This course provides an overview of the organization, reimbursement, regulations and delivery of different healthcare services. The role of various health care professionals is examined. The purpose, use, compliance, and regulations associated with health information systems is emphasized throughout the course.

Upon successful completion of this course, students should be able to:
Describe the major health care organizations and agencies and their role in the health care delivery system.
Identify the role of members of the health care team.
Describe the major components involved in the payment/reimbursement process.
Identify government payment programs.
Describe the role of information technology on practice management.
Define the basic terminology associated with health information and health information technology.
Identify the legal, ethical, privacy, security and confidentially issues and practices applicable to health information.
List the data that are included in a health information record.
List various measures of health care quality.

Prerequisite: Successful Placement Test Scores or (ENG 050 and REA 050) or ENG 099* or REA 075 (*may be taken concurrently).

3 Credits3 Weekly Lecture Hours

This course begins with an analysis of the structural foundation of the body and its ability to function integrating the levels of organization: chemical cellular, tissue, organ, and system. The course then emphasizes the anatomical structure, physiology, and selective disease processes specific to the integumentary, skeletal, muscular, lymphatic, circulatory, and respiratory systems. Mechanisms by which the body maintains fluid and electrolyte balance and acid base balance are also emphasized.

Upon successful completion of this course, students should be able to:
Analyze the architectural plan of the human body as a whole, the organization of its functional units, and the mechanisms by which it performs its various activities.
Discuss the mechanism and patterns of disease-causing pathogens and neoplasms, and the body's response to threat of injury and disease.
Explain the function and interrelationship of fluids and electrolytes, the mechanisms by which the constancy of total body fluids is maintained, and regulation of the acid-base balance.
Describe the structure and function of the integumentary system and major disorders of this system.
Describe the structure and function of the skeletal and muscular systems as well as disorders of these systems.
Describe the structure and function of the circulatory and lymphatic systems as well as disorders of these systems.
Describe the structure and function of the respiratory system as well as disorders of this system.

Prerequisite: AHM 233* and successful Placement Test Scores or ENG 050*. (*May be taken concurrently.)

3 Credits3 Weekly Lecture Hours

This course emphasizes the anatomical structure, physiology, and selective disease processes specific to the digestive system, urinary system, nervous system and sense organs, endocrine system, and reproductive systems. How nutrition, growth, development, aging, and genetics influence body structure and function is also emphasized.

Upon successful completion of this course, students should be able to:
Describe the structure and function of the digestive system as well as disorders of this system.
Describe adequate nutrition and the complex mechanism of metabolism, as well as disorders associated with eating and metabolism.
Describe the structure and function of the urinary system and major disorders of this system.
Describe the structure and function of the nervous system and disorders of this system.
Describe the mechanisms by which the sense organs are able to sense changes in our external and internal environments as a requirement for maintaining homeostasis; and diseases commonly affecting the sense organs.
Describe the structure and function of the endocrine system and major disorders of this system.
Describe the structure and function of the male and female reproductive systems, and briefly describe the major disorders inherent to these systems as well as the major disorders associated with pregnancy.
Describe the concept of development as a biological process characterized by continuous modification and change as well as the effects of aging on major body organ systems.
Describe genetics, the scientific study of inheritance, and its relationship to human disease.
Describe the physiology of congenital diseases and the roles that heredity and environmental factors play in the development of these conditions.

Prerequisite: AHM 233* and successful Placement Test Scores or ENG 050*. (*May be taken concurrently.)

3 Credits3 Weekly Lecture Hours

This course is structured to prepare the student to assist the physician in the clinic, outpatient office and ambulatory health care settings. The responsibilities include preparation of the client for examination, measurement of basic body functions, assistance in diagnostic testing and procedures, and general clinical procedures performed in the medical office. This course includes an in-person simulation laboratory requirement.

