Medical Assisting Program Outcomes_2020.xlsx

	A	B	C	D	E	F
1	Program Outcomes	MEAS 203	MEAS 137	MEAS 204	HLHS 101	APHY 101/102

2	Content Area: Third Party Reimbursement
3	Cognitive (Knowledge)
4	C. Third Party Reimbursement
5	1.Identify: a.Types of third party plans b.Information required to file a third party claim c.The steps for filing a third party claim
6	2.Outline managed care requirements for patient referral		X
7	3.Describe processes for: a.Verification for eligibility for services b.Precertification c.Preauthorization		X
8	5.Differentiate between fraud and abuse		X
9	Psychomotor (Skills)
10	P. Third Party Reimbursement
11	1.Interpret information on an insurance card		X
12	2.Verify eligibility for services including documentation		X
13	3.Obtain precertification or preauthorization including documentation		X
14	4.Complete an insurance claim form		X
15	Affective (Behavior)
16	A. Third Party Reimbursement
17	1.Interact professionally with third party representatives		X
18	2.Display tactful behavior when communicating with medical providers regarding third party requirements		X
19	3.Show sensitivity when communicating with patients regarding third party requirements		X
20	Content Area: Procedural and Diagnostic Coding
21	Cognitive (Knowledge)
22	Describe how to use the most current procedural coding system		X
23	Describe how to use the most current diagnostic coding classification system		X
24	Describe how to use the most current HCPCS level II coding system		X
25	Discuss the effects of: a.Upcoding b.Downcoding		X
26	Define medical necessity as it applies to procedural and diagnostic coding		X
27	Perform procedural coding		X
28	Perform diagnostic coding		X
29	Utilize medical necessity guidelines		X
30	Utilize tactful communication skills with medical providers to ensure accurate code selection		X
31	Define and use all coding terminology, conventions, and abbreviations accurately.	X
32	Utilize medical terminology and abbreviations accurately	X
33	Accurately code primary and principal diagnoses using ICD-10.	X
34	Identify modifiers for HCPCS Levels I and II.	X
35	Develop advanced coding skills by assigning codes to medical, surgical, and diagnostic services	X
36	Identify coding errors on insurance claim forms, superbills, and EOB’s.	X
37	Demonstrate knowledge of coding system and purpose for Level I: CPTand Level II: Medicare National Level II Codes	X
38	Demonstrate knowledge of Level I: Modifiers and Level II: Modifiers	X
39	Demonstrate knowledge of CPT sections: Evaluation and Management, Anesthesia, Surgery Section (Broken down by body system), Radiology Section, Pathology & Laboratory Section, Medicine Section & Unlisted procedures	X
40	Learn official coding and reporting principals and guidelines for claim reimbursement.	X
41	Demonstrate ICD-10 Coding Tabular List, Classification of disease and injuries, supplemental classification, appendicies, volumn II and Vollumn III.	X
42	List and discuss the responsibilities and skills required for the Health Insurance Specialist.			X
43	Describe the Health Insurance Portability and Accountability Act of 1996 and how it defines insurance fraud and abuse			X
44	Explain the reimbursement methods used by different insurance companies			X
45	Code accurately using the ICD-10, CPT, and HCPS coding systems at an advanced level.			X
46	Complete claim forms accurately using both paper copy and computer.			X
47	Describe electronic claims processing.			X
48	Analyze and compare EOB’s from the major insurance carriers.			X
49	Explain claims tracking and follow-up as they relate to aged accounts			X
50	Explain the use of insurance bulletins, journals, and seminar data.			X
51	Explain the process of updating patient information and changing a patient’s insurance electronically.			X
52	List the steps needed when a patient has multiple insurance companies			X
53	Describe Medicare and Medicaid processing, appeals, refunds and verification			X
54	Write appeals letters to insurance companies with justification of coding application.			X
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56	Demonstrate knowledge of the comprehensive relationship between anatomy and physiology in the human organism, including, not limited to, the structure and function of the human organ systems, medical terminology, and the structural hierarchy and levels of organization of the human body.				X	X
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