MIC201 – Billing Systems INSTRUCTOR: Denise Cross CMA (AAMA) PHONE: 517-416-8297 (cell) Email: crossdenised@jccmi.edu For information on school closings due to inclement weather go to: http:www.jccmi.edu/info/closings.htm Pre-requisites: CIS101, MIC101, MIC150 Course Description: This course provides an introduction to the study of the billing and reimbursement processes of hospitals and ambulatory health care settings including: scheduling, registration, insurance verification, fee schedules, encounter forms, charge capturing, billing process, reimbursement process, patient payment and collections. Computer laboratory work with billing software is included. Required Textbooks and Learning Tools: Computers in the Medical Office, CIMO 8th edition, by Susan M. Sanderson- (includes Connect Plus) ISBN 978-0-07-340213-0 Online access for homework (if applicable) Other learning materials : Medical Dictionary; ICD-9-CM or ICD-10-CM books, CPT books, HCPCS Level II book Course Goals & Objectives Create and maintain patient medical records. Schedule patients using learned reasoning for the most appropriate appointment time based upon scheduling policies and availability. (ADO-7 Developing). Assign CPT, ICD-9, and HCPCS codes to office visits and surgeries, applying and mastering all applicable coding guidelines. (ADO-7 Developing). Create and submit accurate and complete insurance claim forms for private, commercial, and government payers for reimbursement. Use the Internet to research coding and billing questions, insurance carrier policies, and medical and surgical protocol, and obtain authorizations and insurance coverage and benefits. Register patients by checking them in and out of the computer system and accurately completing paperwork. Input charges and post payments received in the computer. Improve business communication skills by role-play and drafting letters and memos to patients, insurance carriers, and providers. Discuss the revenue cycle by identifying each step in the process and the responsibilities of the coder and biller. Course Requirements/Evaluation: 1. Students must attend each class session. You will fall behind quickly if you miss this class. This class includes a large “lab” component requiring use of tools and practice skills. It is your responsibility to schedule a make-up lab for missed work. If you miss more than 2 classes, you will not receive a passing grade. 2. Students are expected to conduct themselves in a professional manner and utilize lab time efficiently for practicing skills or completing assigned work. 3. MICB students are expected to adhere to the department dress code (copy attached). 4. Students are required to read the textbook and answer questions in the workbook. It is to your advantage to use the workbook as a study guide to reinforce reading from the text. 5. All assignments are expected to be turned in on time. Late assignments will not be accepted. 6. There will be tests throughout the term along with a final exam. 7. Students will be evaluated a minimum of three times per semester for Professional Behavior. Students that have not met competency by Week 14 will not receive a passing grade in the class. ** If you are absent on a test day, you will have to take a make-up test with a 10% deduction. Only 1 makeup is allowed. Grading: Your grade will be calculated based on the following percentages: 60% - Computer Simulations 30% - Written Final Exam 10% - Other (Homework, Professionalism, Participation) ** You must achieve a minimum of 2.5 overall on the lecture portion and 85% on the final competency (with a max of two attempts) in order to pass the class! If you do not achieve the required percentage on the theory (lecture) portion of the class, you must repeat the class, regardless of your total overall average for the course. Grading Scale: 4.0 100-94% 3.5 93-89% 3.0 88-85% 2.5 84-80% 2.0 79-75% 1.5 74-70% 1.0 69-65% 0.5 64-60% 0.0 below 60% Course Schedule: Assignments Additional assignments may be given that are not listed here. Weekly assignments listed under homework are taken from the text book. Homework will be checked for completion at the beginning of class and if completed, you will receive full credit. If not completed or you are late, you will receive a zero. Answers will be given in class before the test for a last minute review. WEEK 1 LECTURE In Class: Syllabus review; explanation of course policies HOMEWORK Read Chapter 1 –complete Chapter 1 Connect assignments Lecture: Chapter 1- The Medical Billing Cycle and the Use of Health Information Technology in Physician Practices