California Career and Technical Education Standards

• HSMT.E.E2.1 Understand the collection and formatting of information by using facility protoc...
• HSMT.E.E2.2 Use medical terminology appropriate to therapeutic services to interpret and com...
• HSMT.E.E4.2 Understand the process for reporting patients’ and clients’ responses to adminis...
• HSMT.E.E4.3 Know the process for assessing patients’ and clients’ responses to administered ...
• HSMT.E.E5.1 Use the appropriate evaluation tools to assess patients and clients.
• HSMT.E.E5.2 Understand the process for revising or creating modifications to treatment plans...

• Blank HCFA (Health Care Financing Administration)form - Hooks / Set

  As students enter my classroom have the classroom semi darkened.  On their desks, place a folder containing a copy of a blank HCFA (Health Care Financing Administration) form as well as copies of medical health physical forms, standard medical  chief complaint forms, and a dental form for comparison.

  As the bell rings, begin a clip of John Grisham's "The Rainmaker" 1997,  based upon the novel of the same name.  This particular segment is of the courtroom where the insurance company adjuster is telling  the mother of the  young man who has just died, that she is " stupid, stupid, stupid" for resubmitting  the insurance  papers repeatidly even though the company continues to deny the claims. 

  The use of this particular segment will attract the students attention by focusing on the negative connotations commonly placed  upon the insurance companies.  Use this powerful opening to transition the student's curiosity into instructive matierial that will allow  them to approach the subject of insurance processing factually and practically.

  • YouTube- The Rainmaker.mp4 [ Watch Video ] [ Download Original Video ] WOW !! How many have of you have heard your parents say something derogatory about the insurance company that they have? How many of you even know what insurance company you have? Do you have a card that you carry in your wallet? Let's go back to the film clip one more time....now let's look at the first form in your packet. Would the mother in the film truly have been "stupid,stupid, stupid?"...perhaps not. Let us consider that she has an insurance card, then insurance forms...she fills in the blanks...just as we will be doing in a later lesson with one of our patients. *Give students a brief period of time to discuss any experiences they may have had with hospitals or large medical bills etc.
  • HCFA (Health Care Financing Administration)1500_fill.jpg [ View Image ] [ Download Original ] This first form is a standard encounter form that is used by all physicians to bill for their services in their offices. Almost done entirely electronically.
  • hospital form.jpg [ View Image ] [ Download Original ] This next form in your packet is representative of a standard hospital billing encounter form. It is important to remember that this type of billing form is used to bill for ONLY the facility charges. Each actual special 'person' or entity that serves the patient will be billing for that special department ...
  • dental form.jpg [ View Image ] [ Download Original ] This next form that you see is obviously different...that difference is what? yes, it has teeth on it ...therefore it would be used by....that is correct, it would be used by dentists. Again, although almost all offices medical and dental transmit there offices electronically...they still have to enter the information in this form format for it to transmit.
  • history and physical.jpg [ View Image ] [ Download Original ] This last form that you have is representative of the information that your physician has you complete...and then the office translates that information onto the forms for future submission. We will be completing insurance forms in the future as we study the codes that are representative of the services that the providers provide to the patients.