Valencia College Intent to Register Form Technical Certificate Medical Information Coder/Biller

Transcription

1 Valencia College Intent to Register Form Technical Certificate Medical Information Coder/Biller *If you plan to start the Technical Certificate, this Intent to Register Form must be completed before registering for courses. Please your completed form to: The following courses will be offered in Spring 2018 (January start date). Please indicate by checking the box below which course(s) you plan to enroll into for the Spring Term. HIM Introduction to HIM HIM 1430-Principles of Disease HIM 1012-Legal Aspects of HIM HSA 1100-Health Care Delivery Systems HIM 2222C- Basic ICD Coding *(It is strongly recommended that you have taken HSC 1531-Medical Terminology and BSC 2093C- Human Anatomy & Physiology or OST Introduction to Body Systems before taking this course in the spring term) HIM Health Data Concepts Date of Submission: / / Valencia ID (Required) V# Name (Last) (First) (Middle) Date of Birth / / Gender: Male Female Home Address City, State, Zip Phone Number - Mobile: Work: Emergency Contact Name and Phone: Atlas Are you a U.S. citizen or permanent resident? Yes No Why did you choose the Medical Coder/Biller Certificate Program? How did you learn about the Medical Coder/Biller Certificate Program?

2 Have you ever worked in the Health Care field? If so, describe: Please list all colleges/universities/postsecondary institutions you have attended: If you have attended other institutions outside of Valencia, have all of your official transcripts from these institutions been submitted to Valencia and posted to your Valencia record? (check unofficial transcript in Atlas.) Yes No What is your overall college GPA, including all transfer work? Have you previously been enrolled in a Health Information Technology program? If so, please list name(s) of institution(s) and dates attended: Have you previously been or currently enrolled in the Medical Information Coder/Biller Administration, A.S. degree program at Valencia College? Yes No Technical Certificate Medical Information Coder/Biller Curriculum 1 st Semester: (12 cr.) HSC 1531 Medical Terminology 3 cr. or OST 1257 Medical Terminology for the Office 3 cr. HIM 1000 Introduction to HIM (submit intent) 2 cr. + OST 1467 Introduction to Body Systems for OST 3 cr. HIM 2222C Basic ICD Coding (submit intent) 4 cr. + Students majoring in Health Information Technology A.S. degree are highly recommended to take BSC 2093C Human Anatomy & Physiology in place of OST 1467 Introduction to Body Systems for OST. 2 nd Semester: (13 cr.) Select ONLY ONE from the following computer courses CGS 1060C Introduction to Computers 3 cr. or CGS 2100C Computer Fundamentals and Applications 3 cr. or OST 2854 Microsoft Office 3 cr. HIM 1430 Principles of Disease (submit intent) 3 cr. HIM 2729C Advance ICD Coding (pre-req HIM 2222C) 4 cr. HIM 1012 Legal Aspects of HIM (co-req HIM 1000) 3 cr. 3 rd Semester: (12 cr.) HIM 1110 Health Data Concepts- (pre-req HIM 1000) 3 cr. HSA 1100 Health Care Delivery Systems 3 cr. HSC 1149 General Pharmacology (submit intent) 1 cr. HIM 2253 Basic CPT Coding (pre-req HIM 2222C) 3 cr. HIM 2810L PPE II (pre-req HIM 2222C, 2729C; co-reg HIM 2253) 2 cr. Total Credit 37 This Certificate would prepare the student for the Certified Coding Associate (CCA) certification examination.

