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HC 463 Third Party Reimbursement and Risk Management
Sims, Phillip L.


Mission Statement: The mission of Park University, an entrepreneurial institution of learning, is to provide access to academic excellence, which will prepare learners to think critically, communicate effectively and engage in lifelong learning while serving a global community.

Vision Statement: Park University will be a renowned international leader in providing innovative educational opportunities for learners within the global society.

Course

HC 463 Third Party Reimbursement and Risk Management

Semester

S1B 2006 BL

Faculty

Sims, Phillip L.

Title

adjunct faculty

Degrees/Certificates

BA
MA

Other Phone

915-204-8985

E-Mail

psims@park.edu

psims@elp.rr.com

Semester Dates

31 July to 20 September 2006

Class Days

-M-W---

Class Time

5:00 to 7:30 PM

Credit Hours

3


Textbook:
Principles of Risk Management and Insurance, 9th Edition, G. Rejda, Addison-Wesley Publications, 2005

Additional Resources:
None


Course Description:
Public and private insurance, case management, preferred provider  organizations, health maintenance organizations, and other forms of third  party payment for health care services.  Loss prevention for the health care  organization through risk management and cost containment.  3:0:3

Educational Philosophy:
Lecture/discussion, examinations.

Class Assessment:
Examinations, research papers, research presentations.

Grading:
Mid-term exam                        30%
Final exam                           30%
Research paper                       30%
Paper presentation                   10%

Late Submission of Course Materials:
The research paper must be typewritten and submitted at the last lecture prior to the final examination (9-13) unless previously coordinated with the instructor. Late
papers will not be accepted and will be marked down one letter grade.

Classroom Rules of Conduct:
Students are expected to come to all classes and be on time. Roll will be checked at each class meeting. Classes missed for legitimate reasons, such as illness,temporary duty, are excusable; however, the student must make up the missed work. The student is responsible for providing the instructor with justification for an excused absence either prior to or immediately after the absence. Two unexcused absences are excessive and three unexcused absences will result in an involuntary withdrawal and a grade of “F” (attendance) for the course

Course Topic/Dates/Assignments:
7-31 Administrative announcements, discussion of the syllabus, lecture/discussion on history and types of health insurance. Chapters 1 & 2. Risk in our society. Insurance and risk.

8-2  Discuss Chapter 3. Introduction to risk management.

8-7  Discuss Chapters 4 and 5. Advanced topics in risk management. Fundamental legal topics.

8-9  Discuss Chapters 6 and 7. Analysis of insurance contracts. The liability risk.

8-14 Discuss Chapters 8 and 9. Homeowners insurance, sections I and II.

8-16 Discuss Chapters 10, 11, and 12. Automobile insurance and society. Other property and liability insurance.

8-21 Discuss Chapters 13 and 14. Commercial property insurance and commercial liability insurance. Review for the mid-term examination.

8-23 Mid-term examination, chapters 1 through 14.

8-28 Discuss Chapters 15 and 16. Crime insurance and surety bonds. Fundamentals of
life insurance.

8-30 Discuss Chapters 17, 18, and 19. Types of life insurance. Life insurance contractual provisions. Buying
Life insurance. Student presentations.
         
9-4  Discuss Chapters 20, 21, and 22. Annuities and IRAs. Individual health insurance. Employee benefits. Student presentations.

9-6  Discuss Chapters 23 and 24. Retirement plans. Social insurance. Student presentations.

9-11 Discuss Chapters 25 and 26. Types of insurers. Insurance company operations. Student presentations.

9-13 Discuss Chapters 27 and 28. Insurance pricing. Government regulation of insurance. Student presentations. Review for the final examination.

9-18 Final examination. Chapters 15 through 28.

9-20 Review of the final examination. Make-up student presentations

Academic Honesty:
Academic integrity is the foundation of the academic community. Because each student has the primary responsibility for being academically honest, students are advised to read and understand all sections of this policy relating to standards of conduct and academic life.   Park University 2005-2006 Undergraduate Catalog Page 85-87

Plagiarism:
Plagiarism involves the use of quotations without quotation marks, the use of quotations without indication of the source, the use of another's idea without acknowledging the source, the submission of a paper, laboratory report, project, or class assignment (any portion of such) prepared by another person, or incorrect paraphrasing. Park University 2005-2006 Undergraduate Catalog Page 85-87

Attendance Policy:
Instructors are required to maintain attendance records and to report absences via the online attendance reporting system.

  1. The instructor may excuse absences for valid reasons, but missed work must be made up within the semester/term of enrollment.
  2. Work missed through unexcused absences must also be made up within the semester/term of enrollment, but unexcused absences may carry further penalties.
  3. In the event of two consecutive weeks of unexcused absences in a semester/term of enrollment, the student will be administratively withdrawn, resulting in a grade of "WH".
  4. A "Contract for Incomplete" will not be issued to a student who has unexcused or excessive absences recorded for a course.
  5. Students receiving Military Tuition Assistance or Veterans Administration educational benefits must not exceed three unexcused absences in the semester/term of enrollment. Excessive absences will be reported to the appropriate agency and may result in a monetary penalty to the student.
  6. Report of a "F" grade (attendance or academic) resulting from excessive absence for those students who are receiving financial assistance from agencies not mentioned in item 5 above will be reported to the appropriate agency.

Park University 2005-2006 Undergraduate Catalog Page 89

Disability Guidelines:
Park University is committed to meeting the needs of all students that meet the criteria for special assistance. These guidelines are designed to supply directions to students concerning the information necessary to accomplish this goal. It is Park University's policy to comply fully with federal and state law, including Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, regarding students with disabilities. In the case of any inconsistency between these guidelines and federal and/or state law, the provisions of the law will apply. Additional information concerning Park University's policies and procedures related to disability can be found on the Park University web page: http://www.park.edu/disability .

Copyright:

This material is protected by copyright and can not be reused without author permission.

Last Updated:7/6/2006 11:05:29 AM