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CCOG for MA 117 Fall 2022

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Course Number:
MA 117
Course Title:
Medical Office Administrative Procedures
Credit Hours:
4
Lecture Hours:
40
Lecture/Lab Hours:
0
Lab Hours:
0

Course Description

Introduces principles of the Patient-Centered Medical Home model, including: social determinants of health, population management, data metrics, and continuous quality improvement. Includes administrative functions of a medical office. Covers appointment scheduling, telephone techniques, financial record keeping, accounts receivable and payable, medical insurance, office care and management, and medical records management. Corequisites: MA 118.

Addendum to Course Description

Required course which fulfills a portion of the curriculum for the Certificate in Medical Assisting.
Students must also enroll in Medical Office Administrative Procedures Lab (MA 118) concurrently for laboratory practice of materials covered in this course.
 

Intended Outcomes for the course

Upon completion of the course students should be able to:

  1. Communicate appropriately and in a caring manner in a medical setting.
  2. Conduct a health history interview and accurately document medical information.
  3.  Follow Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) security regulations for all patient clinical records.
  4. Recognize and apply appropriate accommodations for special needs and cultural differences within the healthcare setting.
  5. Examine the Patient-Centered Medical Home model and its effect on the delivery of healthcare.
  6. Follow standard practices for accounts payable and receivable in a healthcare setting. 
  7. File insurance claim forms using an understanding of the different types of medical insurance. 

Course Activities and Design

Patient Centered Medical Home (PCMH) will be discussed in relation to each skill introduced during this course.  Students will learn how the healthcare system is changing and what role a Medical Assistant has within a Patient Centered Medical Home. 

Outcome Assessment Strategies

Students will demonstrate these learning outcomes by these tasks conducted individually and in cooperation with other students:

1.  Answer theoretical and application multiple choice questions on information covered in lecture and reading assignments.

2. Critical thinking activities with small groups.

3. Peer assessment of work within small groups. 
 

Course Content (Themes, Concepts, Issues and Skills)

The following list 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.


CONCEPTS OF EFFECTIVE COMMUNICATION 

  • Identify styles and types of verbal communication
  • Identify types of nonverbal communication
  • Recognize barriers to communication
  • Identify techniques for overcoming communication barriers
  • Recognize the elements of oral communication using a sender-receiver process
  • Define coaching a patient as it relates to: health maintenance, disease prevention, compliance with treatment plan, community resources, and adaptions relevant to individual patient 
  • Recognize elements of fundamental writing skills
  • Discuss applications of electronic technology in professional communication
  • Identify medical terminology and how it is used in professional coorespondence
  • Define medical terms and abbreviations (acronyms) related to all body systems
  • Define the principles of self-boundaries 
  • Define patient navigator and describe the role of the medical assistant as a patient navigator
  • Relate the following behaviors to professional communication; assertive, aggressive, passive
  • Differentiate between adaptive and non-adaptive coping mechanisms
  • Differentiate between subjective and objective information 
  • Discuss examples of diversity; cultural, social, ethnic
  • Discuss the theories of; Maslow, Erikson, Kubler-Ross

PATIENT-CENTERED COMMUNICATION 

  • Develop knowledge on the importance of effective, patient-centered communication relating to quality care; understand ethical implications necessary for informed consent, effective patient engagement, means to avoid errors, improve quality, and achieving better health outcomes

BASIC PRACTICE FINANCES 

  • Define the following bookkeeping terms: charges, payments, accounts receivable and payable, adjustments 
  • Describe banking procedures as related to the ambulatory care setting
  • Identify precautions for accepting the following types of payments; cash, check, credit card, debit card
  • Describe types of adjustments made to patient accounts including; non-sufficient funds, collections agency transaction, credit balance, third party 
  • Identify types of information contained in the patient's billing record
  • Explain patient financial obligations for services rendered 


THIRD PARTY REIMBURSEMENT 

  • Identify: types of third party plans, information required to file a third party claim, the steps for filing a third party claim
  • Outline managed care requirements for patient referral
  • Describe processes for: verification of eligibility for services, pre-certification, pre-authorization
  • Define a patient-centered medical home (PCMH)
  • Differentiate between fraud, waste, and abuse

LEGAL IMPLICATIONS 

  • 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 and Accountability Act (HIPAA)
  • Summarize the Patient Bill of Rights

HEALTH LITERACY

  • Develop knowledge for individuals to have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and services needed to prevent or treat illness, understanding the dependence on individual and systemic factors, communication skills of lay persons and professionals, lay and professional knowledge of health topics, culture, demands of the healthcare and public health systems, demands of the situation/context, and how this applies to chronic-disease management

MOTIVATIONAL INTERVIEWING

  • Develop knowledge and skills that works on facilitating and engaging intrinsic motivation within the student in order to change behavior through the interview process. Students will be exposed to goal-oriented, self reflecting behavior changes and improvements  to explore and resolve ambivalence

TEAM BASED CARE

  • Develop knowledge and skills to understand the importance of team collaboration within the medical group; understand clear roles of each team member and health professional; importance of mutual trust and effective communication; understanding and application of measurable outcomes

Related Instruction

Computation
Hours: 30

  1. Follow standard practices for accounts payable and receivable in a healthcare setting. 
  2. Use an understanding of the different types of medical insurance and how to properly file insurance claim forms. 

  • Apply knowledge of banking terms and skills in accounting.
  • Prepare bank deposits, post entries on day sheets.
  • Perform accounts receivable procedures and billing and collection procedures.
  • Post adjustments, process credit balance, refunds, NSF checks and post collection agency payments.
  • Apply knowledge and skill in the maintenance of accounts receivable records including various billing methods and collection procedures.
  • Students will properly fill out CMS-1500 insurance claim forms.

Communication
Hours: 45

  • Demonstrate a clear understanding of the patient-centered guidelines when interacting with patients. 
  • Communicate appropriately and in a caring manner in a medical setting.
  • Conduct and accurately record a health history. 
  • Recognize and apply appropriate accommodations for special needs and cultural differences within the healthcare setting. 

  • Demonstrate appropriate patient-centered behaviors and communication. 
  • Perform entry-level competency in the performance of administrative duties of the medical office.
  • Apply knowledge and skill to function effectively in the reception area of a physician's office making appointments, answering telephones and obtaining patient information. Schedule and manage mock appointments for both inpatients and outpatients.
  • Apply knowledge and skill in the initiation and maintenance of medical records. Create, manage and maintain mock medical records.
  • Obtain and record patients’ histories. Understand medical record confidentiality and HIPAA.
  • 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.
  • Apply knowledge and skill in the use of the telephone, handling incoming and placing outgoing calls with knowledge, efficiency and courtesy. Students will practice mock phone conversations practicing professional phone technique.
  • Apply knowledge and basic vocabulary of computers and perform basic functions of a computer specific for the medical office. Utilize computer awareness to maintain administrative and clinical equipment. Introduce electronic medical records (EMR).
  • Apply 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. Students will type up mock lab letters and mail them properly. Students will also fill out preset lab letter and properly mail them out.
  • Apply knowledge and skills in the basic principles of psychology and self-understanding of social adaptability for communications and actions with physicians, employees and patients.
  • Understand principles of recognition and response to verbal and nonverbal communication.