessed at any day or time, as long as student has internet access.

Contact Information


Brenda Walker, MS, RHIA, CCS

8441 Riverside Pkwy

#2538 Clinical Bldg 1

Health Science Center

Bryan, TX 77801

[email protected]

979-691-2142

 

Office Hours

Monday - Thursday 8:00 a.m. - 3:30 p.m.

Friday by appointment

Virtual by appointment

Description


Skill development in coding to prepare reimbursement forms in various health care settings for submission to payors. 

Requisites

Prerequisites: HITT 1341 Coding and Classification Systems,

HITT 1342 Ambulatory Coding

Co-requisite: HITT 2435 Coding and Reimbursement Methodologies

A Student must be college ready in Reading according to TSI college-ready standards.

The student must achieve a grade of 70% or higher to complete the course. 

Core Curriculum Statement


This course is not a core curriculum course.

Outcomes


1. Coding of health records using various classification systems.

2. Execute reimbursement forms.

3. Apply revenue cycle management procedures.

Materials


Understanding Health Insurance: A Guide to Billing Reimbursement

  • Author: Green
  • Publisher: Cengage
  • Edition: 14th
  • ISBN: 978-1-337-55422-0

ICD-10-CM Coding Book

  • Author: Casto
  • Publisher: AHIMA
  • Edition: 2018
  • ISBN: 978-158-426-5894

(should have from HITT 1341)

ICD-10-PCS Coding Book

  • Author: Casto
  • Publisher: AHIMA
  • Edition: 2018
  • ISBN: 978-158-426-5900

(should have from HITT 1341)

CPT Coding Book

  • Publisher: AMA
  • Edition: 2018-Professional
  • ISBN: 978-162-202-6005

(Should have from HITT 1342)

-internet access

-speakers/headset

-webcam/microphone

-AHIMA Vlab access (given by program director)

Course Requirements


  • Achievement of all learning outcomes
  • Completion of assignments
  • Completion of all major exams and final exam
  • Completion of project
  • Participation in classroom (online) discussion and activities

Evaluation


Criteria

Types of evaluations and related weights
Type Weight Topic Notes
 

Course must include a comprehensive final worth 20% of course grade, student participation grade of 10%, and minimum of 4 major grades.

  1. Major Exams:  Score determined by points earned on objective portion
  2. Minor Exams/Quizzes/Assignments: Points determined by accuracy, and correct answers
  3. Project: Points determined by accuracy, grammar, and other criteria stated on project instruction sheet
  4. Final Exam:  Points determined by accuracy, (problem portion) and correct answers (objective portion)

Breakdown

Point Distribution

900-1000  = A

800-899   = B

700-799    = C

600-699    = D

below 599   = F

Breakdown

Discussions 2%

Major Exams 38%

Project 10%

Final Exam 20%

Quizzes 16%

Case Studies 11.5%

Essays 1.5%

Vlab Assignments 1%

Blinn College Policies


All policies, guidelines, and procedures in the Blinn College CatalogBlinn College Board Policies, and the Blinn College Administrative Regulations are applicable to this course.

Specific information on civility, attendance, add/drop, scholastic integrity, students with disabilities, final grade appeal, alternative retailers, campus carry and proctoring arrangements and cost.

Notice of any action taken under these protocol and procedures, by Blinn College or its employees, may be delivered by hand, through the U.S. Postal Service, or electronically to the student’s Blinn Buc e-mail account. Notice shall be deemed received upon actual receipt, on deposit in the U.S. Mail, or upon entering the information processing system used by Blinn College for Blinn Buc e-mail accounts, whichever first occurs.

Course Policies


Proctored Exams

TWO MAJOR EXAMS FOR THIS CLASS WILL BE CLOSED TEXTBOOK AND PROCTORED.  TAKING AN EXAM WITHOUT A PROCTOR WILL RESULT IN A GRADE OF ZERO (0).

It is the responsibility of faculty to maintain scholastic integrity at the College District by refusing to tolerate any form of scholastic dishonesty.  Adequate control of test materials, strict supervision during testing, and other preventative measures shall be utilized, as necessary, to prevent cheating or plagiarism. (Blinn College Policy:  Section Student Complaints/Course Grade Complaints #239501)

PROCTORING OPTIONS:  

This class will be testing some proctoring options that are still to be determined.  The proctoring options being considered at this point are free to the student and may be accessed from your home computer.

