Medical Office Administrative Procedures

Course Number:

MA 117

Transcript Title:

Medical Office Administrative Procedures

Created:

Aug 15, 2022

Updated:

Jun 01, 2023

Total Credits:

5

Lecture Hours:

50

Lecture / Lab Hours:

0

Lab Hours:

0

Satisfies Cultural Literacy requirement:

No

Satisfies General Education requirement:

No

Grading Options

A-F

Default Grading Options

A-F

Repeats available for credit:

0

Suggested Outcome Assessment Strategies

The determination of assessment strategies is generally left to the discretion of the instructor. Here are some strategies that you might consider when designing your course: writings (journals, self-reflections, pre writing exercises, essays), quizzes, tests, midterm and final exams, group projects, presentations (in person, videos, etc), self-assessments, experimentations, lab reports, peer critiques, responses (to texts, podcasts, videos, films, etc), student generated questions, Escape Room, interviews, and/or portfolios.

Course Activities and Design

The determination of teaching strategies used in the delivery of outcomes is generally left to the discretion of the instructor. Here are some strategies that you might consider when designing your course: lecture, small group/forum discussion, flipped classroom, dyads, oral presentation, role play, simulation scenarios, group projects, service learning projects, hands-on lab, peer review/workshops, cooperative learning (jigsaw, fishbowl), inquiry based instruction, differentiated instruction (learning centers), graphic organizers, etc.

Course Content

Outcome #1: Perform procedures that are necessary to quickly check patients into the medical office emphasizing appointments, insurance verification and payment processing.

• Types of scheduling
  • Time-Specified (Stream) Scheduling
  • Wave Scheduling
  • Modified Wave Scheduling
  • Double Booking
  • Open Booking
  • Patient Appointment Requests and Self-Scheduling
  • Clustering or Categorization
  • Multiple Offices
• Maintaining Confidentiality
• Acknowledgement of Receipt of Notice of Privacy Practices
• Verifying Insurance and Obtaining Authorizations
• Verifying a Managed Care Referral
• Accepting Copayments

Outcome #2: Understand and perform the tasks required in the maintenance of the medical record, the reports contained within and HIPAA guidelines with regard to medical information.

• Storage of electronic health records
• Maintaining the integrity of the EHR
  • Levels of access
  • Staff training to maintain integrity
• Storing computerized records
• Equipment and supplies for paper-based medical records
  • Storage equipment
  • Filing supplies
• Filing systems
  • Alphabetic Filing
  • Numeric Filing

Outcome #3: Compose and respond to written communication from businesses and patients.

• Business letter standards
• Postal addressing
• Grammar and punctuation
• Spelling and Proofreading

Outcome #4: Perform the procedures for screening incoming telephone calls and taking messages.

• Telephone courtesy
• Telephone personality
• Maintaining patient privacy
• Effective telephone communication
• Centralized or electronic routing
• Managing incoming calls
  • Performing telephone screening
  • Taking messages on a paper message form
  • Taking messages on the computer
• Urgent or emergency calls
• Dealing with problem calls

Outcome #5: Understand and perform procedures to maintain accounts receivable in the medical office including post charges, payments and/or adjustments to the patient account.

• Perform procedural and diagnostic coding.
• Insurance claim forms
• CMS-1500 forms.
• Post entries on day sheets.
• Perform accounts receivable, billing, and collection procedures.
• Post adjustments, process credit balance, refunds, NSF checks and post collection agency payments.

Outcome #6: Compare and contrast various health insurance plans including managed care plans, Medicare and Medicaid.

• Fee-for-Service Plans
• Managed Care Plans
  • Health Maintenance Organization Models
  • Other Managed Care Models
• Government Plans
  • Medicare
  • Medicaid
  • Children's Health Insurance Program
  • Insurance Plans for Dependents of Members of the Armed Services and Veterans
  • Workers’ Compensation 

Outcome #7: Assist in the business functions of the medical office, including inventory, accounts payable, writing policies and procedures, procurement of supplies, and compliance with OSHA.

• Cash disbursements
  • Check register
  • Computerized bookkeeping system
• Computerized charge entry
• Fee schedule
• Patient account ledger
  • Posting payments to the patient account
  • Posting adjustments to the patient account
• Maintaining equipment
  • Inventory
  • Monitoring equipment function and readiness for use
  • Service contracts
  • Service calls
  • New equipment purchases
• Supplies
  • Supply inventory
  • Restocking
  • Ordering supplies
  • Receiving supplies
• Patient and employee safety
  • Safe work practices
  • Monitoring environmental safety
  • Signs and instructions

Suggested Texts and Materials

Today's Medical Assistant, current edition  Published by Elsevier with Evolve Resources