HU MBIC handbook (6)

HERZING UNIVERSITYMBIC

HANDBOOK

Revised August 2011

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WELCOMECONGRATULATIONS for successfully completing your courses and as you enter the Internship

portion in the Medical Billing and Insurance Coding Program (MBIC) at Herzing University.

We are pleased you chose this university and program for your career. As faculty, please know

that we are here to guide you during your study and practice of MBIC. The instructors are well

versed in the medical profession and are experienced in the field and in teaching.

This handbook is designed to be used in conjunction with program procedures and the policies

of the university.

Table of Contents Welcome letter

Vision and Mission Statement

American Academy of Professional Coders (AAPC)

American Health Information Management (AHIMA)

Student Guidelines

Dress Code

Internship Information

Certification Information

Forms

HERZING UNIVERSITYVISION STATEMENT

The vision of Herzing University is to be the preferred career-oriented university of students,

employers, and employees.

MISSION STATEMENT

It is the mission of Herzing University to provide high-quality undergraduate and graduate

degree and diploma programs to prepare a diverse and geographically distributed student

population to meet the needs of employers in technology, business, health care, design, and

public safety. Career-oriented degree programs include a complementary and integrated

general education curriculum established to stimulate students’ intellectual growth, to contribute

to their personal development, and to enhance their potential for career advancement.

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CERTIFIED PROFESSIONAL CODER CERTIFICATION (CPC)

The AAPC's gold standard CPC credential demonstrates a broad encompassing knowledge and

expertise in reviewing and assigning the correct coding of physician services, procedures and

diagnosis for medical claims. It rigorously validates an individual's ability to assign codes based

on national coding guidelines and operative reports, comprehend medical terminology and

human anatomy and apply billing reimbursement guidelines. The CPC examination consists of

questions regarding the correct application of CPT, HCPCS Level II procedure and supply

codes and ICD-9-CM diagnosis codes used for billing professional medical services to

insurance companies and CMS. Take the CPC exam if you code in the following places or

situations:

Physician office or group

Hospital-associated physician office or group

Health system-associated physician office or group

Home health agency

Physician group at a university and or in a teaching setting

Compliance auditor or forensic auditor of physician claims

Physician billing service

Ambulatory Surgery Center (ASC)

Outpatient hospital services not reimbursed by Ambulatory Patient Category (APCs)

groups

If you are a consultant, educator, legal counsel, physician or other care-giver seeking a

credential to demonstrate prowess in outpatient medical coding for physician services

MEDICAL CODING CERTIFICATION

The AAPC's certifications allow medical coders, billers and other health care professionals to:

Validate superior knowledge and expertise in various medical coding environments

Earn 20% more than non-credentialed coders

Show credentials nationally recognized by employers, physician societies and

government organizations

Have confidence in their ability to capture lost revenue for their practice, diminish post-

payment risk and protect their practice from unfavorable audit results

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AAPC Code of EthicsMembers of the American Academy of Professional Coders shall be dedicated to providing the

highest standard of professional coding and billing services to employers, clients and patients.

Professional and personal behavior of AAPC members must be exemplary.

AAPC members shall maintain the highest standard of personal and professional conduct.

Members shall respect the rights of patients, clients, employers and all other colleagues.

Members shall use only legal and ethical means in all professional dealings and shall refuse to

cooperate with, or condone by silence, the actions of those who engage in fraudulent, deceptive

or illegal acts.

Members shall respect and adhere to the laws and regulations of the land and uphold the mission

statement of the AAPC.

Members shall pursue excellence through continuing education in all areas applicable to their

profession.

Members shall strive to maintain and enhance the dignity, status, competence and standards of

coding for professional services.

Members shall not exploit professional relationships with patients, employees, clients or

employers for personal gain.

Above all else we will commit to recognizing the intrinsic worth of each member.

This code of ethical standards for members of the AAPC strives to promote and maintain the

highest standard of professional service and conduct among its members. Adherence to these

standards assures public confidence in the integrity and service of professional coders who are

members of the AAPC.

Failure to adhere to these standards, as determined by AAPC, will result in the loss of credentials

and membership with the American Academy of Professional Coders.

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AHIMA (AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION)

CERTIFIED CODING SPECIALIST CERTIFICATION (CCS)

CCSs are skilled in classifying medical data from patient records, generally in a hospital setting.

These coding practitioners:

Review patients’ records and assign numeric codes for each diagnosis and procedure

Possess expertise in the ICD-9-CM and CPT coding systems

Are knowledgeable about medical terminology, disease processes, and pharmacology.

