HC463 Third Party Reimburse & Risk Mgt

for S2LL 2013

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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.




S2LL 2013 LR


Oates, Terri T.


Adjunct Faculty


BS Business Administration-Philander Smith College
MS Human Resource Training & Development-Amberton University

Office Location


Office Hours


Daytime Phone

(501) 912-2082

Other Phone

(501) 568-5569




Semester Dates

March 18-May 12, 2013

Class Days


Class Time

5:00pm - 10:00 PM



Credit Hours



Principles of Risk Management & Insurance, 11th Edition; George E. Rejda; Prentice Hall.

Textbooks can be purchased through the MBS bookstore

Textbooks can be purchased through the Parkville Bookstore

Additional Resources:

The internet will be needed in order to complete some homework/classwork assignments.

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. 

Educational Philosophy:

The instructor's educational philosophy is one of interactiveness based on lectures, readings, quizzes, writings, team collaborations, exams, and assignments,.  The instructor will encourage each student to explore new ideas and examine different view points.

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:

Articles, Homework, Mid-term, Final Exam, Group project,  Participation   (may change if necessary)



200 points


100 points (4 @25 pts each)

Group Project

150 points

Midterm Exam

200 points

Final Exam

250 points


100 points


1000 points

Grading Scale

900 - 1000 points= A; 800-899 points= B; 700-799 points= C; 600-699 points= D; 599 points or below= F

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:

All assignments are considered late if not turned in at the beginning of each class. Late assignments will be deducted 5 points each day it is late. Friday is the last day to have the assignment turned in or zero points will be awarded.

Classes missed for legitimate reasons (illness, temporary duty, etc) 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.

Classroom Rules of Conduct:

Each student is expected to be on time, and present for the entire class (roll will be taken at the beginning and end of class).

Students are expected to act in a mature and appropriate manner at all times and must be respectful of one another.

Cell phones are expected to be turned on vibrate so as not to disturb the class.  Use of cell phones is only allowed during break time unless an emergency occurs.



Course Topic/Dates/Assignments:

Week 1

March 18

Chapters 1-4

Discussion, Assignment,

Project Info

Week 2

March 25

Chapters 5-8

Discussion, Assignment,

Article 1 due

Week 3

April 1

Chapters 9-12

 Discussion, Assignment,

Article 2 due

Week 4

April 8

Chapters 13-16

Discussion, Assignment,

Mid-term review,

Week 5

April 15

Chapters 17-19

Mid-term exam, Assignment

Week 6

April 22

Chapters 20-24

Discussion, Assignment,

Article 3 due, Group Project due

Week 7

April 29

Chapters 25-27

Final exam review,

Article 4 due

Week 8

May 6

Final exam

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 2012-2013 Undergraduate Catalog Page 97

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 2012-2013 Undergraduate Catalog Page 95

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 2012-2013 Undergraduate Catalog Page 98

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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Last Updated:3/1/2013 1:08:49 PM