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Outcomes
As a result of successful completion of this course, the student will be able to:
- List the industry based certifications for Insurance Billing Specialists.
- Investigate types of jobs/careers available for Insurance Billing Specialists.
- Describe the differences in benefits and billing requirements in the types of health insurance plans available including group plans, individual, private, and government-sponsored policies.
- List the purposes and types of health insurance plans available, giving examples of each.
- Explain the importance of correlating accurate diagnostic (ICD) and procedural coding (CPT) in processing insurance claim forms to receive prompt payment of benefits.
- Describe in detail the procedure for completing CMS-1500 standard insurance claim forms with accuracy, legibility, and confidentiality.
- Explain benefits/procedures and answer patient/client questions concerning insurance claims/benefits as a component of patient education.
- Complete the Universal Health Insurance claims form (CMS-1500).
- Submit Medicare claims electronically.
Required Textbooks
Green, Michelle. Understanding Health Insurance: A Guide to Billing and Reimbursement. 12th Edition bundled with MindTap. Cengage Publisher
This must be a new book or at least purchase the MindTap Access code from Cengage which has the e-book in the access.
Coding Manuals from BOTH 1240 & 1250 will be used.
Additional Materials/Resources
1. Since this is an online course, you will need to have reliable access to an online connection, as well as the browser of your choice.
2. You may need to access YouTube videos, so you must have the capability to play those.
3. You must have access to Adobe Reader – If you need to download this free software: www.adobe.com
4. You will need to use the Canvas Learning Management System located on the CLTCC homepage. You may want to watch the introduction to Canvas videos provided on the CLTCC homepage if you have not used Canvas before.
5. You may want to upload videos for some of the assignments—a suggestion, not a requirement. If your cell phone has the capability to create videos, then you have all you need.
6. All students of CLTCC have access to computer labs at the local campus level, and these are available during normal office hours. Also, faculty and staff at the local campus are available to help in any way possible.
TECHNICAL SUPPORT:
● Canvas Help: At the bottom left-hand side of the Canvas screen is a Help button.
● MindTap: Issues with MindTap and access codes are provided by Cengage Learning and located in the MindTap Access Instructions Module in Canvas.
● Links to CLTCC Student Support can be found on College Homepage (www.CLTCC.edu) under Current Student
Support for course work will be provided by instructor:
Grading Criteria
A = 90-100;
B = 80-89;
C = 70-79;
D = 60-69;
Below 60 = F
Grading Scale
| 100-90 |
A |
| 89-80 |
B |
| 79-70 |
C |
| 69-60 |
D |
| 59-below |
F |
Assessments
All chapter assignments, exams and SimClaim submissions will be through MindTap and open book, but the exams will be timed. All MindTap activities and exams are graded immediately and the grades are automatically integrated into Canvas where the % is broken down and is reflected in your total score in Canvas.
(Chapters 6, 7, 8 and 10 will not be covered.)
Exams = 30 %
There will be 13 multiple choice exams in MindTap, the point values will vary based on the chapter. Total points are 374.
Assignments = 30%
There will be 13 Learning Labs MindTap associated with each covered chapter. The learning labs are interactive instruction videos. The point value will be a total of 1300 as each is 100 points.
There will also be one file submission assignment worth 30 pts.
SimClaim (CMS 1500) Forms = 40%
There will be 20 insurance claim forms required to be completed in MindTap based on information in the book in Appendix A. Total points = 2000 as each is 100 points
Guidelines for Late Work:
As all assignments and quizzes are open after the first week of class (with established due dates), there will be no late work accepted without a valid doctor’s excuse covering a week absence or hospital stay of more than 2 days.