Different facilities and institutions make use of a CCSs' skills:

Hospitals and medical providers take the coded data created by CCSs to insurance

companies—or to the government in the case of Medicare and Medicaid recipients—for

reimbursement of expenses

Researchers and public health officials also use this data to monitor patterns and

explore new interventions

Coding accuracy is highly important to healthcare organizations, and has an impact on

revenues and describing health outcomes. In fact, certification has become an implicit industry

standard. Accordingly, the CCS credential demonstrates a practitioner's tested data quality and

integrity skills, and mastery of coding proficiency. Professionals experienced in coding inpatient

and outpatient records should consider obtaining this certification.

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AHIMA Code of Ethics (2004)Ethical Principles: The following ethical principles are based on the core values of the American Health Information Management Association and apply to all health information management professionals.

Health information management professionals:

I. Advocate, uphold and defend the individual's right to privacy and the doctrine of

confidentiality in the use and disclosure of information.

II. Put service and the health and welfare of persons before self-interest and conduct

themselves in the practice of the profession so as to bring honor to themselves, their

peers, and to the health information management profession.

III. Preserve, protect, and secure personal health information in any form or medium and

hold in the highest regard the contents of the records and other information of a

confidential nature, taking into account the applicable statutes and regulations.

IV. Refuse to participate in or conceal unethical practices or procedures.

V. Advance health information management knowledge and practice through continuing

education, research, publications, and presentations.

VI. Recruit and mentor students, peers and colleagues to develop and strengthen

professional workforce.

VII. Represent the profession accurately to the public.

VIII. Perform honorably health information management association responsibilities, either

appointed or elected, and preserve the confidentiality of any privileged information

made known in any official capacity.

IX. State truthfully and accurately their credentials, professional education, and

experiences.

X. Facilitate interdisciplinary collaboration in situations supporting health information

practice.

XI. Respect the inherent dignity and worth of every person.

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INTERNSHIP INFORMATION

During the internship phase of training, the student will experience various aspects of working in

the insurance/coding field. The internship will provide the student with the opportunity to

experience and participate in the duties of a medical coder in a working environment. Areas

such as abstracting from medical records, CPT-4 and ICD-9-CM coding schemes (and updates)

will also be used. Introduction to ICD-10 will also be discussed. Other aspects of medical

coding and billing will be experienced. Experienced coding personnel provide the instruction.

During the internship phase of training, the student may use a virtual-based internship in place

of or in addition to a medical office setting. The student will utilize operative reports,

reimbursements, and filing claims.

The student will be responsible for completing the packet which includes case studies, claims,

financial reports, aging reports, primary and secondary claims/reimbursements, and appealing

claims as listed in the curriculum.

Students are required to perform 90 hours either in the office setting or the virtual lab setting or

a combination.

To be eligible for Internship, the student must have completed the following criterion:

1. Must have successfully completed the following courses:

a. Medical Terminology

b. Medical Office Procedures

c. Medical Business Operations

d. Medical Billing and Insurance Procedures

e. ICD-9-CM coding

f. CPT coding

g. Anatomy & Physiology 1 and 2

h. Pathophysiology and Pharmacology

i. Program Review

2. Students must have prearranged reliable transportation.

3. Student must be able to spend a minimum of 10 hours per week for 8-10 weeks at the

Internship site for a total of 90 hours in order to receive credit for the class.

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DRESS CODE POLICYAppropriate dress standards have been established in order to present and maintain, at all

times, a professional appearance to patients, employees and visitors. The standards allow for

comfortable performance of duties.

All MBIC students are expected to keep themselves neat, clean and well groomed at all times.

The appearance of a Herzing University student is an important part of public relations.

Anyone not conforming to this policy will be appropriately counseled and may face disciplinary

action. The only exception is at the recommendation of the internship site.

o ID Badge: Identification badge is to be worn at all times above the waist, with

name visible.

o Hair: Should have a clean and neat appearance. Facial hair must be clean,

neat and well groomed.

o Headwear: Religious head covers may be worn; baseball-type caps are

inappropriate.

o Jewelry: Should be appropriate to professional wear and not present a safety

hazard when working with patients or equipment. Body Piercing should be

modest and professional. Most clinics and doctor offices do not allow for piercing

other than earlobe piercing.

o Uniforms: MBIC students are expected to wear a Herzing University polo shirt

with dress slacks. The polo shirt and slacks must be clean, pressed, no stains.

