MAA 103 : Medical Assisting Administrative Procedures

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. Two lecture hours and three lab hours a week. Fall

Prerequisites

Medical Assisting students only. Other students interested in Medical Assisting may register for this course with the approval of the instructor or program coordinator.

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• Demonstrate telephone techniques.
  2. Compose professional/business letters.
  3. Manage appointment schedules by establishing priorities.
  4. Schedule patient admissions and/or procedures.
  5. Organize a patient’s medical record.
  6. File medical records.
  7. Execute data management by using the electronic medical record (EMR).
  8. Use office hardware and software to maintain office systems.
  9. Use the Internet to access information related to the medical office.
  10. Maintain organization by filing properly.
  11. Perform routine maintenance of office equipment with documentation.
  12. Perform an office inventory.
  13. Prepare a bank deposit.
  14. 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.
  15. Utilize computerized office billing systems.
  16. Apply both managed care policies and procedures. 
  17. Apply third-party guidelines. 
  18. Complete insurance claim forms
  19. Obtain pre-certification including documentation.
  20. Obtain pre-authorization including documentation.
  21. Verify eligibility for managed care services.
  22. Respond to issues of confidentiality.
  23. Perform within scope of practice.
  24. Apply HIPAA rules in regard to privacy/release of information.
  25. Practice within the standard of care for a medical assistant.
  26. Incorporate the Patient’s Bill of Rights into personal practice and medical office policies and procedures. 
  27. Complete an Incident Report.
  28. Document the patient record accurately.
  29. 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.

Overview

Subject

Credits

3
Instructional support fee applies.

Degrees/Certificates That Require Course