MAST 1203 - Financial Business Practices for the Medical Office Credit Hours: 3.00 Prerequisites: HHSC 1700, HHSC 1740, and WHES 2072 all with grade C or better
Corequisites: MAST 1201 and MAST 1202
(formerly MAST 1230)
This course focuses on financial skills related to bookkeeping, accounts receivable, third party reimbursement and procedural and diagnostic coding.
Contact Hours: 3
Center Campus
OUTCOMES AND OBJECTIVES Outcome 1: Upon completion of this course, student will be able to define bookkeeping terms.
Objectives:
- Define:
- Charges
- Payments
- Accounts receivable
- Accounts payable
- Adjustments
- Describe banking procedure as related to the ambulatory care setting
- Identify precautions for accepting the following types of payments:
- Cash
- Check
- Credit card
- Debit card
- Describe types of adjustments made to patient accounts including:
- Non-sufficient funds (NSF) check
- Collection agency transaction
- Credit balance
- Third party
- Identify types of information contained in the patient’s billing record
- Explain patient financial obligations for services rendered
Outcome 2: Upon completion of this course, student will be able to perform accounts receivable procedures.
Objectives:
- Perform accounts receivable procedures to patient accounts including posting:
- Charges
- Payments
- Adjustments
- Prepare a bank deposit
- Obtain accurate patient billing information
- Inform a patient of financial obligations for services rendered.
Outcome 3: Upon completion of this course, student will be able to apply third party reimbursement procedures.
Objectives:
- Identify:
- Types of third party plans
- Information required to file a third party claim
- The steps for filing a third party claim
- Outline managed care requirements for patient referral
- Describe processes for:
- Verification of eligibility for services
- Precertification
- Preauthorization
- Differentiate between fraud and abuse
- Interpret information on an insurance card
- Verify eligibility for services including documentation
- Obtain precertification for preauthorization including documentation
- Complete an insurance claim form
Outcome 4: Upon completion of this course, student will be able to identify procedural and diagnostic coding:
Objectives:
- Describe how to use the most current procedural coding system
- Describe how to use the most current diagnostic coding classification system
- Describe how to use the most current HCPCS level II coding system
- Discuss the effects of
- Upcoding
- Downcoding
- Define medical necessity as it applies to procedural and diagnostic coding
- Perform procedural coding
- Perform diagnostic coding
- Utilize medical necessity guidelines
COMMON DEGREE OUTCOMES (Bulleted outcomes apply to the course)
- 1. The graduate can integrate the knowledge and technological skills necessary to be a successful learner.
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- 2. The graduate can demonstrate how to think competently.
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- 3. The graduate can demonstrate how to employ mathematical knowledge.
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- 4. The graduate can demonstrate how to communicate competently.
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- The graduate is sensitive to issues relating to a diverse, global society.
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COURSE CONTENT OUTLINE
- Bookkeeping terms
- Accounts receivable procedures
- Third party reimbursement procedures
- Procedural and diagnostic coding
Primary Faculty Domanke-Nuytten, Donna Secondary Faculty Associate Dean Roose, Diane Dean Mirijanian, Narine
Official Course Syllabus - Macomb Community College, 14500 E 12 Mile Road, Warren, MI 48088
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