If a student is out of uniform he/she will be sent home.

o Footwear: Professional; no flip flops, heels over 2 ½ inches, or dirty shoes will

be allowed. Sandals may be worn in the summer and must be in good taste—

professional in appearance (unless otherwise noted by the site).

o Grooming: Fragrances: Do not wear any perfume or cologne it may cause

allergic reactions.

o Tattoos and Piercings: Cover all obvious tattoos and remove all facial piercing.

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MEDICAL BILLING AND INSURANCE CODING

INTERNSHIP CHECK LIST

DATE:____________________________

INSTRUCTOR:____________________________________

STUDENT:_______________________________________

The following items have been reviewed and/or completed with the above name student.

ITEM YES NOCourse SyllabusStudent PoliciesWeekly Status Reports (one per week)Mid Term EvaluationFinal EvaluationStudent Externship EvaluationStudent Site EvaluationThank you letterWork Experience Report

COMMENTS:_________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Student Signature:________________________________________ Date:_______________

Instructor Signature:______________________________________ Date:_______________

Student is assigned at:_________________________________________________________

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MEDICAL BILLING AND INSURANCE CODING INTERNSHIP STUDENT POLICIES

GENERAL

Please remember that you are now a professional. You are a representative of the university. Your actions not only are a reflection of your character, but of the university as well. Herzing University is striving to supply highly qualified persons in the medical business sector.

The student is expected to follow the dress code as determined by the University or the Site. The ID must be worn. You are expected to conduct yourself as a professional at all times.

REPORTING TO THE SITE

Your working hours will be determined between you (the student) and the facility contact where you will be completing your internship. Failure to adhere to the set schedule may result in failure of the internship.

SICK TIME OR ABSENCES

Regular attendance is expected. If you are unable to report to your internship site, you must call your site first then call your instructor. You are required to bring documentation for the absence to your instructor the next business day. You will also be required to make up the time missed.

The student is required to obtain 90 hours; 10+ hours per week.

REMOVAL FROM THE INTERNSHIP SITE

The internship site has the right to request the student’s removal from their facility if they feel the conduct of performance is not within their standards. The university will not interfere in this decision but will investigate thoroughly. Depending on the outcome of this investigation, reassignment may be considered but is not guaranteed.

Internship Site

The student will follow the policies and regulations set forth by the internship site.

The internship site has the sole responsibility of the patient care. At no time are you to provide patient care. You are there to observe and learn the coding and insurance practices.

If at any time you are uncomfortable with a situation or have a problem you need to discuss, please call your instructor. We are here to make this a worthwhile learning experience for you

HIPAA regulations require that healthcare employees be held accountable for using or disclosing patient health information appropriately. You will encounter personal medical information during your internship experience. Federal and State privacy laws prohibit you from sharing any patient’s medical information. What you may see and/or hear in the course of your internship MUST BE KEPT CONFIDENTIAL. BREACH OF CONFIDENTIALITY IS GROUNDS FOR IMMEDIATE REMOVAL FROM THE EXTERNSHIP SITE AND POSSIBLY THE MBIC PROGRAM.

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PRIOR TO INTERNSHIP/EXTERNSHIP

Student Name

Resume Mantoux Tb

CPR/FirstAid (Opt.)

BackgroundCheck

Drug Screen

Comments

DATE OF INTERNSHIP/EXTERNSHIP: __________________________________

SITE OF INTERNSHIP/EXTERNSHIP: ___________________________________

I, ____________________________________, have successfully completed the requirements listed above. I have presented a copy of my CPR/First Aid card, physical, and immunizations, including Tb and Hepatitis vaccines, to the program director. ______ (student initial)

I have completed the background check and drug screen. The background check does not demonstrate any felony violations and the drug screen is negative. ______ (student initial)

I understand that if any of the requirements are not completed prior to the start of the term I will not be eligible for externship/internship until next term. ______ (student initial)

I understand that the program director may assist me in securing an externship/internship site, but securing a site is ultimately my responsibility. If the program director secures a site and the student is removed from the site, the student is responsible for finding another site. ______ (student initial)

I understand that I must show up on time on my scheduled days. If I am unable to go to the site I will contact the site first and the program director next. I understand that I must make up the hours that were missed. Excessive absenteeism will result in failing the class and possible removal from the program. ______ (student initial)

I understand that I am required to submit my hours weekly to the program director. ______ (student initial)

I understand the midterm evaluation must be completed by the site and turned in to the program director after completing four weeks, and the final evaluation at the completion of week 8. I understand my final evaluation will be based on medical coding skills, ability to work well with others, enthusiasm, professionalism, grammar skills, and confidentially. I have been informed that I will not pass externship/internship until the evaluations are turned in to the program director and they indicate my work was average or above. ______ (student initial)

