HCR 220

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HCR 220 Entire Course

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HCR 220 Week 1 Checkpoint Features of Health

Plans
HCR 220 Week 1 CheckPoint Payment Methods
Presentation
HCR 220 Week 1 Assignment Steps in the Medical
Billing Process
HCR 220 Week 2 DQ 1 and DQ 2
HCR 220 Week 2 CheckPoint Medical Records
Documentation and Billing
HCR 220 Week 3 CheckPoint Eligibility, Payment,
and Billing Procedures
HCR 220 Week 3 Assignment Understanding the
Patient Intake Process
HCR 220 Week 4 DQ 1 and DQ 2

HCR 220 Week 1 Assignment Steps in the Medic

al Billing Process
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Assignment: Steps in the Medical Billing Process

Resource: Figure 1.6 on p. 17 of Medical Insurance
Write a 500 to 750 word paper that lists the
sequence of steps in the medical billing process. In
your own words, provide a 3 to 4 sentence
explanation for each step.
Your paper must be formattedaccording to APA
standards to be graded.
Attach in a Word Document.

HCR 220 Week 1 Checkpoint Features of Healt

h Plans
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CheckPoint: Features of Health Plans

Resource: Table 1.1 on p. 13 of Medical Insurance:
An Integrated Claims Process Approach
Write and post a 250 to 300 word response to the
following questions:
Describe the similarities and differences among the
major types of health plans. Do you believe any one
plan offers greater financial or coverage benefits to
either a consumer or a provider? Explain your
answers.

HCR 220 Week 1 CheckPoint Payment Methods

Presentation
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CheckPoint: Payment Methods Presentation
Resources: Appendix B and Microsoft Help at
http://support.microsoft.com/
Create a 4 to 5 slide PowerPoint presentation in
which you describe, in your own words, the fee-forservice and capitation payment cycles. Include the
relationship among provider, patient, and payer in
your presentation, and their roles in the process.
Include an introduction and conclusion slide in
your presentation.

HCR 220 Week 2 CheckPoint Medical Records D

ocumentation and Billing
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CheckPoint: Medical Records Documentation and

Billing
Write a 250 to 300 word response to the following:
Describe how compliance plans correlate to
different medical records documentation standards.
Which steps in the medical billing process, listed in
Ch. 1 of Medical Insurance, are related to the
following:
Compliance plans
Medical records

HCR 220 Week 2 DQ 1 and DQ 2

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Discussion Questions:
Summarize the purposes and provisions of HIPAA in
one sentence. Also, explain how HIPAA relates to
medical ethics and etiquette. What are some
possible ramifications of a health care industry
without HIPAA regulations? Refer to p. 25 of Medical
Insurance and provide examples. Due day 2 in the
Main Forum.
How do effective medical compliance plans limit the
risk of professional liability? Do you believe it is
reasonable to hold a provider liable for the actions
of his or her clerical staff? Support your opinion with
an example. Due day 4 in the Main Forum.

HCR 220 Week 3 Assignment Understanding the

Patient Intake Process
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Assignment: Understanding the Patient Intake

Process
Resource: Figure 3.1 on p. 75 of Medical Insurance
Write a 750 to 1,050 word essay discussing
strategies to improve patient intake efficiency not
covered in the text. Include the following
components in your essay:
Provide at least one must-have item not covered in
the text.
Provide a minimum of one reliable reference from
the University Library or the Internet.
Your paper must be formattedaccording to APA

HCR 220 Week 3 CheckPoint Eligibility, Paymen

t, and Billing Procedures
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CheckPoint: Eligibility, Payment, and Billing

Procedures
Resource: pp. 8688 of Medical Insurance
Write a 250 to 300 word response to the following:
Describe a factor that determines patient benefits
eligibility.
What are the appropriate steps to take when
insurance does not cover a planned service?
Relate these steps to the eligibility factor you
identified and provide two examples of patient
charges with corresponding billing transactions.

HCR 220 Week 4 CheckPoint Determining Diag

nosis Code Categories
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CheckPoint: Determining Diagnosis Code

Categories
Resource: pp. 130-135 of Medical Insurance
Due Date: Day 5 [Individual forum]
Post a response to the following: Determine a
diagnosis code category for the following case
studies and explain the rationale for your
selections:

HCR 220 Week 4 DQ 1 and DQ 2

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Discussion Questions
Suppose you were helping a new office file clerk
who was curious about the coding process. How
would you explain appropriate use and purposes of
the Alphabetic Index and Tabular List to the file
clerk? What problems might occur if proper coding
procedures are not used? Provide examples of
problems and propose solutions. Due day 2 in the
Main Forum.

HCR 220 Week 5 Assignment Assigning Evalua

tion and Management (E M) Codes
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Assignment: Assigning Evaluation and

Management (E/M) Codes
Resources:Figure 5.3 on p. 161, and Table 5.4 on
p. 165 of Medical Insurance
Assign appropriate E/M codes for the following five
cases:
Initial consultation performed for a 43-year-old
woman with unexplained weight loss, abdominal
pain, and rectal bleeding. A comprehensive history
and examination is performed.