3 The following courses below are not required for the Technical Certificate. However, they are required for the Health Information Technology Program. Please complete chart below where applicable. -Enter grades for courses completed with a minimum grade of C (for Humanities, highest grade should be entered). -Enter AP/IB/CLEP as the grade, if applicable. You must submit official scores and we cannot accept scores from other school transcripts. -Enter R as the grade if you are currently registered in a course. -If you have not taken a course, please enter No or leave blank. -Any blank spaces will be assumed to be courses not taken; therefore, please fill out chart carefully and completely. If you are unsure about a course, enter it just in case and it will be reviewed. Valencia Course prefix/ number Course prefix/ number (if different) Credits Course Title Grade Semester & Year Taken Name of Institution Attended BSC 2093C BSC 2094C HSC Human Anatomy & Physiology I 4 Human Anatomy & Physiology II 3 Medical Terminology CGS 1060 OR CGS Introduction to Computers OR Computer Fundamentals and Applications ENC 1101 MAC 1105 PSY Freshman Composition I 3 College Algebra 3 General Psychology 3 Any course that meets Gen. Ed. Humanities requirement (highest grade) SLS 1122 OR HSC New Student Experience OR Professions of Caring I understand that it is fraudulent to misrepresent any information on this form and I affirm that all information is true. Signature Date

4 Change of Program/Major Please submit the attached *Change of Major form along with your Intent to Register From. DO NOT submit this form to the Answer Center. Read the instructions below if the form is not filled out correctly, this will delay the processing of your change of major. Instructions Page 1 of Change of Major Form: Fill in your Last Name, First Name, Middle Initial, Maiden Name if appropriate, Valencia Identification Number (VID) and Date of Birth. For #1, fill in the names of all previously attended colleges in the space provided. For #2, Primary enter AS HIT and for Secondary enter TC Coder/Biller Sign and date at the bottom of the page. Page 2-3 of Change of Major Form: Locate your program and check the box next to your chosen health science program. How to Submit Change of Major Form: In-Person Valencia West Campus, Health Sciences Advising Office (Turn into Carolyn Lynch) 1800 S Kirkman Road Building 1, Room 130 General Office Hours: Monday-Thursday 8am to 5 pm, Friday 9am to 5pm (Summer Fridays: 9am to 12pm) Or, mail to the following address: Valencia College West Campus MC 4-30 Health Sciences Advising, Bldg 1, Rm S Kirkman Road Orlando, FL If you have questions about filling out the Change of Major Form: Carolyn Lynch at HealthScienceApplications@valenciacollege.edu and include your VID number and enter Change of Major in the subject line. Revision: 10/31/17

5 CHANGE OF PROGRAM/MAJOR FORM Please type or print in ink your name as it currently appears on your Valencia records. LAST NAME FIRST NAME M.I. MAIDEN NAME VALENCIA ID/SOCIAL SECURITY NUMBER DATE OF BIRTH COLLEGE USE Completed by: Date Month Day Year Campus of Record: q E q W q OSC q WP q LN WHAT INFORMATION WOULD YOU LIKE TO UPDATE? q Program/Major q Admit Term q Meta-Major q DirectConnect CHANGE OF PROGRAM/MAJOR Change of Program requests received after the Drop/Refund Deadline for a term will be processed for the following term. To change to a degree-seeking student, all official transcripts (high school and/or college) must have been received by Valencia. To be considered degree-seeking at Valencia, students must have a standard high school diploma, completed a GED, or have transfer work from a regionally accredited institution and must complete and satisfy assessment requirements. 1. List all colleges attended: 2. Indicate your primary (1) and/or secondary (2) choice of program or technical certificate. (See page 2 of this sheet for list of programs.) Primary Secondary Catalog Term* * If you indicate a catalog term and you are pursuing two programs, the catalog term will be updated for both programs. Catalog terms are in effect for five years; however, if you change your program you will be required to follow the catalog term currently in effect at the time you submit your change of program request. 3. If you no longer plan to pursue a specific program, degree or certificate, please check the selection below that best describes your situation: Job Improvement q Do not intend to earn a Valencia degree (Personal Interest) q Teacher Recertification q Transient Student ( You will be transferring credits to your home institution where you will be obtaining your degree) Change of interest CHANGE OF ADMIT TERM Change term from (choose one) q Fall q Spring q Summer Change term to (choose one) q Fall q Spring q Summer META-MAJOR SELECTION The following meta-major academic pathways are established for the purposes of aligning your intended academic and career goals. For more information, please refer to Florida Statute S Select one of the following below to indicate which meta-major you would like: q Arts, Humanities, Communication and Design q Industry/Manufacturing and Construction q Business q Public Safety q Education q Science, Technology, Engineering and Mathematics q Health Sciences q Social and Behavioral Sciences and Human Services CHANGE OF DirectConnect CLASSIFICATION 1. After you complete your degree at Valencia, are you planning to complete a bachelor s degree with the University of Central Florida? q Yes q No If not at UCF, where? 2. If you indicated a Florida institution above, do you agree to allow Valencia to release your academic record to that institution? q Yes q No What is your expected date of graduation from Valencia? STUDENT SIGNATURE (REQUIRED) DATE 1

