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HCR 230 Entire Course FOR MORE CLASSES VISIT HCR 230 Week 1 CheckPoint Comparing Cost Control Strategies HCR 230 Week 1 CheckPoint Ramifications of Participation Contracts HCR 230 Week 1 Assignment Features of Private Payer and Consumer-Driven Health Plans HCR 230 Week 2 DQ 1and DQ 2 HCR 230 Week 2 CheckPoint Summarizing the Medigap Program HCR 230 Week 3 CheckPoint Working with Medicaid HCR 230 Week 3 assignment welfare reforms act

HCR 230 Week 1 Assignment Features of Private Payer and Consumer-Driven Health Plans FOR MORE CLASSES VISIT Assignment: Features of Private Payer and Consumer-Driven Health Plans Resources: Table 9.1 on p. 293 of Medical Insurance, Table 9.2 on p. 296 of Medical Insurance, and the U.S. Treasurer’s Office and Oregon Blue Cross/Blue Shield Web sites Due Date: Day 7 [post to the Assignment Folder] Refer to Table 9.1 on p. 293 and Table 9.2 on p. 296 of your textbook. Review

HCR 230 Week 1 CheckPoint Comparing Cost Control Strategies FOR MORE CLASSES VISIT CheckPoint: Comparing Cost Control Strategies Resource: Ch. 9 (pp ) of Medical Insurance Due Date: Day 3 [post to the Individual forum] Post a 200- to 300-word response to the following: Compare cost control strategies of employer-sponsored (employers buy from insurance companies) to self-funded (employers cover costs of benefits) health plans. Include the following factors: Riders

HCR 230 Week 1 CheckPoint Ramifications of Participation Contracts FOR MORE CLASSES VISIT CheckPoint: Ramifications of Participation Contracts Resource: Ch. 9 (pp ) of Medical Insurance Due Date: Day 4 [post to the Individual forum] Discuss how participation contracts represent financial opportunities for providers. What are positive and negative ramifications of discounted fee-for-service arrangements? Explain your answers in 200 to 300 words.

HCR 230 Week 2 CheckPoint Summarizing the Medigap Program FOR MORE CLASSES VISIT Resources: Figure 10.7 on p. 350 of Medical Insurance, and the WebMD® and Diabetes.org Web sites Due Date: Day 5 to the Assignment Folder Refer to Figure 10.7 and the WebMD® and Diabetes.org Web sites at: and legalresources/healthcare/medicare/medigap.jsphttp:// legalresources/healthcare/medicare/medigap.jsp Compose a 250- to 300-word summary reflecting upon the Medigap program. Address the following questions in your summary:

HCR 230 Week 2 DQ 1and DQ 2 FOR MORE CLASSES VISIT Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: Explain whether or not you believe Medicare’s eligibility limitations are reasonable in scope. 4. Discussion Question 2 Due Date: Day 4 [Main forum] Post your response to the following: In your opinion, what potential positive and negative ramifications could result from offering payment incentives for physician participation in Medicare programs? Explain your answers and provide examples from this week’s Internet and ERR readings located on your student web page.

HCR 230 Week 3 Assignment welfare reforms act FOR MORE CLASSES VISIT Due Date: Day 7 [to the Assignment Folder] Write a 750- to 1,050-word paper discussing the positive and negative implications of the Welfare Reform Act of 1996 on Medicaid. Respond to one or more of the following questions in your paper: Did the Welfare Reform Act cause existing Medicaid beneficiaries to lose necessary coverage? Do eligible Medicaid candidates sometimes remain un-enrolled even though they are needy as a result of the Welfare Reform Act? Is the Welfare Reform Act effective in reducing welfare fraud and increasing personal responsibility? Has the Welfare Reform Act been successful in meeting its intended goals?

HCR 230 Week 3 CheckPoint Working with Medicaid FOR MORE CLASSES VISIT CheckPoint: Working with Medicaid Resources: Ch. 11 (pp , ) of Medical Insurance and the U.S. Department of Health & Human Services Web site. Due Date: Day 4 [to the Assignment Folder] Refer to U.S. Department of Health & Human Services Web site at Select Medicaid Program - General Information. Post a 250- to 300-word response to the following: Briefly discuss factors that determine Medicaid eligibility, and whether a procedure or service is covered.

HCR 230 Week 4 Assignment The TRICARE Program FOR MORE CLASSES VISIT CheckPoint: Describing TRICARE Resources: Appendix B and Ch. 12 (pp , ) of Medical Insurance Due Date: Day 5 [to the Assignment Folder] Refer to Appendix B for guidance on presentations and the Microsoft® Help and Support Web site for assistance with questions related to PowerPoint® at Create a 5- to 8-slide PowerPoint® presentation that describes features of the TRICARE program and its four subsidiaries. Include detailed speaker notes to explain the following topics in your presentation:

HCR 230 Week 4 DQ 1and DQ 2 FOR MORE CLASSES VISIT Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: Based on eligibility and cost sharing requirements, what are the financial advantages for either providers or patients participating in the TRICARE program? How do annual limits (catastrophic caps) affect patients’ cost sharing requirements? Explain your answers. 3. Discussion Question 2 Due Date: Day 4 [Main forum] Post your response to the following: Explain whether or not you believe CHAMPVA provides an adequate level of health insurance for participants.