A 32-year-old patient presents complaining of flulike symptoms characterized by unremitting cough,

HCR 220 Week 5 CheckPoint Describing CPT Co

ding Categories
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CheckPoint: Describing CPT Coding Categories

Resource: p. 145 of Medical Insurance
Write a 250 to 300 word response in which you
assume you are a medical office manager who
wants to make the coding process easier for
employees to understand. To facilitate better
understanding of this process, respond to the
following:
Come up with buzzwords or slogans that would best
describe the three CPT code categories.
What types of procedures or services are included
in each of the three CPT code categories?
Provide one example for each category in your

HCR 220 Week 5 Exercise Working with CPT Mo

difiers
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Exercise: Working with CPT Modifiers

Resource: Table 5.2 on p. 154 of Medical Insurance
Complete the exercise by identifying the correct
CPT modifier to its corresponding procedure for the
following:
Bilateral procedures
Multiple procedures
Prolonged evaluation and management
Unusual anesthesia
Mandated services

HCR 220 Week 6 CheckPoint Applying Level II

HCPCS Modifiers
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CheckPoint: Applying Level II HCPCS Modifiers

Resource: Table 6.2 on p. 195 of Medical Insurance
Apply the appropriate Level II HCPCS code modifier
for each of the following examples. Explain your
rationale for each selection. For example, the
first one would be:
Portable home oxygen unit - QM
Emergency ambulance transport and extended life
support
Diagnostic mammogram, left breast
Cortisone 10 mg injection, right shoulder
Nonelectric wheelchair
Intravenous catheter line, right arm

HCR 220 Week 6 DQ 1 and DQ 2

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Discussion Questions:
How are permanent codes different from temporary
codes? What could be the result of a system
without permanent codes? Provide examples in
your answer. Due day 2 in the Main Forum.
Briefly explain the steps used to assign HCPCS
codes for billing purposes. Do you believe it is more
or less efficient to use different billing procedures
for Medicare, Medicaid, or private payers? Why or
why not? What are advantages and disadvantages
of having unique coding systems for each type of
insurance? Due day 4 in the Main Forum.

HCR 220 Week 7 Assignment Evaluating Compl

iance Strategies
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Assignment: Evaluating Compliance Strategies

Write a 750 to 1,050 word essay evaluating billing
and coding compliance strategies. In your essay,
provide an overview of the compliance process, and
offer your judgment either supporting or criticizing
a particular method. Make suggestions for
improvement at the end of your evaluation.
Address the following questions in your essay:
What is the importance of correctly linking

HCR 220 Week 7 CheckPoint Errors and Compli

ance in Coding
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CheckPoint: Errors and Compliance in Coding

Resource: pp. 207 & 211 of Medical Insurance, and
Medical News Today Web site at
http://www.medicalnewstoday.com/
Review the NPR Web site at
http://www.npr.org/templates/story/story.php?stor
yId=5348863
Write a 250 to 300 word response to the following:
Briefly explain causes and solutions for three of the
most common billing and coding errors. What effect
does the Medicare National Correct Coding Initiative
have on the billing and coding process? Explain

HCR 220 Week 8 Checkpoint Complete a CMS1500 Claim Form

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Checkpoint: Complete a CMS-1500 Claim Form
Complete the CMS-1500 claim form worksheet
located in Appendix C. If you believe information
provided in the following list is insufficient to
adequately fill a required field with data, for
example, to supply a specific diagnosis code,
indicate this by typing N/A.
Name: Jane Smith
Insurer: TRICARE
Policy Number: 123456
ID number: 999000666
DOB: 01/01/1950
Gender: Female

HCR 220 Week 8 DQ 1 and DQ 2

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Discussion Questions
How are the data elements contained in the HIPAA
837 claim form similar to the CMS-1500, and how
does each form relate to the claims process? In
your opinion, do the similarities between HIPAA 837
and CMS-1500 complicate or simplify the claims
process? Explain your answers. Due day 2 in the
Main Forum.
Why is it important to prepare a clean claim? What
suggestions might you make to ensure that
submission of a clean claim takes place? Provide
examples. Due day 4 in the Main Forum

HCR 220 Week 9 Capstone CheckPoint

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Capstone CheckPoint
Post a 250 to 300 word response in which you
explain, in your own words, how HIPAA, ICD, CPT,
and HCPCS influence each of the ten steps of the
medical billing process.

HCR 220 Week 9 Final Project How HIPAA Violat

ions Affect the Medical Billing Process
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Final Project: How HIPAA Violations Affect the

Medical Billing Process
Part One:
Resources:Appendix A, Appendix C, and Table 8.3
on pp. 258259 of Medical Insurance
Refer toTable 8.3 on pp. 258259 of your text to
complete the CMS-1500 form, located in Appendix
C, according to the following case study:

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