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HC 463 Third Party Reimburse & Risk Mgt
Geyer, Christine


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 Reimburse & Risk Mgt

Semester

S2T 2011 DL

Faculty

Geyer, Christine

Title

Adjunct Faculty

Degrees/Certificates

CLU, ChFC, CEBS, RHU, MSFS, MA (English)

Office Location

online only - no campus office

Office Hours

MWF 10:30 - 11:30 a.m.

Daytime Phone

315-655-7987

E-Mail

christine.geyer@park.edu

Semester Dates

March 14 - May 8, 2011

Class Days

Online only - no class meetings

Prerequisites

None

Credit Hours

3


Textbook:

View Larger Cover Image
View Larger Image

George E. Rejda, University of Nebraska

Publisher: Addison-Wesley
Copyright: 2008 10th Edition
Format: Cloth; 747 pp

ISBN-10: 0321414934
ISBN-13: 9780321414939 Help icon

Textbooks can be purchased through the MBS bookstore

Textbooks can be purchased through the Parkville Bookstore

Additional Resources:
Articles for discussion and some assignments will be provided through the Doc Sharing area and through web links. Students are responsible for accessing, downloading and/or printing such items as needed to participate in course activities.

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/.
Advising - Park University would like to assist you in achieving your educational goals. Please contact your Campus Center for advising or enrollment adjustment information.
Online Classroom Technical Support - For technical assistance with the Online classroom, email helpdesk@parkonline.org or call the helpdesk at 866-301-PARK (7275). To see the technical requirements for Online courses, please visit the http://parkonline.org website, and click on the "Technical Requirements" link, and click on "BROWSER Test" to see if your system is ready.
FAQ's for Online Students - You might find the answer to your questions here.


Course Description:
HC463 Third Party Reimbursement and Risk Management: 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:
I believe teaching is facilitating discovery, to help students discover knowledge in ways that are meaningful and interesting to them. I believe in co-constructed learning between student and teacher whenever possible and that as a teacher I am there to guide, to assist, and to occasionally point out the pitfalls in the path.

I am interested in critical inquiry into just about any subject, and I try to share with my students the benefits of asking the meaning of words, phrases and visual images they hear and see everyday. As a student, I learned to see canonical literature in modern situation comedies, to see the formulaic nature of the evening news, and pay attention to the details in advertising. As a teacher, I attempt to share these insights and to encourage my students to ask “what does it mean” and “what would have to be true for x to happen”. I encourage them to see beyond the immediate image or sound, to be a more attentive consumer of information.

I try to help my students anticipate reception of their written work in various audiences. Whether in the academy or in the world of work, students participate in several different discourse communities. I believe it is my job to help them identify those communities, and to understand the “rules” of discourse in them. I try to show how a text produced for a friend as e-mail may not be well received as an academic paper, or how business formality differs from academic formality. At the same time, I encourage them to preserve their own voice in their writing, no matter the form. I believe if I can show them that there are differences, and help them understand how the texts they produce might be received, I can help them prepare for success in whatever community they inhabit.

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:

You will be able to track your average throughout the course. The grading scale is below. You will know in advance the standards for each assignment. My goal is to give you prompt, clear, and useful feedback to help you learn about risk management. Each student is responsible for:
 Completing weekly quizzes
   80
 Reading the weekly discussion article and posting to related discussion thread
 120
Weekly homework questions and essays. (place in Drop Box).
 120
Midterm Exam
 180
Writing a summary article on a current risk management article
   50
Completing a Research Paper on the Risk Management Process
 150
Final Exam
 300
Total
1000

    • Completing weekly quizzes consisting of true and false questions from the text             80 pts
    • Reading the weekly discussion article and posting to related discussion thread            120 pts
    • Answering the weekly homework questions and essays. (place in Drop Box)                120 pts
    • Taking the  Midterm Exam                                                                                       180 pts
    • Writing a summary article on a current risk management article                                    50 pts*
    • Completing a Research Paper on the Risk Management process.                                150 pts *
    • Completing the Final Exam                                                                                       300 pts

                                                                                                                                                __________

Total Points                                                                                                                               1000 Pts


Other Assessment Guidelines

All work must contain appropriate formatting, grammar, and spelling.

Completing a student opinion survey form located in the Distance Learning section of the Park University website in Week Eight of this class.

Locating a suitable Proctor with e-mail and Completing a Proctored Final Examination.

The final exam will be closed book and closed notes.

"All requirements for the Summary Article and Research Paper may be found in the DOCSHARING section of the course.

Grading:

Grading:

Course Grading Scale 

  A = 900-1000 points

  B = 800-899   points

  C = 700-799   points

  D = 600-699   points

  F =      0-599   points
 


BREAKDOWN 

Quizzes                          80  points
Discussion                     120 points 
Research Paper              150 points
Weekly Homework           120 points
Article Summary               50 points
Midterm Exam                 180 points
Final Exam                     300 points 
                            
Total                           1000 points


 

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.

The grade for students who pass the proctored final will be based on the overall average of homework and tests taken during the course.  The proctored final exam must address only material which the student has been taught in class.

The course grade for students will be based on the overall average of homework and tests taken during the course in accordance with the weighting of the various requirements as stated in the syllabus.

All final exams in all School of Business courses will be comprehensive and will be closed book and closed notes. They will constitute 30% of the total course grade and will not be a take-home exam. They will be completed during the test week in the period designated by the registrar or by the Proctor in the case online courses. 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 Dean of the School of Business.