I understand that I am required to be present for Program Review at the scheduled times. If I am unable to be present due to externship/internship, I will make arrangements with the program director. I understand that failure to show for the class will result in an “F” and I will not graduate until this class has been successfully completed. ______ (student initial)

I acknowledge that I have read, understand, agree, and have successfully fulfilled all statements listed above. _____________________________________________________________________________________Student Signature Date

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______________________________________________________________________________________________________ Print Student Name

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Week 1 Weekly Status Report for MBIC Internship

Student Name:____________________________________________ Student ID:___________

Internship Site:________________________________________________________________

Date Time Total hoursMonday

Tuesday

Wednesday

Thursday

Friday

Saturday

Total hours for the week

THIS MUST BE VERIFIED BY THE SITE SUPERVISOR

Supervisor signature:________________________________________________________

To be filled out by the student:

Duties performed this week:

What did you learn this week?

Do you have any questions or concerns regarding your training?

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Internship Site:________________________________________________________________


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Student Name:____________________________________________ Student ID:__________

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Internship Site:________________________________________________________________


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Internship Site:________________________________________________________________


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Internship Site:_______________________________________________________________________


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Internship Site:________________________________________________________________


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Weekly Status Report for MBIC Internship


Internship Site:________________________________________________________________


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Internship Site:________________________________________________________________


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Internship Site:________________________________________________________________


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HERZING UNIVERSITY MEDICAL INTERNSHIP 4 WEEK (90/180) EVALUATION – MEDICAL BILLING & INSURANCE CODING

Student Name_________________________________________________________

Name of Internship site__________________________________________________

Internship Supervisor___________________________________________________

Internship Dates (beginning and ending) _____________________________________

We do not expect the student to be exposed to every item on the evaluation form. We would appreciate your introducing them to as much as possible.

Please evaluate the student’s performance and knowledge by indicating the quality of their work. Please circle a number 1-5 for each objective. If you do not feel you can evaluate a specific task, just indicate N/A for not applicable. There is room for comments after each question. We would appreciate any comments or suggestions (positive and negative) that you can provide us pertaining to the student’s performance. On any skill you feel the student’s performance was below what was expected, please provide a comment in order that we may help to improve the student in that area.

RATING SCALE:

1 NEEDS IMPROVEMENT Student performance in this area was not acceptable and needs improvement

2 POOR Student’s work in this area is below average3 FAIR Student’s work in this area was average4 GOOD Student’s work in this area was slightly above average5 EXCELLENT Student’s work in this area exceeded expectations

The student demonstrated knowledge of medical terminology.

1 2 3 4 5

The student demonstrated knowledge of anatomy and physiology.

1 2 3 4 5

The student demonstrated knowledge of diseases, disorders, and diagnoses of the human body.

1 2 3 4 5

The student demonstrated knowledge of various treatments, procedures, and prognoses of the human body.

1 2 3 4 5

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The student demonstrated proficiency in CPT and ICD-9-CM coding procedures used in your facility.

1 2 3 4 5

The student demonstrated an ability to perform the following medical office procedures: Properly answer phones.

1 2 3 4 5

Prepare and maintain patient records.

1 2 3 4 5

Utilize the computer software effectively.

1 2 3 4 5

The student demonstrated an ability to use oral and/or written communication skills to interact effectively with patients and coworkers.

1 2 3 4 5

The student demonstrated proficiency in completion of insurance claim forms.

1 2 3 4 5

The student demonstrated professional, responsible, and conscientious habits. Student worked to their best ability, took pride in the quality of his/her work, was aware of work to be done, worked well without supervision, willing to perform any task assigned, welcomed suggestions, and was dependable and responsible.

1 2 3 4 5

Integrity: the student followed moral and ethical guidelines, showed respect toward others, was honest, and kept confidential information to her/himself.

1 2 3 4 5

Appearance: the student’s appearance was appropriate for your office.

1 2 3 4 5

The student was willing to learn and has a “can do” attitude.

1 2 3 4 5

The student appeared to enjoy his/her work.

1 2 3 4 5

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HERZING UNIVERSITY MEDICAL INTERNSHIP 8 WEEK (180/180) EVALUATION – MEDICAL BILLING & INSURANCE CODING

Student Name_________________________________________________________

Name of Internship site__________________________________________________

Internship Supervisor___________________________________________________

Internship Dates (beginning and ending) _____________________________________

We do not expect the student to be exposed to every item on the evaluation form. We would appreciate your introducing them to as much as possible.