Attendance Policy (Drop policy)

If the student misses 1 week's worth of assignments, the student will be given 1 absence. When the student misses 2 week's worth of assignments, the student will be given 2 absences and dropped from the course. 

The student must complete two assignments per chapter on time per week to receive attendance credit.  Completing late work does NOT make up for current assignments and students will still be counted absent if current work is not submitted.

The 4 excused absences include: 

  1. Observance of religious holy days - Students should notify their instructor(s) no later than the 15th day of the semester concerning the specific date(s) for absences for any religious holy day(s);
  2. Representing the College District at an official institutional function;
  3. Dual credit students representing the high school or independent school district at an official institutional function; and
  4. Military service.

Sickness, death of friend or family member, work, failed technology, loss of electricity, etc. are not excused absences.

 

Late Work Policy

Late Work: Assignments, Exams, Project, Quizzes, etc. are due according to the schedule

Assignments are due by 11:30 pm central standard time on Tuesdays. Late assignments will be deducted:

10% from 11:31 p.m. on Tuesday through 11:30 p.m. on Wednesday,

20% from 11:31 p.m. on Wedneday through 11:30 p.m. on Thursday

30% from 11:31 p.m. on Thursday through 11:30 p.m. on Friday.  

After 11:30 p.m. on Friday a grade of zero will be assigned.

Final Exams: No late work will be accepted. 

A 'broken’ computer or Internet connection is not an acceptable excuse for missing or late assignments. It is the student's responsibility to have a backup location to use if the student's Internet connection or computer fails.

If Blinn has technology issues, then I will extend the due date, but I must get an e-mail from Blinn in order for this to apply. 

2014 CAHIIM Competencies

The Commission on Accreditation for Health Informatics and Information Management Education CAHIIM has approved competency tasks for entry-level health information technicians. The objectives of this course relate specifically to those tasks listed below.

Domain IV. Revenue Management

Subdomain IV. A. Revenue Cycle and Reimbursement

  1. Apply policies and procedures for the use of data required in healthcare reimbursement
  2. Evaluate the revenue cycle management processes

Academic Integrity (Cheating Policy)

Dishonesty of any kind will not be tolerated.  This includes copying work from another student or computer and turning it in as your own.  Depending on the severity of the dishonesty, one may receive either a zero for the assignment or fail the course.  All persons involved in the copying or granting permission for copying will be penalized.

Minor assignments may be discussed together as a group, but submissions must be individualized. No group work on major exams or projects, unless otherwise instructed.

Answers from Quizlet, answer keys, internet searches, etc. will not be accepted.  Cite your sources when applicable.

Communication

Communication is very important in distance education classes.  I will communicate within the course room through news items, discussion boards, and e-mail Your Blinn e-mail will also be used at times for communication from other Blinn departments.  You are responsible for all e-mail going to your Blinn e-mail address.  The best scenario is to check that e-mail daily!  Your e-mail address is your first and last name with a period in between and the last 2 digits of your student ID @ buc.blinn.edu.   To find out more information about your Blinn e-mail account and to set up your account, go to the Student e-mail accounts page.

Criminal Background Checks

Per Texas HB 1508, effective 9/1/2017:

"For students in this course, who may have a criminal background, please be advised that the background could keep you from being licensed by the State of Texas.  If you have a question about your background and licensure, please speak with your faculty member or the department chair. You also have the right to request a criminal history evaluation letter from the applicable licensing agency.”