Upon successful completion of this course, students should be able to:
Describe the role and function of the medical assistant in the health care delivery system.
Evaluate the impact of disease and disease causing organisms on humans and their environment.
Describe the role of the medical assistant in assisting with physical measurements.
Perform the duties necessary to assist the physician with the health history and physical examination.
Identify and describe the role of the medical assistant in the collecting and handling of specimens.
Analyze the role of the medical assistant in assisting the physician in minor surgery.
Describe the importance of nutrition, exercise, and diet therapy to the well being of the patient.

Prerequisites: MAT 050 and ((ENG 050 and REA 050) or ENG 099* or REA 075). Successful College Placement Test Scores may be accepted. *(Courses may be taken concurrently)

4 Credits3 Weekly Lecture Hours
 2 Weekly Lab Hours

The course prepares students to assist the physician in the clinic, outpatient office and ambulatory health care settings. Responsibilities include administration of medications, phlebotomy, and aiding in diagnostic tests and procedures commonly performed in the medical office. This course includes an in-person simulation laboratory requirement.

Upon successful completion of this course, students should be able to:
Analyze the role and the responsibility of the Medical Assistant concerning the principles of pharmacology and drug administration.
Classify the commonly used diagnostic laboratory procedures that are utilized in a physician's office.
Classify the commonly used diagnostic radiological procedures that are utilized in the physician's office.
Describe the role of the Medical Assistant in the recording of an EKG and other cardiac tests.
Describe the role of the Medical Assistant in assisting with therapeutic modalities, rehabilitative procedures, orthopedic medicine and physical therapy.
Evaluate the role of the Medical Assistant during a medical emergency and in preparing for an emergency situation.

Prerequisite: AHM 106.

4 Credits3 Weekly Lecture Hours
 2 Weekly Lab Hours

This course is structured to provide the student with a review of the simulation laboratory experience in assisting the physician in the clinic, hospital or private office. Clinical skills covered include preparation of the client for examination, measurement of basic body functions, assistance in diagnostic testing and procedures, and general patient care procedures performed in the medical office.

Upon successful completion of this course, students should be able to:
Understand the role and function of the medical assistant in the health care delivery system.
Describe the role of the medical assistant in assisting with physical measurements.
Analyze the role of the medical assistant in assisting the physician with the health history and physical examination.
Understand the role of the medical assistant in the collecting and handling of specimens.
Analyze the role of the medical assistant in assisting the physician in minor surgery.

Prerequisite: AHM 106.

1 Credit
 2 Weekly Lab Hours

The course prepares students with simulation laboratory experience in assisting the physician in the clinic, hospital or private office. Responsibilities include preparation of the client for examination, measurements of body functions, aiding in diagnostic tests and procedures, and general operation of the office.

Upon successful completion of this course, students should be able to:
Apply the principles of pharmacology and drug administration.
Perform diagnostic laboratory procedures that are utilized in a physician's office.
Perform an EKG.
Describe the role of the medical assistant in assisting with physical therapy.
Evaluate the role of the medical assistant during a medical emergency and giving first aid.

Prerequisite: AHM 106 and AHM 107.

1 Credit
 2 Weekly Lab Hours

This course, for non-coding majors, is designed to teach students general principles of the most current ICD-CM (International Classification of Disease) And CPT (Current Procedural Terminology) coding. Students will learn to translate medical terminology and descriptions into code numbers. In this course will focus on coding for outpatient procedures and diagnoses. Emphasis will be placed on accuracy of coding in a variety of settings. In addition the course will focus on various aspects of insurance and reimbursement and forms and documents used in the field.

Upon successful completion of this course, students should be able to:
Identify and explain the organization of both the ICD-CM manual and CPT manual.
Transform descriptions of diagnostic terms and symptoms into correct ICD-CM codes.
Transform outpatient procedures into valid CPT codes.
Follow rules and guidelines for selecting the current ICD-CM and CPT codes.
Identify and use the HCPCS (Healthcare Common Procedural Coding System) Codes for Medicare patients.
Complete forms related to insurance reimbursement, insurance eligibility and describe the process for these activities.

Prerequisite: AHM 233.