Please evaluate the student’s performance and knowledge by indicating the quality of their work. Please circle a number 1-5 for each objective. If you do not feel you can evaluate a specific task, just indicate N/A for not applicable. There is room for comments after each question. We would appreciate any comments or suggestions (positive and negative) that you can provide us pertaining to the student’s performance. On any skill you feel the student’s performance was below what was expected, please provide a comment in order that we may help to improve the student in that area.

RATING SCALE:

1 NEEDS IMPROVEMENT Student performance in this area was not acceptable and needs improvement

2 POOR Student’s work in this area is below average3 FAIR Student’s work in this area was average4 GOOD Student’s work in this area was slightly above average5 EXCELLENT Student’s work in this area exceeded expectations

The student demonstrated knowledge of medical terminology.

1 2 3 4 5

The student demonstrated knowledge of anatomy and physiology.

1 2 3 4 5

The student demonstrated knowledge of diseases, disorders, and diagnoses of the human body.

1 2 3 4 5

The student demonstrated knowledge of various treatments, procedures, and prognoses of the human body.

1 2 3 4 5

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The student demonstrated proficiency in CPT and ICD-9-CM coding procedures used in your facility.

1 2 3 4 5

The student demonstrated an ability to perform the following medical office procedures: Properly answer phones.

1 2 3 4 5

Prepare and maintain patient records.

1 2 3 4 5

Utilize the computer software effectively.

1 2 3 4 5

The student demonstrated an ability to use oral and/or written communication skills to interact effectively with patients and coworkers.

1 2 3 4 5

The student demonstrated proficiency in completion of insurance claim forms.

1 2 3 4 5

The student demonstrated professional, responsible, and conscientious habits. Student worked to their best ability, took pride in the quality of his/her work, was aware of work to be done, worked well without supervision, willing to perform any task assigned, welcomed suggestions, and was dependable and responsible.

1 2 3 4 5

Integrity: the student followed moral and ethical guidelines, showed respect toward others, was honest, and kept confidential information to her/himself.

1 2 3 4 5

Appearance: the student’s appearance was appropriate for your office.

1 2 3 4 5

The student was willing to learn and has a “can do” attitude.

1 2 3 4 5

The student appeared to enjoy his/her work.

1 2 3 4 5

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As part of the student’s requirements, several General Education courses are required: Communications, Mathematics, Social Sciences, and Humanities. To help determine and evaluate whether the goals of the General Education Department were met, we would appreciate your evaluation of your student in the following areas.

Rate 1-5 with 1 being the lowest and 5 being the highest.

The student demonstrated ability to:

Write clearly in standard English 1 2 3 4 5Speak clearly in standard English 1 2 3 4 5Listen and understand spoken messages 1 2 3 4 5Read and understand what was read 1 2 3 4 5Apply analytical thinking to approach problem solving 1 2 3 4 5Work well with people of various ages, races, and backgrounds 1 2 3 4 5Find and use information 1 2 3 4 5

If the student’s performance is below average, please provide an explanation so we can coach the student.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Additional comments:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

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HERZING UNIVERSITY MEDICAL INTERNSHIPSITE EVALUATION – MEDICAL BILLING & INSURANCE CODING

Student__________________________________________ Student ID_________________

Site _______________________________________________________________________

Site Supervisor and Title _______________________________________________________

Good Average Poor N/AInterest of management in training programWillingness of site supervisor to helpWillingness of coworkers to helpWillingness to work around school scheduleOpportunity to use CPT coding skillsOpportunity to use ICD-9-CM coding skillsOpportunity to deal directly with patients or clients utilizing oral communication skillsOpportunity to learn or enhance skillsOpportunity to ask questionsOpportunity for a variety of work experienceOverall appearance of work environmentEmployment opportunity

If given the opportunity, would you want to work at this site?

OVERALL EVALUATION OF SITE:

STUDENT SIGNATURE____________________________________ DATE__________________

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Student Internship Evaluation – MBIC

Name ____________________________________________ Student ID ________________

Site _____________________________________________

Site Supervisor(s) and Title _____________________________________________________

1. What skills did you acquire on internship?

2. What learned skills do you feel you were given the opportunity to use?

3. What was the single most helpful part of the internship program?

4. At the site, what skills did you observe that you would like to acquire?

5. What are your plans for acquiring these skills?

6. How has the internship influenced your career planning? Has the internship experience reinforced goals or changed your goals?

7. What in the internship program needs improvement? (Site or Classroom)

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