OADM70004
Medical Office Billing Procedures
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  I: Administrative Information   II: Course Details   III: Topical Outline(s)  Printable Version
 
Section I: Administrative Information
  Total hours: 42.0
Credit Value: 3.0
Credit Value Notes: N/A
Effective: Spring/Summer 2015
Prerequisites: (OADM70006) AND (OADM70007) AND (APPL70051) AND (APPL70052)
Corequisites: N/A
Equivalents:
N/A
Pre/Co/Equiv Notes: Keyboarding skills Computer literacy

Program(s): Office Administration -Medical
Program Coordinator(s): Shaji Mathew
Course Leader or Contact: Sharon Tiraborrelli
Version:
14.0
Status: Approved (APPR)

Section I Notes: This course is offered in a classroom version and an online version. In the classroom version, there are three hours per week of classroom instruction. The online version is a web-based course offered entirely online through Sheridan and hosted by Sheridan College. Students taking this course will need reliable access to the internet, and should have a basic level of comfort using computers as well as the self- discipline to study online. Students can expect to spend an additional three hours per week for online activities such as postings, discussions, and homework.

 
 
Section II: Course Details

Detailed Description
Students review various aspects of electronic medical scheduling and billing procedures including specialty areas within a medical office setting. Using medical billing software, students practice using simulated electronic health claims payable by the Ontario Health Insurance Plan (OHIP), Workers Safety Insurance Plan (WSIB), and private billing practices. Emphasis is placed on the rules and regulations as outlined by the Ontario Ministry of Health, maintaining an electronic scheduling and billing system and identifying the differences between diagnostic and service codes. Students gain practical experience through the use of simulated claims and billing scenarios. In the online course students engage in collaborative discussions, journal entries, and assigned chats. Note: College-level English skills and computer literacy are required.

Program Context

 
Office Administration -Medical Program Coordinator: Shaji Mathew
N/A


Course Critical Performance and Learning Outcomes

 
 Critical Performance:

By the end of this course, students will have demonstrated the 
ability to produce accurate health claims and maintain an electronic 
scheduling and billing system following the rules and regulations as 
outlined by the Ministry of Health.


As per Standard Course Outline

Learning Outcomes:

To achieve the critical performance, students will have demonstrated 
the ability to:

1.	Explain how the Ministry of Health monitors the validity of 
        submitted health claims.
2.	Locate the correct service and diagnostic codes when 
        preparing medical health claims. 
3.	Insert the data bases for a medical electronic 
        billing/scheduling system.
4.	Produce accurate office visit health claims payable by the 
        Ministry of Health.
5.	Produce accurate in-patient and out-patient institution 
        health claims payable by the Ministry of Health.
6.	Produce accurate WSIB health claims and reports.
7.	Produce accurate RMB (Reciprocal Medical Billings) payable by 
        the Ministry of Health.
8.	Apply the rules and regulations as outlined by the Ministry 
        of Health when submitting health claims.
9.	Discuss the different kinds of services physicians in Ontario 
        can claim for, from the Ministry of Health. 
10.	Generate medical billing reports and summaries. 
11.	Create private and miscellaneous billing claims, and invoices.
12.	Produce accurate therapeutic and surgical procedure health 
        claims payable by the Ministry of Health.


As per Standard Course Outline

Evaluation Plan
Students demonstrate their learning in the following ways:

 
MARK BREAKDOWN

Students demonstrate their learning in the following ways:
    
           Test #1 Health Claim .....................20%
           Test #2 Health Claim .....................20%
           Test #3 Health Claim .....................20%
           Test #4 Health Claim .....................20%
           Test #5 Written Theory (Rules & Regulations) ....20%
           
     
MARKING SCHEME:

All computerized claims are worth five (5) marks per claim.  No 
partial marks are given on health claim tests.  They are either 
right 
or wrong.

On the Theory Test (Rules and Regulations) one mark will be deducted 
for incorrect answers and spelling erors.