3 Credits3 Weekly Lecture Hours

This course is designed to provide the student with the knowledge and skills needed to communicate effectively in the health care setting. Emphasis is on development of interpersonal skills for workplace and therapeutic communication. Among the topics covered are basic communication skills, conflict resolution, cultural awareness, confidentiality, and professionalism.

Upon successful completion of this course, students should be able to:
Apply basic principles of communication in responding to verbal and nonverbal communication.
Respond appropriately to issues of confidentiality in the health care setting.
Demonstrate knowledge of federal and state health care legislation and regulations.
Describe professionalism in relation to the health care setting.
Explain the role of alternative and complimentary medicine in health care.
Develop transcultural communication skills.

Prerequisite: NONE New students should complete Placement Testing prior to registration. Visiting students may submit college transcript.

3 Credits3 Weekly Lecture Hours

This course is structured for the Medical Assisting and other Administrative Health Professions and introduces students to the administrative procedures commonly performed in a health care setting. Emphasis on medical ethics and legal considerations, a history of medicine, communication skills, managing accounts payable and receivable, electronic health records, receptionist responsibility, operational functions and workplace dynamics will help prepare the student for entry-level office management. Coursework will be presented and completed in both manual and computerized formats, so that the student will have a more comprehensive understanding of an administrative health care facility and its procedures.

Upon successful completion of this course, students should be able to:
Describe the ethical and legal responsibilities of a medical office administrator.
Demonstrate effective oral and written communication both with professionals and patients.
Utilize electronic health record software applications in the health care setting.
Use and understand systems of maintaining patient clinical and financial records.
Perform office tasks appropriate for computer solutions.
Organize and maintain the physical requirements of a medical office.

Prerequisite: AHM 233 and CS 100.

4 Credits3.5 Weekly Lecture Hours
 1 Weekly Lab Hour

Selected medical coding experiences are provided in a healthcare facility or insurance company. Knowledge and guidelines basic to applying correct coding systems for appropriate reimbursement are stressed. NOTE: All certificate program requirements in the Medical Coding or Medical Coding for the Healthcare Professional must be completed before taking this course.

Upon successful completion of this course, students should be able to:
Maintain ethical and legal standards of a Medical Coding ProfessionalDemonstrate the ability to use computer applications and technology relating to Medical Billing and Coding.
Interpret and evaluate data in the Electronic Medical Record while searching for deficiencies in demographic and/or insurance information.
Apply correct coding systems for appropriate reimbursement.
Evaluate coding procedures for achievement of optimal quality in seeking appropriate reimbursement.
Create a portfolio to demonstrate professional skills to enhance marketability for employment.

Prerequisite: All program requirements in Medical Billing or Medical Coding and Billing certificate.

3 Credits

This 4 credit course is 240 hours and includes administrative and clinical experiences in a medical office or ambulatory health care facility during working hours. Externship must be scheduled with the practicum coordinator of the Medical Assistant program. NOTE: All program courses must be completed prior to taking this course.

Upon successful completion of this course, students should be able to:
Apply knowledge of the anatomical structure and physiological functioning of the human body and of medical terms descriptive of body systems.
Apply the business/administrative and clinical duties of the medical assistant.
Function as an assistant to the physician in a medical and/or other health care setting.
Implement the ethical and legal responsibilities of the medical assistant in the health care delivery system.
Apply selected principles of biophysical and psychosocial sciences in providing assistance to the physician.
Maintain business and patient health records.
Discuss the fundamental concepts of disease.

Prerequisites: AHM 107 and AHM 130 and AHM 185 and AHM 208 and AHM 220.

4 Credits0 Weekly Lecture Hours

This course is an introduction to the Health Information Management (HIM) profession and the patient health record. Some of the topics covered are functions of the health record, content and structure of the health record, analysis of health records and health information, health care data sets, data access and retention, storage and retrieval systems, forms and screen design, and indexes and registers. Information is presented for both the paper-based and electronic health record.