Complete Ch. 1 Quiz in Connect Date: Read ahead Chapter 2 Create Connect Accounts WEEK 2 Chapter 2- Introduction to Medisoft Date: In Class: Complete chapter 2 Medisoft exercises Connect: Chapter 2 Connect Assignments Ch.2 Quiz in Connect Read Chapter 3 WEEK 3 Chapter 3- Scheduling Date: In Class: Complete Chapter 3 Medisoft exercises WEEK 4 Chapter 4- Entering Patient Information Date: Connect: Chapter 3 Connect assignments Ch. 3 Quiz in Connect Read Chapter 4 Connect: Chapter 4 Connect assignments Ch. 4 Quiz In Class: Complete chapter 4 exercises Read Chapter 5 LECTURE WEEK 5 Chapter 5- Working with Cases Date: In Class: Complete chapter 5 Medisoft exercises HOMEWORK Connect: Chapter 5 homework assignments Chapter 5 Quiz Read Chapter 6 WEEK 6 Chapter 6- Entering Charge Transactions and Patient Payments Date: Connect: Chapter 6 homework assignments Chapter 6 Quiz In Class: Chapter 6 Medisoft exercises Read Chapter 7 WEEK 7 Chapter 7- Creating Claims Date: In Class: Chapter 7 Medisoft exercises Connect: Chapter 7 homework assignments Chapter 7 Quiz Read Chapter 8 WEEK 8 Chapter 8- Posting Payments and Creating Patient Statements Date: Connect: Chapter 8 homework assignments Chapter 8 Quiz In Class: Chapter 8 Medisoft exercises Read Chapter 9 WEEK 9 Chapter 9- Creating Reports Date: In Class: Chapter 9 Medisoft exercises Connect: Chapter 9 homework assignments Chapter 9 Quiz Read Chapter 10 Week 10 Chapter 10- Collection in the Medical Office Connect: Chapter 10 homework assignments Chapter 10 Quiz In Class: Chapter 10 Medisoft exercises Read Chapter 11 Week 11 Chapter 11- Appointments and Registration Connect: Chapter 11 homework assignments Chapter 11 Quiz In Class: Chapter 11 Medisoft exercises Read Chapter 12 Chapter 12- Cases, Transactions, and Claims Connect: Chapter 12 homework assignments Chapter 12 Quiz Date: Week 12 In Class: Chapter 12 Medisoft exercises Read Chapter 13 Week 13 Chapter 13- Reports and Collections Date: In Class: Chapter 13 Medisoft exercises Connect: Chapter 13 homework assignments Chapter 13 Quiz Read Chapter 14 Week 14 Chapter 14- Putting It All Together Date: Connect: Chapter 14 homework assignments Chapter 13 Quiz In Class: Chapter 14 Medisoft exercises Prepare for final exam Week 15 Final Exam in Connect Date: Success!! DRESS CODE FOR MICB STUDENTS Your career in the medical field is one of importance and prestige. People will seek you out for help with their problems and also look to you as a representative of the health care field. You are becoming part of a team, and along with this responsibility, there are rules you will be expected to follow in the MOA courses in preparation for your career in health care. 1. You must wear the required colored scrubs for your program. MICB students can wear any color/print scrub or business casual. You can wear any colored shirt underneath, but hoodies are not allowed. Please purchase these ASAP. Clean white tennis shoes must be worn with scrubs, professional dress shoes with business casual. 2. Good personal hygiene is imperative. 3. Hair should be neat and clean. 4. NAILS MUST BE CLEAN AND NEATLY TRIMMED! You will not be allowed to keep long nails working in a medical setting due to harboring of microorganisms under the nails. Nail polish must be light or neutral shades to maintain a professional appearance. 5. Jewelry should be discreet: no dangling earrings, chains around the neck, or multiple rings on hands. A wedding/engagement ring is acceptable. 6. Use good discretion and moderation with make-up: perfumes are not allowed – no smoke smell either. 7. Gum chewing is frowned upon as it does not look professional. 8. A “Dress Code Check-Off” will be conducted twice in the term - please see attached. MICB Dress Code Check-off Name________________________________ Points________________ Area of Conduct or Dress Code Desired Uniform- Clean & pressed Yes No top & pants Program Designated Scrubs *Any scrub or bus. casual for MICB White Socks that covers ankles Yes No Yes No Clean Yes No Yes No Clean & polish Clean Yes No Yes No Clean Yes No Styled appropriately Neat; does not fall in face, or has loose ends or flyways strands Yes No Hair accessories Hair band, barrette Yes No Beard, sideburn, mustaches Clean, neat, and trimmed Yes No Facial piercing Tattoos Not allowed Not allowed; Should not be visible None None No No Yes No Necklaces Only wedding & engagement rings allowed Only one set allowed on lower lobe With second hand Simple, subtle Bracelets Not allowed Socks Shoes Shoe Laces Hair White Leather Shoes or dress shoes for business casual Not Appropriate Compliant