Jul 06, 2022  
College Catalog 2021-2022 
    
College Catalog 2021-2022 [ARCHIVED CATALOG]

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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.

Billable Contact Hours: 3

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OUTCOMES AND OBJECTIVES
Outcome 1: Upon completion of this course, student will be able to define bookkeeping terms.

Objectives:

  1. Define:
    1. Charges
    2. Payments
    3. Accounts receivable
    4. Accounts payable
    5. Adjustments
  2. Describe banking procedure as related to the ambulatory care setting
  3. Identify precautions for accepting the following types of payments:
    1. Cash
    2. Check
    3. Credit card
    4. Debit card
  4. Describe types of adjustments made to patient accounts including:
    1. Non-sufficient funds (NSF) check
    2. Collection agency transaction
    3. Credit balance
    4. Third party
  5. Identify types of information contained in the patient’s billing record
  6. Explain patient financial obligations for services rendered

Outcome 2: Upon completion of this course, student will be able to perform accounts receivable procedures.

Objectives:

  1. Perform accounts receivable procedures to patient accounts including posting:
    1. Charges
    2. Payments
    3. Adjustments
  2. Prepare a bank deposit
  3. Obtain accurate patient billing information
  4. 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:

  1. Identify:
    1. Types of third party plans
    2. Information required to file a third party claim
    3. The steps for filing a third party claim
  2. Outline managed care requirements for patient referral
  3. Describe processes for:
    1. Verification of eligibility for services
    2. Precertification
    3. Preauthorization
  4. Differentiate between fraud and abuse
  5. Interpret information on an insurance card
  6. Verify eligibility for services including documentation
  7. Obtain precertification for preauthorization including documentation
  8. Complete an insurance claim form

Outcome 4: Upon completion of this course, student will be able to identify procedural and diagnostic coding:

Objectives:

  1. Describe how to use the most current procedural coding system
  2. Describe how to use the most current diagnostic coding classification system
  3. Describe how to use the most current HCPCS level II coding system
  4. Discuss the effects of
    1. Upcoding
    2. Downcoding
  5. Define medical necessity as it applies to procedural and diagnostic coding
  6. Perform procedural coding
  7. Perform diagnostic coding
  8. Utilize medical necessity guidelines

COMMON DEGREE OUTCOMES (CDO)
• Communication: The graduate can communicate effectively for the intended purpose and audience.
• Critical Thinking: The graduate can make informed decisions after analyzing information or evidence related to the issue.
• Global Literacy: The graduate can analyze human behavior or experiences through cultural, social, political, or economic perspectives.
• Information Literacy: The graduate can responsibly use information gathered from a variety of formats in order to complete a task.
• Quantitative Reasoning: The graduate can apply quantitative methods or evidence to solve problems or make judgments.
• Scientific Literacy: The graduate can produce or interpret scientific information presented in a variety of formats.

CDO marked YES apply to this course:
Communication: YES
Critical Thinking: YES
Global Literacy: YES
Information Literacy: YES
Quantitative Reasoning: YES
Scientific Literacy: YES

COURSE CONTENT OUTLINE

  1. Bookkeeping terms
  2. Accounts receivable procedures
  3. Third party reimbursement procedures
  4. Procedural and diagnostic coding

Primary Faculty
Austin, Delena
Secondary Faculty

Associate Dean
Primeau, Paula
Dean
Mirijanian, Narine



Official Course Syllabus - Macomb Community College, 14500 E 12 Mile Road, Warren, MI 48088



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