Schedule


Week Day Sections Covered Assignments Points  Hours Lab Hours Due Date
1 M 01/14/19 Orientation Activities Orientation Activities   3 1 1/22/2019
  T 01/15/19 Ch 1 "Health Insurance Specialist  Read chapter/watch Tegrity video        
    Career" Ch 1 Review pp. 19-21 5      
  W 01/16/19 Ch 2 "Introduction to Health  Read chapter/watch Tegrity video        
  R 01/17/19 Insurance" Calculating Reimbursement 5      
  F 01/18/19   Ch 2 Review pp. 41-43 5      
2 M 01/21/19 Holiday--Campus Closed          
  T 01/22/19 Ch 3 "Managed Health Care" Read chapter/watch Tegrity video   3 1 1/29/2019
  W 01/23/19   Managed Health Care Federal Legislation Literature Review 10      
  R 01/24/19   Literature Review continued        
  F 01/25/19   Ch 3 Review pp. 59-60 5      
3 M 01/28/19 Ch 4 "Revenue Cycle Management" Read chapter/watch Tegrity video   3 1 2/5/2019
  T 01/29/19   Exercises 4.2 - 4.4 (eCampus) 5      
  W 01/30/19   Eercises 4.6 - 4.8 (eCampus) 5      
  R 01/31/19   Exercises continued        
  F 02/01/19   Ch 4 Review pp. 110-114 5      
4 M 02/04/19 Ch 5 "Legal and Regulatory Issues" Read chapter/watch Tegrity video   3 1 2/12/2019
  T 02/05/19   Discussion 1 (Initial) 5      
  W 02/06/19   Hospital Inpatient Quality Reporting Program 5      
  R 02/07/19   Ch 5 Review pp. 157-159                Discussion 1 (Reply) 5      
  F 02/08/19 Exam1 (Ch 1-5) Exam 1 (Ch 1 - 5) 100      
5 M 02/11/19 Ch 6 "ICD-10-CM Coding" Read chapter/watch Tegrity video   3 1 2/19/2019
  T 02/12/19   Exercises 6.2 - 6.8  (eCampus)                  10      
  W 02/13/19   Exercises 6.2 - 6.8  (eCampus)                 
      Clintegrity #6 Physician Query 5      
  R 02/14/19   Ch 6 Review (eCampus) 10      
  F 02/15/19   Ch 6 Review (eCampus)        
6 M 02/18/19 Ch 7 "CPT Coding" Read chapter/watch Tegrity video   3 1 2/26/2019
      Exercises 7.1 - 7.11                            10      
  T 02/19/19   Exercises continued        
  W 02/20/19   Find-A-Code #4 and #5 5      
  R 02/21/19   Review pp. 279-282 10      
  F 02/22/19   CPT Coding Verification 5      
7 M 02/25/19 Ch 8 "HCPCS Level II Coding" Read chapter/watch Tegrity video   3 1 3/5/2019
  T 02/26/19   Exercises 8.1-8.2 5      
  W 02/27/19   Review pp. 296-298 10      
  R 02/28/19   Review continued        
  F 03/01/19   Review continued        
8 M 03/04/19 Ch 9 "CMS Reimbursement Methodologies" Discussion 2 (Initial) 5 3 1 3/19/2019
  T 03/05/19   Ch 9 Data Reports (eCampus) 5      
      Ch 9 MS-DRGs (eCampus) 5      
      Review pp. 331-333 5      
  W 03/06/19 Ch 10 "Coding Compliance, CDI,  Read chapter/watch Tegrity video        
    Coding for Medical Necessity" Exercises 10.1 - 10.6 5      
  R 03/07/19   Review pp. 373-378 5      
      Discussion 2 (Reply)        
  F 03/08/19 Exam 2 (Ch 6-10) Exam 2 (Ch 6-10)  100      
  M 03/11/19 College Closed          
  T 03/12/19 College Closed          
  W 3/13/19 College Closed          
  R 03/14/19 College Closed          
  F 03/15/19 College Closed          
9 M 03/18/19 Ch 11 "CMS-1500 and UB-04 Claims" Read chapter/watch Tegrity video   3 1 3/26/2019
      Exercise 11.1 and UB-04 Case Study 5      
  T 03/19/19   Ch 11 Review 5      
  W 03/20/19 Ch 12 "Commercial Insurance" Read chapter/watch Tegrity video        
  R 03/21/19   Exercise 12.1 Case Study - Mary S. Patient p. 428 5      