6 MAJORS AT VALENCIA Select your primary and/or secondary program interest and enter your selection on page 1 of this form. Bachelor of Science (B.S.) q Cardiopulmonary Sciences*** (indicate concentration): Community Health Non-Invasive Cardiology q Electrical and Computer Engineering Technology*** (indicate concentration): Audio and Electro-Acoustical Systems Computer Systems Electrical/Electronic Systems Laser and Photonics q Radiologic and Imaging Sciences*** (indicate concentration): Computed Tomography Magnetic Resonance Imaging Quality Management Associate in Arts (A.A.) Students may earn only one A.A. degree. If you have already completed an A.A. or Bachelor s degree at Valencia College or at another institution, you may not seek another A.A. degree at Valencia College. q Associate in Arts q Articulated Architecture (University of Central Florida) q Articulated Architecture (University of Florida) q Articulated Art, Studio/Fine Art (Ringling College of Art and Design) q Articulated Computer Science (University of Central Florida) q Articulated Electrical and Computer Engineering Technology (Valencia College) q Articulated Engineering (Florida Institute of Technology) q Articulated Engineering (Polytechnic University of Puerto Rico, Orlando Campus) q Articulated Engineering (University of Central Florida) q Articulated Engineering (University of Miami) q Articulated Information Technology (University of South Florida) q Articulated Information Technology (University of Central Florida) q Articulated Logistics/Management (Florida Institute of Technology) q Art, Studio/Fine Arts Pre-Major q Aviation Management q Dance Performance Pre-Major*** q Early Childhood Education q Music Performance Pre-Major q Sign Language Interpretation Pre-Major q Theater/Drama/Dramatic Arts Pre-Major Associate in Science (A.S.) q Accounting Technology q Baking and Pastry Management q Biotechnology Laboratory Sciences q Building Construction Technology q Business Administration Articulated A.S. to B.A./B.S. Career Path in General Business Administration Finance Human Resources Management International Business Management Marketing Property and Casualty Insurance Management Real Estate Management Small Business Management q Cardiovascular Technology* q Civil/Surveying Engineering Technology q Computer Information Technology q Computer Programming and Analysis q Criminal Justice Technology (Articulated) Homeland Security q Culinary Management q Dental Hygiene* q Diagnostic Medical Sonography* q Digital Media Technology Live Event Video Production Mobile Journalism Video and Motion Graphics Web Development q Drafting and Design Technology q Electronics Engineering Technology Electronics Laser and Photonics Robotics and Mechatronics Telecommunication and Wireless q Emergency Medical Services Technology* q Entertainment Design and Technology Live Show Production Production Design q Film Production Technology q Fire Science Technology*** Fire Officer Specialization Fire Prevention q Graphics and Interactive Design Technology Graphic Design Interactive Design q Health Information Technology*** q Hospitality and Tourism Management Career Path in Hospitality and tourism Management Career Path to B.S. in Hospitality Administration/ Management (Articulated A.S. to B.S.) q Industrial Management Technology*** q Landscape and Horticulture Technology Horticulture Landscape q Medical Office Administration Medical Front Office Medical Transcription q Network Engineering Technology Cisco Routing and Switching Cyber Security and Digital Forensics Microsoft Systems Administration q Nursing, R.N. (Articulated)* Online R.N. Advanced Standing Track* q Office Administration q Paralegal Studies (Articulated) Litigation Transactional q Radiography* q Respiratory Care* q Restaurant and Food Service Management Career Path in Restaurant and Food Service Management Career Path to B.S. in Restaurant and Food Service Management (Articulated A.S. to B.S.) q Sound and Music Technology Audio and Music Business Management Audio Engineering Technology Music Production Sound Production q Veterinary Technology** *** This is a limited access, selective admissions program that requires an additional application. Contact the specific department for more specific information. An Associate in Arts in General Studies will be added to your student record if you have not been previously awarded an A.A. degree or higher. This will allow you to take prerequisite courses for the limited access program. *** For information on this program, see the online catalog. Students pursuing this program may choose to receive an Associate in Arts degree; Veterinary Technology degree is awarded by St. Petersburg College. *** This is a limited access, selective admissions program that requires an additional application. Contact the specific department for more information. 2