Upon successful completion of this course, students should be able to:
Describe the purpose, structure, Code of Ethics and certification processes of the American Health Information Management Association (AHIMA).
Differentiate the roles of Health Information Management (HIM) professionals.
Describe the workflow of records within a HIM Department.
Differentiate between the functions and uses of primary and secondary health records.
Identify the basic forms and formats for collection of patient information in various health care facilities.
Evaluate and apply principles of forms design.
Describe the purposes and techniques related to record analysis, including quantitative, qualitative, and legal.
Compare different storage and retrieval systems.
Discuss what forces are driving the adoption of electronic health records.
Identify the legal.
ethical.
privacy, security and confidentiality issues and practices as they apply to health information.

Prerequisite: AHM 102.

3 Credits4 Weekly Lecture Hours

This course provides students with opportunities to learn fundamental concepts of disease processes followed by further study of specific diseases as they relate to a developmental stage or body system. Pathophysiology, etiology, clinical manifestations, diagnostic and laboratory procedures, and treatment modalities, including pharmacology are emphasized. NOTE: College Academic Learning Goal Designation: Scientific Inquiry (SI) when taken with AHM 220.

Upon successful completion of this course, students should be able to:
Explain the disease process, including causes of disease, risk factors, diagnosis, and treatment modalities.
Explain the physiology, assessment and management of pain.
Describe common infectious diseases and neoplasms.
Describe common congenital diseases and mental health disorders.
Correlate the pathophysiology with the etiology, clinical manifestations, diagnosis, and treatment of diseases for each human body system.
Classify commonly used medications by action and body system.
Identify the routes of administration, indications, adverse effects, and related laboratory studies of commonly used medications.

College Academic Learning Goal Designation: Scientific Reasoning (SI)

Prerequisites: AHM 233 and (AHM 104 or AHM 105 or BIO 150).

4 Credits4 Weekly Lecture Hours

This is a survey course intended for allied health majors. This 1 credit course contains microbiological information and skills needed for the allied health professions. This course differs from a traditional 4 credit microbiology course in that the 4 credit course emphasizes general microbiology for science majors, whereas the 1 credit applied microbiology course emphasizes concepts for students entering health professions. The concepts of specimen collection and transport, identification of microorganisms, pathogenesis, and control, and treatment of infectious disease are the main emphasis of the course. Clinical laboratory experiences will emphasize application of concepts to skills. NOTE: College Academic Learning Goal Designation: Scientific Inquiry (SI) when taken with AHM 208 Pathophysiology and Pharmacology.

Upon successful completion of this course, students should be able to:
Explain the relationship between the structure and function of microorganisms.
Describe techniques of microbial control.
Apply principles of sterile technique in specimen collection and performing laboratory procedures in the microbiology lab.
Describe the distribution of normal and pathogenic flora for different body sites.
Discuss antibiotic treatment for disease.
Classify and perform diagnostic procedures of body fluid specimens.

College Academic Learning Goal Designation: Scientific Reasoning (SI)

Prerequisite: Successful Placement Test Scores or (ENG 050* and REA 050) or ENG 099* or REA 075 (*may be taken concurrently).

1 Credit0.67 Weekly Lecture Hours
 0.67 Weekly Lab Hours

The primary focus of this course is to provide students the principles, guidelines and application of The Current Procedural Terminology (CPT) coding system. CPT is the coding system used to describe services provided by physicians. CPT is also used for services provided by hospital outpatient and ancillary departments, hospital emergency departments, and other health care facilities. In addition, students will be introduced to Procedural groupings such as APCs (Ambulatory Payment Classifications) and RUGs (Resource Utilization Groups). This course also addresses reimbursement and compliance issues related to physician-based coding as well as the purpose and application of the CMS (Center for Medicare and Medicaid Services Healthcare Common Procedural Coding System (HCPCS).

