MEDA 1020 - Administrative Procedures for Medical Assistants

1. Administrative Functions
2. Electronic Medical Records
3. Basic Practice Finance
4. Third-Party Reimbursement
5. Procedural and Diagnostic Coding
6. Concepts of Effective Communication
7. Legal Implications
8. Ethical and Professional Considerations
9. Protective Practices

1. demonstrate professional telephone techniques
2. document telephone messages accurately
3. using technology, compose clear and correct correspondence
4. use a list of community resources to facilitate referrals
5. manage appointment schedule, using established priorities
6. schedule a patient procedure
7. input patient data using an electronic system
8. perform an inventory of supplies
9. perform accounts receivable procedures to patient accounts including posting: charges, payments and adjustments
10. input accurate billing information in an electronic system
11. inform a patient of financial obligations for services rendered
12. interpret information on an insurance card
13. verify eligibility for services
14. obtain precertification or preauthorization with documentation
15. complete an insurance claim form
16. assist a patient in understanding an Explanation of Benefits (EOB)
17. perform procedural coding
18. perform diagnostic coding
19. utilize medical necessity guidelines
20. apply HIPAA rules in regard to: privacy and release of information
21. complete an incident report related to an error in patient care
22. identify different types of electronic technology used in professional communication
23. identify subjective and objective information
24. identify different types of appointment scheduling methods
25. identify critical information required for scheduling patient procedures
26. recognize the purpose for routine maintenance of equipment
27. identify steps involved in completing an inventory
28. identify the importance of data back-up
29. identify the components of an Electronic Medical Record, Electronic Health Record, and Practice Management system
30. define the following bookkeeping terms: charges, payments, accounts receivable, accounts payable, adjustments and end of the day reconciliation
31. identify precautions for accepting the following types of payments: cash, check, credit card, and debit card
32. identify types of adjustments made to patient accounts including: non-sufficient funds (NSF) check, collection agency transaction, credit balance and third party
33. identify patient financial obligations for services rendered
34. identify: types of third-party plans and the steps for filing a third-party claim
35. outline managed care requirements for patient referral
36. identify processes for: verification of eligibility for services, and precertification/ preauthorization, tracking unpaid claims and claim denials and appeals
37. identify fraud and abuse as they relate to third party reimbursement.
38. define the following: bundling and unbundling of codes, advanced beneficiary notice (ABN), allowed amount, deductible, co-insurance and co-pay
39. identify the purpose and components of the Explanation of Benefits (EOB) and Remittance Advice (RA) Statements
40. identify the current procedural and diagnostic coding systems, including Healthcare Common Procedure Coding Systems II (HCPCS Level II)
41. identify the effects of: upcoding and downcoding
42. define medical necessity
43. identify the provider role in terms of standard of care
44. identify components of the Health Insurance Portability & Accountability Act (HIPAA)
45. identify the standards outlined in The Patient Care Partnership
46. identify criminal and civil law as they apply to the practicing medical assistant
47. 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
48. identify the purpose of medical malpractice insurance
49. identify legal and illegal applicant interview questions
50. identify: Health Information Technology for Economic and Clinical Health (HITECH) Act, Genetic Information Nondiscrimination Act of 2008 (GINA) and  Americans with Disabilities Act Amendments Act (ADAAA)
51. identify the process in compliance reporting: errors in patient care, conflicts of interest and incident reports
52. identify compliance with public health statutes related to: communicable diseases, abuse, neglect, and exploitation, wounds of violence
53. 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, and arbitration-mediation
54. define: ethics and morals
55. identify personal and professional ethics
56. identify potential effects of personal morals on professional performance
57. identify principles of: ergonomics

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