Late Submission of Course Materials:

Late work is not accepted. There may be some situations where a deviation could be allowed; however, this is the exception and not the rule. In these rare occasions, late work will only be accepted on a case by case basis with instructor approval. The following applies to all late work, unless prior arrangements have been made with and approved by the instructor: All late work will be downgraded at the discretion of the instructor, up to 20 points for every day or part of a day it is late. Late work WILL NOT be accepted if it is more than 7 days late, period.  No late work will be accepted after the end of week 8. Unless all required work is submitted, the student could receive a failing grade for the course.


Classroom Rules of Conduct:

Ground Rules for Online Participation:
 
1. If you experience computer difficulties (need help downloading a browser or plug-in, you need help logging into the course, or if you experience any errors or problems while in your online course, please contact the Park Computer Center.
 
2. Back up: every piece of work you complete. This will ensure that a computer glitch, or a glitch out there in cyberspace won't erase your hard work.
 
3. Communicate: If you are experiencing any confusion over course material, technical difficulties that are not being resolved and are preventing you from completing your assignments, or general questions about the course, let me know and refer to Course Policy #1.
 
4. Please check the Announcements area in the Course Conference before you ask general course questions.  If you don't see your question there, then please post your question.  Posting them in the threaded discussion area will allow your fellow students to benefit from your questions.  And remember, there are no stupid/silly questions.  We are all here to learn!
 
5. E-Mail Procedures and Submitting General e-mail: When sending e-mail other than assignments, you must identify yourself fully by name and class in all e-mail sent to me and/or other members of our class.
 
My Response Policy: I will check my e-mail frequently. I will respond to course-related questions within 24-48 hours (unless I notify you previously that I will be unavailable).
 
6.  Late Work: Each week's work must be completed by the end of that week. No credit for work turned in after the week, unless you have contacted me beforehand and explained any "special" circumstance.
 
7.  Online Etiquette: All your online communications need to be composed with fairness, honesty and tact. Your online writings will be graded.  Here are a couple of online references that discuss writing online http://goto.intwg.com/ and netiquette http://www.albion.com/netiquette/corerules.html. If you have questions about any of these policies, please contact me for clarification.

8. This course is offered on-line, over the Internet, using the ECollege computer service. Each students is expected to devote a minimum of five hours per class week logged on to the computer conferencing system. This is same amount of time you'd spend in the physical classroom. See "Ground Rules for On-line Participation" for additional information.

9. According to Park University guidelines, this course is divided into eight weeks with the first week beginning on the first day of the semester, a Monday, and ends midnight the following Sunday. Weeks Two through Eight also begin on Monday and end on the following Sunday. Assignments scheduled for completion during a class week should be completed by the end of the week assigned, ie.,1,2,3-8. Writing assignments and formal papers should be completed and successfully emailed so that they are in by the due date.

10. Students are expected to complete 5 hours per week of conferencing or other appropriate online activities, including sending/receiving E-mail and navigating and conducting research over the World Wide Web.

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 On-line 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. 
  • Some Graduate Online courses may not require a proctored Final Examination.
 If you need help of any kind, please feel free to email or call me at the numbers included above with the syllabus.

 

Course Topic/Dates/Assignments:

Week 1                     

Read Lecture
Review Powerpoints
Read Chapters 1-2
Discussion & Case Study
Take Quiz
Homework

Week 2

Set Up Proctor
Read Lecture      
Review  Powerpoint
Read Chapters 3-4
Discussion & Case Study
Take Quiz
Homework
Research Topic Due

Week 3

Read Lecture
Review Powerpoints
Read Chapters 6 & 8
Discussion 
Take Quiz
Homework
Summary Article Due

Week 4

Read Lecture
Review Powerpoints
Read Chapters 9-10
Discussion
Take Quiz
Homework
Midterm

Week 5

Read Lecture
Review Powerpoints
Read Chapters 15-16
Discussion
Take Quiz
Homework
Check on Research Paper 

Week 6

Read Lecture                 
Review  Powerpoints
Read Chapter 18
Discussion
Take Quiz
Homework
Check on Research Paper 

Week 7

Read Lecture
Review Powerpoints
Read Chapters 19 & 24
Discussion
Research Report Check
Take Quiz
Homework
Research Paper Due

Week 8

Read Lecture
Review Notes & Powerpoint
Read Chapters 25-27
Discussion Questions
Take Quiz
Homework
Complete Final Exam

Research paper topic due by end of Week 2.
Article Summary due by Sunday of Week 3.

Proctor process needs to be completed by the end of Week 5.
The entire Research Paper will be submitted by Sunday at the end of Week Seven for grading.

(There will be opportunity for revisions in each section, based on interaction with the professor and peer reviews until the end of Week 7.)

The Final Exam must be taken under the supervision of a proctor during Week 8.
Please check your calendar dates and arrange to complete the final accordingly.



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 students and faculty members are encouraged to take advantage of the University resources available for learning about academic honesty (www.park.edu/current or http://www.park.edu/faculty/).from Park University 2010-2011 Undergraduate Catalog Page 92

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. from Park University 2010-2011 Undergraduate Catalog Page 92-93

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 "F".
  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.
ONLINE NOTE: An attendance report of "P" (present) will be recorded for students who have logged in to the Online classroom at least once during each week of the term. Recording of attendance is not equivalent to participation. Participation grades will be assigned by each instructor according to the criteria in the Grading Policy section of the syllabus.

Park University 2010-2011 Undergraduate Catalog Page 95-96

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 .

Additional Information:


Copyright:

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

Last Updated:2/25/2011 8:31:19 AM