Upon successful completion of this course, students should be able to:
Define terms, phrases and abbreviations related to medical coding.
Apply specific volumes of Current Procedural Terminology (CPT) and Healthcare Common Procedural Coding Systems as they pertain to the identification of procedures, medications and medical equipment in healthcare facilities.
Apply Current Procedural Terminology (CPT) coding as they pertain to identification of procedures, medications, and medical equipment in a variety of medical specialties, including but not limited to: Evaluation and Management Coding, Surgery Coding, Pathology and Laboratory Coding, and Radiology coding.
Describe insurance carrier reimbursement systems, such as APCs, RUGs, Outpatient Prospective Payment System (OPPS), Fee-For-Service Payments and Capitation payments.
Apply legal concepts to issues of medical coding.

Prerequisites: (AHM 104 and AHM 105 and AHM 233) or (BIO 150 and BIO 151 and AHM 233).

3 Credits3 Weekly Lecture Hours

This course is designed for students who plan to work in the variety of healthcare facilities in departments including medical records, medical coding, medical billing, or other reimbursement and documentation departments. It is intended to provide additional in depth study of coding principles, clinical topics, and case studies to increase knowledge and skills in CPT (Current Procedural Terminology) coding. The use of CMS Healthcare Common Procedural Coding System (HCPCS) is also addressed. Extensive coding of case studies from various medical specialties will be completed in this course.

Upon successful completion of this course, students should be able to:
Code accurately a medical or surgical operative report, physician office visit (Evaluation and Management) or outpatient procedural case study.
Recognize the economic and ethical implications of coding assignment on reimbursement, and how these are impacted by reimbursement systems such as APC's (Ambulatory Payment Classifications, ASC's (Ambulatory Surgery Center) and RBRVS (Resource Based Relative Value Scale).
Determine if coded data is of optimal quality and evaluate if coded cases require a single code or multiple codes (both CPT and HCPCS codes) as well as analyze sequencing of these codes.

Prerequisites: AHM 231

3 Credits3 Weekly Lecture Hours

This course is designed to introduce the skills and knowledge needed to develop an understanding of the language of medicine. The basic structure of medical terms and the rules for word building will be discussed in the context of how the body works in health and disease. Upon completion, students should be able to pronounce, spell, and define accepted medical terms. In addition to medical terms, common medical abbreviations applicable to each system will be interpreted.

Upon successful completion of this course, students should be able to:
Identify word parts and their meanings in medical terms.
Utilize reference materials to determine meaning, usage, and spelling of medical terms.
Describe the main functions of each body system.
Define diagnostic, symptomatic, and therapeutic terms related to each system.
Identify terms describing pathology affecting body systems.
Define anatomical landmarks, directional, positional, and numeric medical terms.
Recognize common classes of drugs and their actions.
Recognize the correct spelling of medical terms.
Develop a medical vocabulary.

Prerequisite: Successful Placement Test Scores or (ENG 050 and REA 050) or ENG 099* or REA 075 (*may be taken concurrently).

3 Credits3 Weekly Lecture Hours

This course is designed to teach those interested in learning ICD-10-CM diagnosis coding, the basic skills required to accurately code diagnosis in ICD-10-CM. Students will learn how to interpret and apply the ICD-10-CM guidelines to properly assign diagnosis codes to patient encounters. The ICD-10-CM codebook, textbook class-work, homework activities, and lectures will provide students with hands-on experience in assigning accurate diagnosis codes in ICD-10-CM. NOTE: Students must obtain a grade of "C" or better in this course to successfully complete their program.

Upon successful completion of this course, students should be able to:
Understand the format, convention and chapter specific guidelines to correctly assign ICD-10-CM codes.
Apply general guidelines and chapter specific guidelines to correctly assign ICD-10-CM codes.
Understand the code of ethics for coders.

Prerequisites: AHM 208 and AHM 233 and (AHM 104 + AHM 105) or (BIO 150 + BIO 151). Grade of C or better required in all courses.

3 Credits3 Weekly Lecture Hours

This course is designed for students who plan to work in the Health Information Management (HIM) department of a hospital. It is intended to provide additional in-depth study of inpatient medical record case studies to increase knowledge and skills in ICD-10-CM diagnosis coding. This course will also provide students the opportunities to use and apply ICD-10-PCS coding classification system. Students will learn coding characteristics, conventions and apply guidelines to identify and accurately assign codes to inpatient hospital procedures. NOTE: Students must achieve an overall grade of "C" (70% or above) to receive credit for this course for Allied Health Programs or certificates.

