Medical Office Administrative Procedures

Course Number: MA 117
Transcript Title: Med Office Admin Procedures
Created: September 1, 2012
Updated: October 28, 2016
Total Credits: 3
Lecture Hours: 30
Lecture / Lab Hours: 0
Lab Hours: 0
Satisfies Cultural Literacy requirement: No
Satisfies General Education requirement: No
Grading options: A-F (default)
Repeats available for credit: 0

Course Description

Introduces medical office administrative procedures with emphasis on patient reception, appointment scheduling, telephone techniques, mail handling, financial records, accounts receivable and payable, insurance, office management, and medical records management. Corequisite: MA 118 & MA 180.

Intended Outcomes

  1. Perform procedures that are necessary to quickly check patients into the medical office emphasizing appointments, insurance verification and payment processing.
  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.
  3. Compose and respond to written communication from businesses and patients.
  4. Perform the procedures for screening incoming telephone calls and taking messages.
  5. Understand and perform procedures to maintain accounts receivable in the medical office including post charges, payments and/or adjustments to the patient account.
  6. Compare and contrast various health insurance plans including managed care plans, Medicare and Medicaid.
  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.

Outcome Assessment Strategies

Students will demonstrate these learning outcomes by any combination of the following as determined by the instructor.

  1. Answer theoretical and application questions on information covered in the lecture, graded assignments and reading assignments.
  2. Participate in class discussion on chapter highlights.
  3. Describe and prepare a medical record and its component parts.

Course Activities and Design

The list in Learning Activities below outlines the concepts, themes and issues you need to understand and be able to use appropriately.  You will have the opportunity to demonstrate your understanding in written and oral form, individually and in groups.

To be able to successfully complete this course, the student must receive a minimum of 70% on the total points for all exams, therefore any grade less than 70% represent a failing grade and the student will be dropped from the Medical Assisting Program.

There will be some chapter specific pop quizzes as well as two major exams both comprehensive to be taken in class.

The total achievable score from homework is worth 30% of the grade, Exams worth 60% of the grade and participation worth 10% of the grade.

Course Content (Themes, Concepts, Issues and Skills)