Tests are to be done in class, and handed in before the student 
leaves the classroom.  A comprehensive make up test may be given at 
the end of the course, at the discretion of the instructor, to 
replace a missed test. You may be asked to provide a Doctor's note.

ONLINE Evaluation Plan:

Students demonstrate their learning in the following ways:

Group Discussions (4 x 2.5%) 		10%
Journal Entries (5 x 2%)	  	10%
On-Line Tests (5 x 16%)		        80% 
Total                                  100%

Please note: 
Evaluation details will be provided within the online course.
Provincial Context
The course meets the following Ministry of Training, Colleges and Universities requirements:

 

Essential Employability Skills
Essential Employability Skills emphasized in the course:

  Communication   Critical Thinking & Problem Solving   Interpersonal
  Numeracy   Information Management   Personal

Notes: N/A

Prior Learning Assessment and Recognition
PLAR Contact (if course is PLAR-eligible) : Office of the Registrar

Students may apply to receive credit by demonstrating achievement of the course learning outcomes through previous relevant work/life experience, service, self-study and training on the job. This course is eligible for challenge through the following method(s):

Challenge Exam Portfolio Interview Other Not Eligible for PLAR
X   X    

Notes:  Both a Challenge Exam and and Interview are required for PLAR

 
 
Section III: Topical Outline
Some details of this outline may change as a result of circumstances such as weather cancellations, College and student activities, and class timetabling.
Print Effective Term Professor Applicable Student Group(s)
Spring/Summer 2015 Multiple Professors Continuing Education: Office Administration:Medical 14 Weeks
Spring/Summer 2015 Multiple Professors Continuing Education: Office Administration: Medical 12 Weeks
Spring/Summer 2015 Multiple Professors ONLINE TOPICAL: Continuing Education Students

Sheridan Policies

All Sheridan policies can be viewed on the Sheridan policy website.

Academic Integrity: The principle of academic integrity requires that all work submitted for evaluation and course credit be the original, unassisted work of the student. Cheating or plagiarism including borrowing, copying, purchasing or collaborating on work, except for group projects arranged and approved by the professor, or otherwise submitting work that is not the student's own, violates this principle and will not be tolerated. Students who have any questions regarding whether or not specific circumstances involve a breach of academic integrity are advised to review the Academic Integrity Policy and procedure and/or discuss them with the professor.

Copyright: A majority of the course lectures and materials provided in class and posted in SLATE are protected by copyright. Use of these materials must comply with the Acceptable Use Policy, Use of Copyright Protected Work Policy and Student Code of Conduct. Students may use, copy and share these materials for learning and/or research purposes provided that the use complies with fair dealing or an exception in the Copyright Act. Permission from the rights holder would be necessary otherwise. Please note that it is prohibited to reproduce and/or post a work that is not your own on third-party commercial websites including but not limited to Course Hero or OneNote. It is also prohibited to reproduce and/or post a work that is not your own or your own work with the intent to assist others in cheating on third-party commercial websites including but not limited to Course Hero or OneNote.

Intellectual Property: Sheridan's Intellectual Property Policy generally applies such that students own their own work. Please be advised that students working with external research and/or industry collaborators may be asked to sign agreements that waive or modify their IP rights. Please refer to Sheridan's IP Policy and Procedure.

Respectful Behaviour: Sheridan is committed to provide a learning environment that supports academic achievement by respecting the dignity, self-esteem and fair treatment of every person engaged in the learning process. Behaviour which is inconsistent with this principle will not be tolerated. Details of Sheridan's policy on Harassment and Discrimination, Academic Integrity and other academic policies are available on the Sheridan policy website.

Accessible Learning: Accessible Learning coordinates academic accommodations for students with disabilities. For more information or to register, please see the Accessible Learning website (Statement added September 2016)

Course Outline Changes: The information contained in this Course Outline including but not limited to faculty and program information and course description is subject to change without notice. Any changes to course curriculum and/or assessment shall adhere to approved Sheridan protocol. Nothing in this Course Outline should be viewed as a representation, offer and/or warranty. Students are responsible for reading the Important Notice and Disclaimer which applies to Programs and Courses.


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