7 MAJORS AT VALENCIA Select your primary and/or secondary program interest and enter your selection on page 1 of this form. Advanced Technical Certificate (ATC) q Computed Tomography*** q Magnetic Resonance Imaging*** Technical Certificate/Career Certificate/Applied Technology Diploma Programs q Accounting Applications q Accounting Operations q Accounting Specialist q Advanced Electronics Technician q Advanced Network Administration q Advanced Network Infrastructure q Baking and Pastry Arts q Basic Electronics Technician q Building Construction Specialist q Business Management q Business Operations q Business Specialist q Chef s Apprentice q Computer Information Technology Analyst IT Security IT Support q Computer Information Technology Specialist q Computer Programming Computer Programming Web Development q Computer Programming Specialist Computer Programming Web Development q Criminal Justice Institute*** Correctional Officer Law Enforcement Officer Crossover: Corrections to Law Enforcement Auxiliary Law Enforcement Officer q Criminal Justice Technology Specialist q Culinary Arts q Culinary Arts Management q Customer Service Management q Customer Service Operations q Customer Service Specialist q Cyber Security q Digital Broadcast Production q Digital Forensics q Digital Media Development q Digital Media Video Production q Digital Media Web Production q Digital Video Editing and Post-Production q Digital Video Fundamentals q Drafting Architectural Drafting Mechanical Drafting Surveying Drafting q Drafting AutoCAD q Emergency Medical Technology (EMT) q Entertainment Stage Technology q Entrepreneurship q Film Production Fundamentals*** q Fire Services Central Florida Fire Institute at Valencia*** Fire Apparatus Operator Fire Fighter Minimum Standards Fire Officer Supervisor q Graphic Design Production q Graphic Design Support q Graphics Interactive Design Production q Graphics Interactive Design Support q Homeland Security Specialist q Homeland Security Law Enforcement Specialist q Hospitality Event Planning Management q Hospitality Food and Beverage Management q Hospitality Guest Services Specialist q Hospitality Rooms Division Management q Human Resources Management q Human Resources Operations q Human Resources Specialist q International Business Specialist q Landscape and Horticulture Professional q Landscape and Horticulture Specialist q Landscape and Horticulture Technician Horticulture Landscape q Laser and Photonics Technician q Medical Office Management q Medical Office Specialist Medical Front Office Medical Transcription q Medical Office Support q Network Administration q Network Infrastructure q Network Support q Office Management q Office Specialist q Office Support q Paramedic Technology*** q Rapid Prototyping Specialist q Real Estate Specialist q Robotics and Mechatronics Technician q Sound and Music Production Audio Visual Production q Webcast Media q Webcast Technology *** This is a limited access, selective admissions program that requires an additional application. Contact the specific department for more information Valencia College 14ADM017 3