  1. The Health Care System
    • Develop knowledge into the changing relationship between patient and provider including discussion of Patient Centered Medical Home and Patient Navigator concepts
  2. Patient Reception:
    • Understand general office policies.
    • Understand basic medical assisting clerical functions, bookkeeping principles and operational functions. 
    • Develop knowledge and skill to function effectively in the reception area of a physician’s office making appointments, answering telephones and obtaining patient information.
  3. Appointments:
    • Understand different types of appointment scheduled and advantages and disadvantages of each type
    • Develop knowledge and skill in scheduling in and out of office appointments and maintain the appointment book as a legal document. 
    • Understand the critical information necessary to schedule patient procedures.
    • Schedule and manage mock appointments for both inpatients and outpatients.
    • Display sensitivity when managing appointments
  4. The Medical Record
    • Develop knowledge and skill in the equipment necessary, initiation and maintenance of medical records, including information contained in the records and the various methods of organizing the record to include POMR and SOMR methods  
    • Create, organize, maintain and file mock medical records. Obtain and record patients’ histories.
    • Understand medical record confidentiality and HIPAA. Students will also create charts they will use in other modules. 
    • Students will fill out patient registration forms, health history forms, medical release forms, immunization record forms, medication record forms and properly place them in the chart.
  5. Medical Records Management
    • Develop knowledge and skills in creating, maintaining, storing, protecting and preserving of the medical record in the physician’s office. 
    • File mock medical records, reports and medical correspondence with an understanding of index filing methods
  6. Telephone techniques
    • Develop knowledge and skill in the use of telephone, handling incoming and placing outgoing calls with knowledge, efficiency and courtesy.
    • Practice mock phone conversations practicing professional phone technique.
    • Document telephone messages accurately
  7. Banking and Financial Procedures
    • Develop knowledge of banking terms and skills in accounting.
    • Prepare bank deposits and post entries on day sheets.
  8. Accounts Receivable Records
    • Develop knowledge and skill in the maintenance of accounts receivable records including various billing methods and collection procedures.
    • Define AR bookkeeping terms to include charges, payments, and adjustments.
    • Explain patient financial obligations for services rendered
    • Perform accounts receivable procedures and billing and collection procedures.
    • Post adjustments, process credit balance, refunds, NSF checks and post collection agency payments.
    • Identify precautions for accepting payments in the forms of cash, check, credit or debit cards
    • Understand professionalism when discussing the patients account with third party representatives
    • Recognize the need for sensitivity when requesting payment for services rendered from patients.
  9. Accounts Payable Records
    • Develop knowledge and skill in the maintenance of accounts payable records in the physician’s office.
  10. Insurance Concepts and Procedures
    • Develop knowledge and skill in the processing of claims for submission to third party payers, including types of third party plans, information required to file a third party claim and the steps for filing a third party claim
    • Apply managed care policies and perform procedures for referrals, pre-authorizations and pre-certifications including documentation
    • Interpret information on an insurance card and be able to discuss third party requirements to patients.
    • Apply third party guidelines and interact professionally with third party representatives
    • Perform procedural and diagnostic coding.  Be able to discuss third party requirements with providers tactfully.
    • Students will properly fill out CMS-1500 forms.
  11. The Computer in the Medical Office
    • Develop knowledge of the basic vocabulary and language of computers and skill in learning the basic functions of a computer programmed for specific purposes in a medical office. 
    • Utilize computer awareness to maintain administrative and clinical equipment. 
    • Differentiate between an Electronic Medical Records (EMR) and a practice management system
    • Explain the purpose of routine maintenance of administrative equipment
  12. Communication and Mail
    • Develop knowledge and skill in handling written communications, both incoming and outgoing mail. 
    • Respond to and initiate written communication using electronic technology.
    • Recognize and respond to verbal and nonverbal communication. 

Related Instruction

Communication
Hours: 75

Outcomes:

  1. Perform procedures that are necessary to quickly check patients into the medical office emphasizing appointments, insurance verification and payment processing.
  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.
  3. Perform the procedures for screening incoming telephone calls and taking messages.
  4. Compose and respond to written communication from businesses and patients.

Content:

  1. Develop knowledge and skill to function effectively in the reception area of a physician’s office making appointments, answering telephones and obtaining patient information.
  2. Obtain and record patients’ histories. Understand medical record confidentiality and HIPAA. Students will also create charts they will use in other modules.  Students will fill out patient registration forms, health history forms, medical release forms, immunization record forms, medication record forms and properly place them in the chart.
  3. Develop knowledge and skill in the use of telephone, handling incoming and placing outgoing calls with knowledge, efficiency and courtesy. Students will practice mock phone conversations practicing professional phone technique.
  4. Develop knowledge and skill in handling written communications, both incoming and outgoing mail.  Respond to and initiate written communication. Recognize and respond to verbal and nonverbal communication.      

Skills/Activity Detail

Hours and Instruction Method

RI Hours

Preparing a Medical Record using patient interview 3 hour lecture 9
Perform patient reception duties 3 hour lecture 9
HIPAA and Confidentiality 2 hour lecture 6
Opening & Closing Procedure 1 hour lecture 3
Practicing Telephone Message Techniques 3 hour lecture 9
Scheduling Appointments 2 hour lecture 6
Responding to and Writing Business Letters 2 hour lecture 6
Processing Mail 1 hour lecture 3
Working with Patient Accounts 3 hour lecture 9
Understanding Insurance Processes 1 hour lecture 3
Medical Office Management 2 hour lecture 6
Resumes and Interviewing 2 hour lecture 6
 

Total

75

Department Notes

This is a required course which fulfills a portion of the curriculum for the certificate in Medical Assisting. The extent of transferability or credit allowed for the course would be dependent upon the institution and the program to which the student is transferring.