Upon successful completion of this course, students should be able to:
Given a scenario, extract the relevant diagnoses and/or procedures and then accurately and completely code them according to ICD-10-CM guidelines and ICD-10-PCS guidelines.
Apply coding guidelines to accurately code principal diagnoses and procedures to determine the correct diagnosis related group assignments.
Demonstrate the use of ICD-10-CM coding and ICD-10-PCS coding in DRG assignment.
Recognize the economic and ethical implications of coding assignment on reimbursement.

Prerequisite: AHM 239 with grade of 'C' or better.

3 Credits3 Weekly Lecture Hours

This course is designed for students to learn the general principles of revenue cycle management and reimbursement methodologies. Students will learn how to complete and use insurance claim forms and insurance related forms (referrals, pre-authorizations, registration forms). The class will provide students with hands-on experiences with a variety of insurance related issues as well as compliance strategies and reporting. Reimbursement systems including fee-for-service payments and capitation payments will be covered in detail as well as regulatory guidelines, management of denials of claims and chargemaster maintenance.

Upon successful completion of this course, students should be able to:
Describe legal and ethical issues involved in revenue cycle management and compliance and identifying potential abuse and fraudulent trends through data analysis.
Describe and explain different types of health insurance carriers and reimbursement systems as well as rules and regulations for each (private insurance, managed care, Medicare, Medicaid, Workers Compensation, Military insurance).
Recognize the economic and ethical implications of coding assignment on reimbursement, and how these are impacted by reimbursement systems such as APC's (Ambulatory Payment Classifications, ASC's (Ambulatory Surgery Center) and RBRVS (Resource Based Relative Value Scale).
Accurately complete referral, preauthorization, registration and encounter forms.
Submit claims in paper and electronic format.
Document billing information using correct medical terminology and perform an internal and external chart audit.
Accurately complete referral, preauthorization, registration forms, encounter forms, EOB (explanation of benefits review and analysis) and ABN forms (Advanced Beneficiary Notices).
and ensure appropriate coding as per CMS (Center for Medicare and Medicaid Guidelines).
Resolve claim errors and learn how to resubmit claims that have been rejected.
Generate patient bills when needed through interpretation of explanations of benefits/remittance advice statements.
Describe the process of how to follow up with insurance companies and patients regarding unpaid bills.
Record changes, payments and adjustments for patient scenarios provided.

Prerequisites: AHM 130 or (AHM 231 and AHM 239).

3 Credits3 Weekly Lecture Hours

This course is designed to have students apply knowledge and skills from their medical coding and billing classes in a comprehensive hands-on experiential learning setting using authentic patient cases and patient case scenarios. Through this AHIMA virtual practicum, students will have the opportunity to use various software application programs including 3M coding and reimbursement encoder software, Nuance Clintegrity 360 encoder software, Find-A-Code software which includes an introduction to Hierarchical Condition Category Coding (HCC) and Computer Assisted Coding (CAC), Clinical Documentation Improvement (CDI). Various experts in the field will lecture on their specific subject areas. This course will also provide students with an opportunity to create a portfolio which will demonstrate employment skills to future employers. This course may require approximately 4 on-campus class meetings at the Marple Campus.

Upon successful completion of this course, students should be able to:
Demonstrate the ability to use computer applications and technology related to Medical Billing and Coding.
Analyze, interpret and evaluate data in the medical record to determine correct clinical documentation to support codes used.
Evaluate data from electronic medical records and code these records with appropriate ICD, CPT-4 and HCPCS codes and coding from source documents.
Describe how compliance standards correlate with medical records and documentation guidelines.
Evaluate various specialties of coding and compare and contrast the different specialties.
Create a portfolio to demonstrate professional skills to enhance marketability for employment.

Prerequisites: AHM 232 and AHM 240 and AHM 241

3 Credits1 Weekly Lecture Hour
 4 Weekly Lab Hours