HCR 230 Week 5 Assignment Understanding Work-Related Injuries FOR MORE CLASSES VISIT Assignment: Understanding Work-Related Injuries Resources: Appendix C and Ch. 13 (pp ) of Medical Insurance Due Date: Day 7 [to the Assignment Folder] Compose a 750- to 1,050-word response describing the workers’ compensation claim process. Include the following information in your answer: Overall description of the workers’ compensation claims process Responsibilities of the employee, employer, physician, and insurance carrier

HCR 230 Week 5 CheckPoint Characteristics of Workers Compensation Plans FOR MORE CLASSES VISIT CheckPoint: Characteristics of Workers’ Compensation Plans Resources: Ch. 13 (pp ) of Medical Insurance and the U.S. Department of Labor Web site Due Date: Day 4 [to the Assignment Folder] Refer to Ch. 13 (pp ) of your textbook and the U.S. Department of Labor Web site at: Post a 250- to 300-word response to the following: In your own words, briefly describe the features of the four federal workers’ compensation plans and the two types of state workers’ compensation benefits. Why is it necessary to have both federal and state compensation plans?

HCR 230 Week 6 CheckPoint Purpose of the General Appeals FOR MORE CLASSES VISIT CheckPoint: Purpose of the General Appeals Process Resource: Ch. 14 (p. 463) of Medical Insurance Due Date: Day 5 [to the Assignment Folder] Use the Internet to locate three additional examples of claims errors and classify them according the categories noted on page 463 of your textbook. Respond to the following in 250 to 300 words: Briefly describe the purpose of the general appeals process. Incorporate the three additional examples of claims errors you located on the Internet, classified according to the categories in the text.

HCR 230 Week 6 DQ 1and DQ 2 FOR MORE CLASSES VISIT Discussion Question 1 Due Date: Day 2 [Main forum] Post your response to the following: Do you believe the RA/EOB is an effective method of communicating claim adjudication information to patients? When you have received an RA/EOB in the mail, is it easy or difficult to understand? What suggestions could you make to improve patient-payer communication regarding the claim adjudication process? Explain your answers. 3. Discussion Question 2 Due Date: Day 4 [Main forum]

HCR 230 Week 7 Assignment Understanding the Collection Process FOR MORE CLASSES VISIT Assignment: Understanding the Collection Process Resources: Ch. 15 (pp ) of Medical Insurance and Microsoft® Help Web site Due Date: Day 7 [to the Assignment Folder] Suppose you are working in a medical office and are helping train a new billing specialist about collections. You decide that a job aid in the form of a flow chart would be a useful tool. Refer to Microsoft® Help Web site at for questions related to creating a flow chart in Microsoft® Word. Complete the following:

HCR 230 Week 7 CheckPoint Effective Financial Policies amp Proced FOR MORE CLASSES VISIT CheckPoint: Effective Financial Policies and Procedures Resources: Figures 15.1 and 15.2 (pp ) in Medical Insurance Due Date: Day 4 [to the Assignment Folder] Refer to Figure 15.1 and 15.2 in Medical Insurance. Post a 350- to 400-word response to the following: The three major elements to critical thinking are logical inquiry, problem solving, and evaluative decision making. In this CheckPoint, you will exercise critical thinking skills to answer the following questions: What are the basic elements of an effective medical office financial policy? In what ways do medical office procedures support financial policies?

HCR 230 Week 8 CheckPoint Inpatient and Outpatient Hospital Services FOR MORE CLASSES VISIT CheckPoint: Inpatient and Outpatient Hospital Services Resource: Ch. 16 (pp , ) of Medical Insurance Due Date: Day 5 [to the Assignment Folder]  Post a 250- to 300-word response to the following: What are the major differences between inpatient and outpatient hospital services? Describe how these differences affect the coding process and provide examples.

HCR 230 Week 8 DQ 1and DQ 2 FOR MORE CLASSES VISIT Discussion Question 1 Due Date: Day 2 [Main forum] Refer to your text and the following links to help you answer questions about written consent: American Medical Association Web site at: assn.org/cgi/reprint/135/1/26.pdfhttp://archsurg.ama- assn.org/cgi/reprint/135/1/26.pdf Integrated Publishing Web site at: tm tm

HCR 230 Week 9 Assignment Financial Policy DCSAA Finicial Policy FOR MORE CLASSES VISIT Final Project: Design a Financial Policy Resources: Appendix A and Figure 15.1 on p. 487 of Medical Insurance Due Date: Day 7 [to the Assignment Folder] Use critical thinking skills to complete your final project. These skills include suspending judgment and applying problem-solving skills and methods while conducting research. You will form evaluative decisions and provide your rationale after considering how you would design a medical office financial policy.

HCR 230 Week 9 Capstone Checkpoint FOR MORE CLASSES VISIT Capstone CheckPoint Resources: Appendix A, Chapter 14 (pp ) of Medical Insurance, and Microsoft® Help Web site Due Date: Day 4 [to the Assignment Folder] Refer to Chapter 14 of Medical Insurance and previous assignments from that chapter as a resource. Visit the Microsoft® Help link for assistance with questions related to creating a flow chart in Microsoft® Word at: Create a flow chart using Microsoft® Word illustrating the five steps of the claims adjudication process from the time of initial processing through final payment. Include a brief 250- to 300- word explanation for the following:

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