      Exercise 12.2 Case Study - Mary S. Patient p. 430 5      
      Exercise 12.3 Case Study - Mary S. Patient p. 432 5      
      Exercise 12. 4 Case Study - Mary S. Patient p. 434 5      
  F 03/22/19   Ch 12 Review pp. 437-439 5      
10 M 03/25/19 Ch 13 "BlueCross Blue Shield" Read chapter/watch Tegrity video  Discussion 3 (Initial) 5 3 1 4/2/2019
  T 03/26/19   Exercise 13.1 (BCBS claim) 5      
      Case Study - Mary S. Patient p. 456        
  W 03/27/19   Exercise 13.2 (BCBS Primary & Secondary 5      
      Case Study - Mary S. Patient p. 456        
      Exercise 13.3 (BCBS secondary - not primary) 5      
      Case Study - Janet B. Cross p. 461        
       Discussion 3 (Reply)        
  R 03/28/19   Review pp. 464-465 5      
  F 03/29/19 Exam 3 (11-13) Exam 3 (Ch 11-13) 100      
11 M 04/01/19 Ch 14 "Medicare" Read chapter/watch Tegrity video   3 1 4/9/2019
  T 04/02/19   Exercise 14.1 (Medicare Secondary) pp. 494-495 5      
      Exercise 14.2 (Medicare Primary) 5      
      Case Study - Mary S. Patient p. 503        
  W 04/03/19   Exercise 14.3 (Medicare/Medigap) 5      
      Case Study - John Q Public p. 501        
      Exercise 14.4 (Medicare/Medicaid Crossover) 5      
      Case Study - Mary S. Patient p. 503        
  R 04/04/19   Exercise 14.5 (Medicare Secondary) p. 510 5      
      Case Study - Jack L Neely p. 511        
  F 04/05/19   Review pp. 517-518 5      
12 M 04/08/19 Ch 15 "Medicaid" Read chapter/watch Tegrity video   3 1 4/16/2019
  T 04/09/19   (Medicaid as Primary)        
      Case Study - John Q. Public, p. 535 5      
      Case Study - Patient, Mary S, p. 537 5      
  W 04/10/19   (Medicaid as Secondary        
      Case Study - Jennifer Connelly, p. 540 5      
  R 04/11/19   (Medicaid mother/baby claims)        
      Case Study - Newborn Muracek, p. 543 5      
      (SCHIP claim)        
      Case Study - Edgar Vasquez, p. 546 5      
  F 04/12/19   Ch 15 Review pp. 549-pp.550 5      
13 M 4/15/19 Course Project   100 3 1 4/23/2019
  T 04/16/19 Course Project          
  W 04/17/19 Course Project          
  R 04/18/19 Course Project          
  F 04/19/19 College Closed          
14 M 04/22/19 Ch 16 "TRICARE" Read chapter/watch Tegrity video   3 1 4/30/2019
  T 04/23/19   (TRICARE as Primary)        
      Case Study - Mary S. Patient, p. 573 5      
  W 04/24/19   (TRICARE as Secondary)        
      Case Study - John R. Neely, p. 575 5      
  R 05/25/19   (TRICARE with supplemental)        
      Case Study - Mary S. Patient, p. 573 5      
  F 04/26/19   Ch 16 Review, pp. 581-582 5      
15 M 04/29/19 Ch 17 "Workers' Compensation" Read chapter/Watch Tegrity video Discussion 4 (Initial) 5     5/3/2019
  T 04/30/19   Case Study - John Q. Public, p. 601  5      
  W 05/01/19   Case Study - Mary S. Patient p. 603 5 3 1  
  R 05/02/19   Discussion 4 (reply)        
      Ch 17 Review, pp. 606-607 5      
  F 05/03/19 Exam 4 (14-17) Exam 4 (14-17) 80      
16 M 05/06/19   Finals 200 3 1  
  T 05/07/19 Final Exam (1-17) Finals        
  W 05/08/19   Finals (Due at 12:00 noon)       5/8/2019
    GRADUATION          
    Grades Due          
Total Points       1000 48 16  
Course calendar and related activities
When Topic Notes
WECM table
 
CIP Rubric Number Course Title Status Semester Credit Hrs Min Cont Hrs Max Cont Hrs
51.0713 HITT 2340 Advanced Medical Billing and Reimbursement Active 3 64 96