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HC 463 Third Party Reimbursement and Risk Management
Both, Christopher G.


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

U1G 2007 GR

Faculty

Both, Christopher G.

Title

Adjunct Faculty Instructor Management/Health Care

Degrees/Certificates

MSA Human Resources Administration Central Michigan University
BS Management/HealthCare  Park University

Office Location

Grand Forks ND

Office Hours

08:00-17:00

Daytime Phone

701-772-0360

Other Phone

Cell 218-779-7697

E-Mail

christopher.both@park.edu

cboth@angio.com

Class Days

Friday

Class Time

4:45-10:05

Credit Hours

3


Textbook:
Principles of Risk Management and Insurance. 10th Edition   George E. Rejda Copy Right 2008 Pearson Education Inc.

Additional Resources:

McAfee Memorial Library - Online information, links, electronic databases and the Online catalog. Contact the library for further assistance via email or at 800-270-4347.
Career Counseling - The Career Development Center (CDC) provides services for all stages of career development.  The mission of the CDC is to provide the career planning tools to ensure a lifetime of career success.
Park Helpdesk - If you have forgotten your OPEN ID or Password, or need assistance with your PirateMail account, please email helpdesk@park.edu or call 800-927-3024
Resources for Current Students - A great place to look for all kinds of information http://www.park.edu/Current/.


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, reading, discussion, quizzes and examinations

Learning Outcomes:
  Core Learning Outcomes

  1. Describe the various forms of third party payment mechanisms for health care services.
  2. Define the various types of risk exposure that health care providers are confronted with in today's real world environment.
  3. Differentiate between the various third party payers and identify the most important aspects of each different payer's payment process.
  4. Formulate basic corrective or preventive measures for the various types of risk exposure health care providers must deal with on a day-to-day basis.
  5. Evaluate the loss prevention measures utilized by health care providers.
  6. Select the most appropriate payment methodology for a health care institution's services to ensure the maximum financial benefit to that institution.
  7. Determine the appropriate cost containment measures to be used by a health care provider.
  8. Recommend an appropriate operational response for the common compliance issues faced by health care providers in today's regulatory environment.


Core Assessment:

Class Assessment:
Discussion, Homework questions, Weekly Quizzes and a mid term and final exam

Grading:

Course Grading Scale   A = 94 to 100 %
                                    B = 87 to 93 %
                                    C =  80 to 86 %
                                    D = 73 to 79 %
                                    F = 72 % or lower
 Mid term test 200 points Final Test 200 points  Homework: 400 points (50 per week) Quizzes: 120 points (20 per week) Total points 920
 
 Submission of Late Work:  Late work will be evaluated on a case - by - case basis. Proctored final examination - A computerized examination will be taken in a proctored testing environment during the 8th (or 16th) week at one of the Park University sites around the country or at an alternative location.  For proctored examinations, photo identification is required at the time of the test.  Guidelines for selecting an acceptable proctor can be found on the Park University Website.   Other Information on proctored exams: - It will be the responsibility of the student to arrange for a proctor, by the 6th week of the term, who is accepted and approved by the course instructor.   - Approval of proctors is the discretion of the Online instructor.   - A proctor request form will be made available to you during the first week of class so that you can send your requested proctor to your instructor for approval.   -  Failure to take a final proctored exam (or submit your final project for some online graduate courses) will result in an automatic "F" grade.   - Some Graduate Online courses may not require a proctored Final Examination. A final proctored examination will be taken in a proctored testing environment during the 8th (or 16th) week at one of the Park University sites around the country or at an alternative location.  For proctored examinations, photo identification is required at the time of the test.  Guidelines for selecting an acceptable proctor can be found on the Park University Website.   - Other Information on proctored exams:  It will be the responsibility of the student to arrange for a proctor, by the 6th week of the term, who is accepted and approved by the course instructor.   - Approval of proctors is the discretion of the Online instructor.   - A proctor request form will be made available to you during the first week of class so that you can send your requested proctor to your instructor for approval.   - Failure to take a final proctored exam (or submit your final project for some online graduate courses) will result in an automatic "F" grade.

All final exams will be comprehensive and will be closed book and closed notes.  If calculators are allowed, they will not be multifunctional electronic devices that include features such as: phones, cameras, instant messaging, pagers, and so forth.  Electronic Computers will not be allowed on final exams unless an exception is made by the Associate Dean.

Late Submission of Course Materials:
Late work will be evaluated on a case - by - case basis.

Classroom Rules of Conduct:
 #1: Attend Class if you can't make it notify me ahead of time if possible.  #2:  Participate/Communicate: If you are experiencing any confusion over course material, that is preventing you from completing your assignments, or general questions about the course, let me know.       If you have questions about any of these policies, please contact your instructor for clarification.

Course Topic/Dates/Assignments:

The class work for each week will tie into a core learning objective (CLO). The assignments are listed in each week in the on-line classroom After the week listed below is an identifier linking it to a core learning objective for the course such as CLO #1 will link that weeks assignment to learning objective #1 and so on.
Week 1: CLO #1 and CLO #2
Week 2: CLO #3
Week 3: CLO #5
Week 4: CLO #4
Week 5: CLO #6
Week 6: CLO # 7 and CLO #8
Week 7: CLO # 1-8
Week 8: CLO # 1-8

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 2006-2007 Undergraduate Catalog Page 87-89

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 2006-2007 Undergraduate Catalog Page 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 "W".
  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 2006-2007 Undergraduate Catalog Page 89-90

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 .



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Copyright:

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Last Updated:4/13/2007 11:07:33 AM