MEDA 1020 - Administrative Procedures for Medical Assistants

1. Manual and computerized office procedures
2. Reception and telephone management
3. Appointment scheduling
4. Mail processing
5. Filing
6. Banking
7. Bookkeeping
8. Payroll
9. Coding systems
10. Insurance claims
11. Electronic Medical Records
12. Healthcare law and ethics

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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).
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.

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