Course Outline
Canvas Student Orientation Submit Assignment due by 11:59pm
Discussion Board: Job Search Findings due by 11:59pm
Upload Document on Career Search due by 11:59pm
Apply Yourself: Learning Lab 1 due by 11:59pm
Apply Yourself: Learning Lab 2 due by 11:59pm
Test Yourself (Chapter 1) due by 11:59pm
Test Yourself (Chapter 2) due by 11:59pm
Apply Yourself: Learning Lab 3 due by 11:59pm
Test Yourself (Chapter 3) due by 11:59pm
Apply Yourself: Learning Lab 4 due by 11:59pm
Test Yourself (Chapter 4) due by 11:59pm
Test Yourself (Chapter 5) due by 11:59pm
Apply Yourself: Learning Lab 5 due by 11:59pm
Apply Yourself: Learning Lab 9 due by 11:59pm
Test Yourself (Chapter 9) due by 11:59pm
Apply Yourself: Learning Lab 11 due by 11:59pm
Test Yourself (Chapter 11) due by 11:59pm
SimClaimTM Case 1-1 due by 11:59pm
Apply Yourself: Learning Labdue by 11:59pm
Apply Yourself: SimClaimTM Case 1-2 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-3 due by 11:59pm
Test Yourself (Chapter 12) due by 11:59pm
Test Yourself (Chapter 13) due by 11:59pm
Apply Yourself: Learning Lab due by 11:59pm
Apply Yourself: Learning Lab due by 11:59pm
Apply Yourself: SimClaimTM Case 1-10 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-4 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-5 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-6 due by 11:59pm
Appy Yourself: Learning Lab due by 11:59pm
Test Yourself (Chapter 14) due by 11:59pm
Apply Yourself: SimClaimTM Case 1-7 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-8 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-9 due by 11:59pm
Test Yourself (Chapter 15) due by 11:59pm
Apply Yourself: SimClaimTM Case 1-11 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-12 due by 11:59pm
Apply Yourself: SimClaimTM Case 1-13 due by 11:59pm
Test Yourself (Chapter 16) due by 11:59pm
Apply Yourself: Learning Lab
Apply Yourself: SimClaimTM Case 1-14
Apply Yourself: SimClaimTM Case 1-15
Apply Yourself: SimClaimTM Case 1-16
Apply Yourself: SimClaimTM Case 1-17
Test Yourself (Chapter 17)
Apply Yourself: SimClaimTM Case 1-18
Apply Yourself: SimClaimTM Case 1-19
Apply Yourself: SimClaimTM Case 1-20
ATTENDANCE
Students must be officially enrolled in any course that they attend. It is expected that students will attend scheduled classes regularly and on time. If an absence occurs, it is the responsibility of the student to make up all missed work, if approved by the instructor. Students who stop attending a course and do not officially withdraw will receive grades of “0” for all work missed and will result in a punitive final grade. This policy shall be superseded by any more stringent attendance policy required by a regulatory or licensing body having jurisdiction over program requirements. Attendance will be tracked and maintained for various reporting purposes.
CLASS WITHDRAWAL POLICY
The deadline for dropping a class is published each semester on the CLTCC website in the academic calendar. A student who officially withdraws from a class prior to the designated date will receive a grade of “W” in that class. Any student who receives financial aid and withdraws from any or all classes is subject to repaying a portion of the funding received.
ACADEMIC HONESTY
The faculty of Central Louisiana Technical College supports the concept of academic honesty. The teaching faculty encourages academic honesty in all classes and we require academic honesty from all students. All students are expected to maintain honesty and integrity when completing all academic assignments and examinations. Plagiarism, cheating, and other forms of academic dishonesty will not be tolerated. Any student found guilty of such dishonorable acts in academic work will receive a “0” for the work presented. The instructor may also refer the student to the appropriate administrator for further disciplinary actions, which could result in an “F” in the course, dismissal from the course, or dismissal from the college.
STUDENT CODE OF CONDUCT
Students will be suspended for actions detrimental to the welfare of other students, instructors, staff, and the campus. These actions include, but are not limited to: Firearms and/or weapons, alcoholic beverages, and illegal drugs will not be permitted on campus. Profanity and fighting are strictly prohibited. Smoking or use of any other tobacco products is prohibited. Students must not eat or drink beverages in classrooms or labs. Vandalism will not be permitted on campus. Dishonesty will not be tolerated under any circumstances. Students who cheat, or aid in the act thereof, may be dismissed from campus. Students must display a respectable attitude and behavior toward instructor and other students. The college has a Zero Tolerance Policy, meaning the campuses should be completely free of threats and assaults to ensure the highest standard of safety for all faculty, staff, students, and visitors on each campus. The college will take all reasonably available steps to protect all such persons from violence. Violators of the Zero Tolerance Policy will be suspended.
Title IX
Central Louisiana Technical Community College faculty and staff are committed to helping create a safe and open learning environment for all students. If you (or someone you know) have experienced any form of sexual misconduct, including sexual assault, dating or domestic violence, or stalking, know that help and support are available. The College strongly encourages all community members to act, seek support, and report incidents of sexual misconduct to the Title IX Office. Be advised that we must disclose information about misconduct as per Title IX of the Education Amendments of 1972.
If you wish to speak to a confidential employee who does not have this reporting responsibility, you can contact the Title IX Coordinator for Students at 318-487-5443 ext. 1129. If it is an ADA issue, you can contact CLTCC's ADA Coordinator for Students at 318-487-5443 ext. For more information about reporting options and resources at CLTCC and the community, visit our Title IX page. Please complete the following Incident Report by clicking here to report the incident. Under "Nature of this Report," choose Title IX or Disability Service Request regarding a Reasonable Accommodations issue.
DISCIPLINARY PROBATION
A student may be placed on disciplinary probation when campus rules and policies are disregarded. When a student is placed on disciplinary probation, the student is given a specified time to improve his/her record. If the student’s record does not show improvement, the student may be suspended for a specific time, usually a semester or more.
STUDENTS WITH DISABILITIES
The Central Louisiana Technical College complies with Section 504 and the Americans with Disabilities Act. Students with disabilities who seek accommodations must make their requests known by contacting the Disabilities Coordinator at the beginning of each semester. If a disability is identified later in the semester, a non-retroactive accommodation plan will be developed.
Course Transferability
A student should contact the institution to which he or she intends to transfer to inquire about the potential transferability of the course and to determine whether the course will count in his or her major.
Instructor Credentials
All instructors for this course meet or exceed the criteria for academic and professional preparation as required in the SACS/COC standards for accreditation.