MAA 103 : Medical Assisting Administrative Procedures

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