MEDA 1020 - Administrative Procedures for Medical Assistants Credits: 4
Hours/Week: Lecture 4 Lab None
Course Description: This course introduces common manual and computerized office procedures associated with a clinical practice. Topics include reception and telephone management, appointment scheduling, mail processing, filing, banking, bookkeeping, payroll, ICD-9-CM, ICD-10-CM and CPT coding, insurance claims processing, and health care law and ethics. The student will complete computerized PM and EMR exercises and simulations of tasks completed in a medical practice integrating the above topics.
Prerequisite(s): CAPL 1010 or CSCI 1020 with a grade of C or higher, and HLTH 1001 with a grade of C or higher. Course placement into college-level English and Reading OR completion of ENGL 0950 with a grade of C or higher OR completion of RDNG 0940 with a grade of C or higher and qualifying English Placement Exam OR completion of RDNG 0950 with a grade of C or higher and ENGL 0090 with a grade of C or higher OR completion of ESOL 0051 with a grade of C or higher and ESOL 0052 with a grade of C or higher.
- Manual and computerized office procedures
- Reception and telephone management
- Appointment scheduling
- Mail processing
- Coding systems
- Insurance claims
- Electronic Medical Records
- Healthcare law and ethics
At the end of this course students will be able to:
- differentiate between scope of practice and standards of care for medical assistants.
- compare and contrast provider and medical assistant roles in terms of standard of care.
- describe components of the Health Insurance Portability & Accountability Act (HIPAA).
- summarize the patient bills of rights.
- compare criminal and civil law as they apply to the practicing medical assistant.
- define: negligence, malpractice, statute of limitations, Good Samaritan Act(s), uniform Anatomical Gift Act, living will/advanced directives, medical durable power of attorney, Patient Self Determination Act (PSDA), and risk management.
- describe the following types of insurance: liability, professional (malpractice), & personal injury.
- list and discuss legal and illegal applicant interview questions.
- identify: Health Information Technology for Economic and Clinical Health (HITECH) Act, Genetic Information Nondiscrimination Act of 2008 (GINA), & Americans with Disabilities Act Amendments Act (ADAAA).
- describe the process of compliance reporting: errors in patient care, conflicts of interest and incident reports.
- describe compliance with public health statutes: communicable diseases, abuse, neglect, and exploitation & wounds of violence.
- define the following medical legal terms: informed consent, implied consent, expressed consent, patient incompetence, emancipated minor, mature minor, subpoena duces tecum, respondent superior, res ipsa loquitor, locum tenens, defendant-plaintiff, deposition, arbitration-mediation, Good Samaritan Law.
- define: ethics and morals.
- differentiate between personal and professional ethics.
- identify the effect of personal morals on professional performance.
- locate a states legal scope of practice for medical assistants.
- apply HIPAA rules in regard to: privacy; release of information.
- document patient care accurately in the medical record
- apply the Patient’s Bill of Rights as it relates to: choice of treatment; consent for treatment; refusal of treatment.
- perform compliance reporting based on public health statutes.
- report an illegal activity in the healthcare setting following proper protocol.
- complete an incident report related to an error in patient care.
- develop a plan for separation of personal and professional ethics.
- demonstrate appropriate response(s) to ethical issues.
- demonstrate sensitivity to patient rights.
- protect the integrity of the medical record.
- recognize the impact personal ethics and morals have on the delivery of healthcare.
- identify principles of: ergonomics.
- evaluate the work environment to identify unsafe working conditions.
- define coaching a patient as it relates to: community resources
- recognize elements of fundamental writing skills
- discuss applications of electronic technology in professional communication
- differentiate between subjective and objective information.
- coach patients regarding: office policies.
- demonstrate professional telephone techniques.
- document telephone messages accurately.
- compose professional correspondence utilizing electronic technology.
- develop a current list of community resources related to patients’ healthcare needs.
- facilitate referrals to community resources in the role of a patient navigator.
- report relevant information concisely and accurately.
- demonstrate: empathy; active listening; nonverbal communication.
- demonstrate respect for individual diversity including: gender; race; religion; age; economic status; appearance.
- identify different types of appointment scheduling methods.
- identify advantages and disadvantages of the following appointment systems: manual and electronic.
- identify critical information required for scheduling patient procedures.
- define types of information contained in the patient’s medical record.
- identify methods of organizing the patient’s medical record based on: problem-oriented medical record (POMR) and resource-oriented medical record (SOMR).
- identify equipment and supplies needed for medical records in order to: Create, Maintain and . Store.
- describe filing indexing rules.
- differentiate between electronic medical records (EMR) and a practice management system.
- explain the purpose of routine maintenance of administrative and clinical equipment.
- list steps involved in completing an inventory.
- explain the importance of data back-up.
- explain meaningful use as it applies to EMR.
- manage appointment schedule using established priorities.
- schedule a patient procedure.
- create a patient’s medical record.
- organize a patient’s medical record.
- file patient medical records.
- utilize an EMR.
- input patient data utilizing a practice management system.
- perform routine maintenance of administrative or clinical equipment.
- perform an inventory with documentation.
- display sensitivity when managing appointments.
- define the following bookkeeping terms: charges, payments, accounts receivable, accounts payable and adjustments.
- describe banking procedures as related to the ambulatory care setting.
- identify precautions for accepting the following types of payments: cash, check, credit card and debit card.
- describe types of adjustments made to patient accounts including: non-sufficient funds (NSF) check, collection agency transaction, credit balance, and third party.
- identify types of information contained in the patient’s billing record.
- explain patient financial obligations for services rendered.
- identify: types of third party plans, information required to file a third party claim, and the steps for filing a third party claim.
- outline managed care requirements for patient referral.
- describe processes for: verification of eligibility for services, precertification and preauthorization.
- define a patient-centered medical home (PCMH).
- differentiate between fraud and abuse.
- perform accounts receivable procedures to patient accounts including posting: charges; payments; adjustments.
- prepare a bank deposit.
- obtain accurate patient billing information.
- inform a patient of financial obligations for services rendered.
- interpret information on an insurance card.
- verify eligibility for services including documentation.
- obtain precertification or preauthorization including documentation.
- complete an insurance claim form.
- demonstrate professionalism when discussing patient’s billing record.
- display sensitivity when requesting payment for services rendered.
- interact professionally with third party representatives.
- display tactful behavior when communicating with medical providers regarding third party requirements.
- show sensitivity when communicating with patients regarding third party requirements.
- describe how to use the most current procedural coding system.
- describe how to use the most current diagnostic doing classification system.
- describe how to use the most current HCPCS coding system.
- discuss the effects of: upcoding and downcoding.
- define medical necessity as it applies to procedural and diagnostic coding.
- perform procedural coding.
- perform diagnostic coding.
- utilize medical necessity guidelines.
- utilize tactful communication skills with medical providers to ensure accurate code selection.
Competency 1 (1-6)
Competency 2 (7-10)
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