You have completed the final Module of this Credit Unit!!!

All of your Module Competency Assessments within this Credit Unit must be verified with a passing score of 75% or better before you will be eligible to take the Credit Unit Assessment.

To schedule with the Proctor, please use the following button. Select only one appointment time. You will receive a confirmation email reminding you of your scheduled time.

Schedule your Assessment!

 

 You MUST enter the date and time of your Assessment in the textbox.  

(For the textbox to appear, you must click "Submit Assignment" in the upper right hand corner.)

 Review for Your Credit Unit Assessment

This Credit Unit Assessment consists of fill-in-the-blank, essay, math calculations, and matching questions. You are required to pass this Credit Unit Assessment with a 75% and will have 2 attempts to do so; however, do your best the first time as failing a Credit Unit Assessment twice will result in failing the course.  Once you have submitted your initial attempt, DO NOT attempt the Credit Unit Assessment again unless instructed to do so by your Navigator.

 Assessment Parameters:

1. This is a timed assessment. You will have 2 hours to complete the assessment.

2. Pay close attention to the rubrics (where provided) which list the criteria on which you will be graded.

3. You will need a calculator.

Take a moment to review your textbook, submitted Competency Assessments, and Self-checks before you attempt to take your Credit Unit Assessment. Now is a good opportunity to reach out to your Content Expert with questions. The Credit Unit Assessment is your opportunity to demonstrate your understanding of all the concepts presented in this Credit Unit. 

What should the you study for the Credit Unit Assessment?  Make sure you can answer each of the Course Outcomes listed below.

 Course Outcomes:

  1. Identify types of insurance plans.
  2. Identify models of managed care.
  3. Discuss workers' compensation as it applies to patients.
  4. Describe procedures for implementing both managed care and insurance plans.
  5. Discuss utilization review principles.
  6. Discuss referral process for patients in a managed care program.
  7. Describe how guidelines are used in processing an insurance claim.
  8. Compare processes for filing insurance claims both manually and electronically.
  9. Describe guidelines for third-party claims.
  10. Discuss types of physician fee schedules.
  11. Describe the concept of RBRVS.
  12. Define Diagnosis-Related Groups (DRGs).
  13. Apply both managed care policies and procedures.
  14. Apply third party guidelines.
  15. Complete insurance claim forms.
  16. Obtain precertification, including documentation.
  17. Obtain preauthorization, including documentation.
  18. Verify eligibility for managed care services.
  19. Demonstrate assertive communication with managed care and/or insurance providers.
  20. Demonstrate sensitivity in communicating with both providers and patients.
  21. Communicate in language the patient can understand regarding managed care and insurance plans.
  22. Compute calculations for billing purposes.