This comprehensive course prepares Medical Assisting students to perform administrative procedures in the medical office. Students develop skills using computer software to schedule and manage appointments and to execute data management using electronic medical records (EMR). The course also covers telephone techniques, records and office management, managing practice finances, professionalism, medical law, ethics and effective communication with patients and staff. Prerequisite: Medical Assisting students only. Other students interested in Medical Assisting may register for this course with the approval of the instructor or program coordinator. Two lecture hours and three lab hours a week. Instructional Support Fee applies.
Credits
3
Upon successful completion of this course, the student should be able to:
Cognitive:
1. Discuss pros and cons of various types of appointment management systems
2. Describe scheduling guidelines
3. Recognize office policies and protocols for handling appointments
4. Identify critical information required for scheduling patient admissions and/or procedures
5. Identify systems for organizing medical records
6. Describe various types of content maintained in a patient’s medical record
7. Discuss pros and cons of various filing methods
8. Identify both equipment and supplies needed for filing medical records
9. Describe indexing rules
10. Discuss filing procedures
11. Discuss principles of Electronic Medical Records (EMR)
12. Identify types of records common to the healthcare setting
13. Identify time management principles
14. Discuss the importance of routine maintenance of office equipment.
15. Explain basic bookkeeping computations
16. Differentiate between bookkeeping and accounting
17. Describe banking procedures
18. Discuss precautions for accepting checks
19. Compare types of endorsements
20. Differentiate between accounts payable and accounts receivable
21. Compare manual and computerized bookkeeping systems used in ambulatory healthcare
22. Describe common periodic financial reports.
23. Explain both billing and payment options
24. Identify procedures for preparing patient accounts
25. Discuss procedures for collecting outstanding accounts
26. Describe the impact of both the Fair Debt Collection Act and the Federal Truth in Lending Act of 1968 as they apply to collections
27. Discuss types of adjustments that may be made to a patient’s account
28. Identify types of insurance plans
29. Identify models of managed care
30. Discuss workers’ compensation as it applies to patients
31. Describe procedures for implementing both managed care and insurance plans
32. Discuss utilization review principles
33. Discuss the referral process for patients in a managed care program
34. Describe how guidelines are used in processing an insurance claim.
35. Compare processes for filing insurance claims both manually and electronically
36. Describe guidelines for third-party claims
37. Discuss types of physician fee schedules
38. Describe the concept of Resource-Based Relative Value Scale (RBRVS)
39. Define Diagnosis-Related Groups (DRGs)
40. Discuss the legal scope of practice for medical assistants
41. Explore issues of confidentiality as it applies to the medical assistant
42. Describe the implications of HIPAA for the medical assistant in various medical settings
43. Summarize the Patient Bill of Rights
44. Discuss licensure and certification as it applies to healthcare providers
45. Describe liability, professional, personal injury, and third-party insurance
46. Compare and contrast the physician and medical assistant’s role in care standards
47. Compare criminal and civil law as it applies to the practicing medical assistant
48. Provide an example of tort law as it would apply to a medical assistant
49. Explain how the following impact the medical assistant’s practice with examples: Negligence, Malpractice, Statute of Limitations, Good Samaritan Act(s), Uniform Anatomical Gift Act, Living Will/Advanced Directives, Medical Durable Power of Attorney.
50. Identify how the Americans with Disabilities Act (ADA) applies to the medical assisting profession
51. Discuss all levels of governmental legislation and regulation as they apply to medical assistants
52. Discuss principles of using the Electronic Medical Record (EMR)
Psychomotor:
1. Explain general office policies
2. Demonstrate telephone techniques
3. Compose professional/business letters
4. Manage appointment schedules by establishing priorities
5. Schedule patient admissions and/or procedures
6. Organize a patient’s medical record
7. File medical records
8. Execute data management by using the electronic medical record (EMR)
9. Use office hardware and software to maintain office systems
10. Use the Internet to access information related to the medical office
11. Maintain organization by filing properly
12. Perform routine maintenance of office equipment with documentation
13. Perform an office inventory
14. Prepare a bank deposit
15. Perform accounts receivable procedures to include: Posting entries on a Day Sheet, Performing billing procedures, Performing collection procedures, Post
adjustments, Process a credit balance, Process refunds, Post non-sufficient fund (NSF) checks, Post collection agency payments.
16. Utilize computerized office billing systems
17. Apply both managed care policies and procedures
18. Apply third-party guidelines
19. Complete insurance claim forms
20. Obtain pre-certification including documentation
21. Obtain pre-authorization including documentation
22. Verify eligibility for managed care services.
23. Respond to issues of confidentiality
24. Perform within scope of practice
25. Apply HIPAA rules in regard to privacy/release of information
26. Practice within the standard of care for a medical assistant
27. Incorporate the Patient’s Bill of Rights into personal practice and medical office policies and procedures
28. Complete an Incident Report
29. Document the patient record accurately
30. Apply local, state, and federal healthcare legislation and regulations appropriate to the medical assisting practice setting
Affective:
1. Consider staff needs and limitations in establishing a filing system
2. Implement time-management principles to maintain effective office functions
3. Demonstrate sensitivity and professionalism with patients when handling accounts receivable issues
4. Demonstrate assertive communication with managed care and/or insurance providers
5. Demonstrate sensitivity in communicating with providers, patients & staff
6. Communicate in language the patient can understand regarding managed care and insurance plans
7. Demonstrate sensitivity to patient rights
8. Demonstrate awareness of the consequences of not working within the legal scope of practice
9. Recognize the importance of local, state, and federal legislation and regulations in the practice setting