Not worn Sling backs, sandal type, Crocs Scarves, hats, large decorative hairpieces or ornaments are not allowed Jewelry Rings Earrings Watch None worn Yes No None worn Large or choker type Yes No Yes No None worn No Comments Nails Clean Trimmed to appropriate length Polish clear or neutral color; no chipping Yes Yes No No Yes No Used appropriately; sparingly; should be natural looking Not allowed Yes None worn No Not allowed None Yes No No In full compliance Needs a few minor corrections Needs private conversation with instructor Yes Yes None worn Makeup Perfume/ Cologne Gum chewing Name Tag Original check-off Date No None worn No See below Yes Areas that need correction Comments Follow-up Corrections made Follow-up Corrections made Date Date In full compliance Yes No Needs correction In full compliance Yes No Needs correction What areas Yes What areas Yes Comments Compliance of dress code is worth 50pts. This will be conducted twice per term at the instructor’s discretion. No MICB PROFESSIONAL STANDARDS BEHAVIOR Any behavior that is distracting, disrespectful, or inconsiderate to others will not be tolerated and may result in dismissal from the course or expulsion from the College. Food is not allowed in the classroom. You are allowed to bring water or any closed drink container to classrooms, but drinks are NOT permitted in laboratories. LATE ASSIGNMENTS Assignments are due at the beginning of class. Late assignments will NOT be accepted. If you know you will be absent, please hand in homework early. MAKE-UP QUIZZES & EXAMS Only one test may be taken outside of the scheduled time with a 10% deduction. Students will receive a zero for all other missed tests. Online tests must be completed within the required time – no retakes or make-ups allowed. Students arriving late on exam/quiz days may begin the exam when they arrive, but must turn it in along with the remainder of the class. If, for example, the quiz is scheduled from 10:00-10:30, ALL quizzes will be collected at 10:30, even if you did not arrive until 10:15. CELL PHONES Cell phones must be turned OFF during class. o Students whose phone rings or vibrates during a quiz or exam will have 2% subtracted from their grade on the quiz/exam. Students making or accepting calls or text messages during class will be asked to leave. Exceptions to the phone policy will be considered by the instructor on an individual basis. HONOR CODE VIOLATIONS Students caught plagiarizing or cheating on an assignment, quiz, or exam will receive a zero for the assignment, quiz, or exam. Cheating a second time or on the final exam will result in failure of the class and could result in expulsion from the College. PARTICIPATION A large portion of your grade is based on your participation in the course. This includes adhering to the dress code, actively participating in the class, handing assignments in on time, and acting in a professional manner. If any of these course requirements are not met, participation points will be deducted at the discretion of the instructor. OTHER POLICIES The student is responsible for information and assignments given in class even if they were not present. The instructor will reconsider any question that was marked incorrect if the student can demonstrate that the answer is correct, based either on what was presented in class or in the textbook. Appeals of this nature must be made no later than the class period after the item has been returned to the student. Participation & Professionalism Behavioral Warning Name________________________________ Demonstrates Professional Conduct Non-Compliant Points________________ Comments Regarding Infraction On time to class/ Stayed entire class Verbal & nonverbal language Mannerisms Preparedness Attitude Cooperation Confidentiality Caring personality Willingness to help others Flexibility Participation is worth 10pts per week (5pts per class if two days a week, 10pts per class if one day a week). Students will receive the full ten points unless any of the above are not met. This form will only be used if deductions are made. JCC General Policies Grades: A 2.0 or "C" is a passing grade. Only courses with passing grades count toward graduation. Other colleges transfer in only courses with passing grades. Many financial aid sources, including most employers, require passing grades. Additionally, earning less than a 2.0 in a class results in not being able to participate in the next level of courses in a discipline, which requires this course as a pre-requisite. If you attempt to register for the next course sequence and have not passed