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HC 463 Third Party Reimburse & Risk Mgt
Vanderlinden, Jennifer L.


Mission Statement: Park University provides access to a quality higher education experience that prepares a diverse community of learners to think critically, communicate effectively, demonstrate a global perspective and engage in lifelong learning and service to others.

Vision Statement: Park University, a pioneering institution of higher learning since 1875, will provide leadership in quality, innovative education for a diversity of learners who will excel in their professional and personal service to the global community.

Course

HC 463 Third Party Reimburse & Risk Mgt

Semester

F2L 2011 WT

Faculty

Vanderlinden, Jennifer L.

Title

Adjunct Instructor

Degrees/Certificates

Masters of Business Administration-William Woods University
Bachelor of Science in Nursing-University of Missouri-Kansas City

Office Location

Whiteman Campus Center

Office Hours

TBD and/or by appointment

Other Phone

(660)287-4414

E-Mail

jennifer.vanderlinden@park.edu

jennievanderlinden@yahoo.com

Semester Dates

October 17, 2011-December 11, 2011

Class Days

--T--Th

Class Time

4:55 - 7:35 PM

Credit Hours

3


Textbook:

 George E. Rejda, Addison-Wesley Publications, 2011, Principles of Risk Management and Insurance.  11th ed.  ISBN 978-0-13-611702-5 or ISBN 0-13-611702-3

Textbooks can be purchased through the MBS bookstore

Textbooks can be purchased through the Parkville Bookstore

Additional Resources:

Publication Manual of the American Psychological Association (APA).  6th Edition.

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:
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:

The facilitator's educational philosophy is one of interactiveness based upon lectures, readings, quizzes, dialogs, examinations, internet, videos, web sites and writings.  The facilitator will engage each learner in contemplative, debate-style learning to encourage the lively exploration of ideas, issues and contributions.

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.


  Instructor Learning Outcomes
  1. Understand relationship between managing risk and optimizing revenue sources.
Core Assessment:

Class Assessment:

  1. Students are responsible for the completion of all reading and assignments prior to class.
  2. The content of this course will include practical exercises, case studies, lecture, classroom discussion, and pop quizzes.
  3. Written work assignments must contain appropriate formatting, grammar and spelling.
  4. Exams:  midterm and final examination.
  5. Research paper:  written and oral presentation.
  6. The instructor reserves the option to assign more or less points based upon classroom participation.
  7. Complete a student opinion survey form located in the Distance Learning section of the Park University website in week 8 of this class.
  8. This syllabus may be revised at the discretion of the instructor without the prior notification or consent of the student. 
  9. The instructor reserves the right to add, delete, or modify any weeks of this schedule.  Any changes will be announced prior to class. 
  10. The grading plan below presents an approximate expectation of course progress.

Grading:

30% (150 points) Midterm examination
30% (150 points) Final examination
20% (100 points) Research paper
10% (50 points) Student presentation of research paper
10% (50 points) Completion of weekly assignments consisting of assigned case application questions, review questions, and/or applications question and other assignments as applicable will be due in hard copy to instructor at beginning of class.
 
A=90-100%   (450-500 points)
B=80-89%     (400-449.5 points)
C=70-79%     (350-399.5 points)
D=60-69%     (300-349.5 points)
F=59 and <    (299.5 or < points)
 
 

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 assignments will not be accepted unless prior arrangements have been made with the instructor.

Classroom Rules of Conduct:

1.  Class participation is required. 
2.  Students are expected to be prepared for the lesson as outlined or as assigned in syllabus.
3.  Forty (40) hours of contact time are required for satisfactory completion of each course.  Faculty are required to provide forty (40) hours of contact time and students are expected to receive forty (40) hours of instruction. 
4.  Students are expected to arrive on time and stay for the whole class.  Roll will be taken and documented each class session.
5.  Classes missed for legitimate reasons (illness, family member, work assignments, TDY, or deployment) are excusable; however, students must inform the instructor or the University office prior to the absence and must make up missed coursework.  Missed classes due to taking ordinary leave or vacation are not considered excused absences.
6.  Students are responsible for the content of classroom presentations.  If absent, students must obtain class notes from another student.
7.  Instructor will post power point presentations, or other notes, as applicable on the eCompanion site at www.parkonline.org no later than midnight the Sunday following the class.
8.  Students are expected to act in a mature and appropriate manner at all times and must be respectful of one another.
9.  Cell phones are expected to be turned off or on vibrate so as not to disturb the class.  Use of cell phones is only permitted during breaks.
10. Laptops and other electronic devices must be approved by instructor prior to use in class.
11. Questions and comments pertaining to class material are encouraged.  It is likely someone else may have the same question.  Your question or comment may spark a discussion which is when really great learning may take place.

Course Topic/Dates/Assignments:

Week 1  Review syllabus. Read chapters 1, 2, 3, 4.  At end of each chapter complete all case study questions.  Complete review questions:  Chapter 1 questions 1abc,  2b, 3b, 6ab;  Chapter 2 questions 1abcd, 5, 8;  Chapter 3 questions 1, 3, 8ab 10ab;  Chapter 4 question 1. 
Week 2  Read chapters 5, 6, 7, 8, 9.  Complete case study questions.  Complete review questions as assigned.
Week 3  Midterm exam review.  Read chapters 10, 11, 12, 13, 14.  Complete case study questions.   Complete review questions as assigned.  Inform instructor of topic for research paper.
Week 4  Midterm exam.  Read chapters 15, 16, 17.  Research outline draft due.
Week 5  Read chapters 18, 19, 20, 21.  Complete case study questions.   Complete review questions as assigned.
Week 6  Read chapters 22, 23, 24, 25.  Complete case study questions.   Complete review questions as assigned.
Week 7  Read chapters 26, 27.  Final exam review.  Student presentations and research paper due.  Complete case study questions.
Week 8  Final exam.  Remaining presentations (if any).

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 2011-2012 Undergraduate Catalog Page 93

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 2011-2012 Undergraduate Catalog Page 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.

Park University 2011-2012 Undergraduate Catalog Page 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:

1.  Unapproved class tardiness or absenteeism may affect your final grade.

2.  The University policies are provided in the current course catalog and available in the University's website.  This class is governed by the university policies.

3.  Students must attend the first class session.

4.  Students must have the text book at the first class session.

Copyright:

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

Last Updated:9/15/2011 10:54:49 PM