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STUDENT COURSE SYLLABUS
BERGEN COMMUNITY COLLEGE
DIVISION OF HEALTH PROFESSIONS
MEDICAL OFFICE ASSISTANT PROGRAM
COURSE NUMBER/TITLE: MOA -218, Medical Economics
COURES CREDITS: 2 Credits
CO-REQUISITE: MOA-141, Introduction to Medical Assisting
COURSE DESCRIPTION/GENERAL PURPOSE:
This course provides instruction in health care delivery systems, including Blue
Cross/Blue Shield, Medicare, Medicaid, Workers’ Compensation, CHAMPUS, Health
Maintenance organizations, and other Managed Care Plans. Other topics include
collection and billing procedures and current ethical and Medicolegal requirements and
guidelines.
TEXTBOOK:
The Administrative Medical Assistant by Mary E. Kinn, Eighth, Edition. Philadelphia:
W.B. Saunders Company, Copy Right 2007.
LEARNING OBJECTIVES: The Student will:
1. Demonstrate an understanding of all third party billing types: Blue
Cross/Blue Shield, Commercial Plans, Governmental Plans (Medicare,
Medicaid, Worker’s Compensation, and CHAMPUS) and Prepaid Plans
(HMO’s , PPO’s and IPA’s) by completing insurance forms.
2. Explain the claims processing, including sequencing of filing claims,
tracing claims, and making inquiries and appeals.
3. Discuss the billing and collection procedures, including aging patients’
accounts receivable, in-office collection procedures, calculating collection
ratios, and working with collection agencies.
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4. To demonstrate ethical principles and current medicolegal requirements
and guidelines, including Governmental complianc e as mandated by
OSHA, CLIA, and DEA.
STUDENT ASSIGNMENTS:
1. Reading assignments from textbook, supplementary textbooks, journal a
articles, and handouts.
2. Written assignments on specialized topics as given during the semester.
3. Tests on reading assignments and on lecture/discussion materials.
EVALUATION AND GRADING:
The following criteria will be utilized in determining final grades for this course:
Written/oral assignments 20 percent
Tests 80 percent
Final Grade Evaluation:
% of Points Earned - Grade
90 to 100% A
86 to 89.9% B+
80 to 85.9% B
76 to 79.9% C+
70 to 75.9% C
0 to 69.9% F
Attendance policy: 90% of scheduled class time required. If student falls below 90%,
their grade will drop 10%. Any student having a problem with attendance should contact
instructor and have documentation of missing time.
Students who are late or leave early for 5 classes will be considered as 1 absent class.
90% of scheduled class time is required
Test Policy:
There are no make up tests.
The lowest test grade will be dropped. If student misses a test that is the students
dropped grade and must attend all future tests dates. Final Test is mandatory.
Competencies
Competencies are performed for either a grade which is determined and explained
to the student prior or for a pass\fail determination by the instructor.
The student receives 3 attempts to pass\fail.
The student’s grade determination for a grade is 1 st attempt 100%, minus points if
missing a step, 2nd attempt is minus 11poinits, 3rd attempt minus 22 points. Any steps not
completed for additional attempts will be minus points. Points are determined by the
amount of steps to be completed based on the total grade determination.
3. Process Insurance Claims
a. Apply managed care policies and procedures
b. Apply third party guidelines c. *Perform procedural coding
d. *Perform diagnostic coding
e. *Complete insurance claim forms
Technology Policy:
If technology is not part of the classroom learning then it cannot be used. Cell phones are
prohibited.
Technology Policy:
If technology is not part of the classroom learning then it cannot be used. Cell phones are
prohibited.