the pre-requisite course, you will be dropped from that class. Academic Honesty Policy Academic honesty is expected of all students. It is the ethical behavior that includes producing their own work and not representing others' work as their own, either by plagiarism, by cheating, or by helping others to do so. Plagiarism is the failure to give credit for the use of material from outside sources. Plagiarism includes but is not limited to: Using data, quotations, or paraphrases from other sources without adequate documentation Submitting others’ work as your own Exhibiting other behaviors generally considered unethical Cheating means obtaining answers/material from an outside source without authorization. Cheating includes, but not limited to: Plagiarizing in all forms Using notes/books without authorization Copying Submitting others’ work as your own or submitting your work for others Altering graded work Falsifying data Exhibiting other behaviors generally considered unethical Collaboration While JCC encourages students to collaborate in study groups, work teams, and with lab partners, each student should take responsibility for accurately representing his/her own contribution. Consequences/Procedures Faculty members who suspect a student of academic dishonesty may penalize the student by taking appropriate action up to and including assigning a failing grade for the paper, project, report, exam, or the course itself. Instructors must document all instances of academic dishonesty beyond those of a very minor nature, in writing to the academic dean. The Office of the Academic Deans will record and track students who have been reported as having cheated. If the same student cheats in other courses, the dean will enact sanctions appropriate to level of infraction. The sanction will be selected in consultation with the involved faculty. The Dean can administer consequences up to and including suspension. Student Appeal Process: http://www.jccmi.edu/administration/deans/StudentComplaintProcess.htm Course Agreement (Student Copy) I, _______________________________, have received the syllabus for ____________________ (course name) __________________ (semester/year) and have read and understand the course requirements. I have also been told that no late work will be accepted and understand that it is my responsibility to get any homework, papers, assignments, etc. turned in at at the beginning of class or sooner. I also understand that if any work is handed in after the beginning of class or later, that I will receive a “0” grade on that assignment. I have been told and understand that if I miss more than two (2) classes TOTAL during the semester (lab or lecture) I will be given a failing grade in the class. I have been told and understand that I must complete all assignments and computer simulations to receive a passing grade in the class. If I do not meet these requirements I will be given a grade of 2.0 or my current grade in the course if my overall grade is lower than a 2.0. I have been told and understand that I must pass all items on the Affective Evaluation to receive a passing grade in the class. _________________________________ ______________ Student Date _________________________________ ______________ Witness – Program Director/Instructor Date Student Copy Course Agreement (Instructor Copy) I, _______________________________, have received the syllabus for ____________________ (course name) __________________ (semester/year) and have read and understand the course requirements. I have also been told that no late work will be accepted and understand that it is my responsibility to get any homework, papers, assignments, etc. turned in at the beginning of class or sooner. I also understand that if any work is handed in after the beginning of class or later, that I will receive a “0” grade on that assignment. I have been told and understand that if I miss more than two (2) classes TOTAL during the semester (lab or lecture) I will be given a failing grade in the class. I have been told and understand that I must complete all assignments and computer simulations to receive a passing grade in the class. If I do not meet these requirements I will be given a grade of 2.0 or my current grade in the course if my overall grade is lower than a 2.0. I have been told and understand I must pass all items on the Affective Evaluation to receive a passing grade in this class. _________________________________ ______________ Student Date _________________________________ ______________ Witness – Program Director/Instructor Date Instructor Copy