CCOG for MA 117 archive revision 202404
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- Effective Term:
- Fall 2024 through Winter 2025
- 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
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 successful completion of the course students should be able to:
- Communicate appropriately and in a caring manner in a medical setting.
- Complete a health history interview and accurately document medical information.
- Apply Health Insurance Portability and Accountability Act (HIPAA) security regulations for all patient clinical records.
- Recognize and apply appropriate accommodations for special needs and cultural differences within the healthcare setting.
- Examine the Patient-Centered Medical Home model and its effect on the delivery of healthcare.
- Identify barriers to patient outcomes and apply strategies to address social determinants of health (SDOH).
- Describe components of Maslow's Hierarchy, Erickson's stages of development and Kubler-Ross' stages of grief and how they impact a patient's overall health status.
- Apply standard practices for general financial management in a healthcare setting.
- Conduct accurate billing and coding and adjustments for insurance claims.
Course Activities and Design
Throughout the course regular discussion will ensure an understanding of the healthcare system and what role a Medical Assistant has within a Patient Centered Medical Home.
This course is designed as a flipped classroom model, in which students will be learning content on their own time. During class there will be numerous activities in which students are solidifying the content information, such as group discussions, role playing, team projects and review games.
Outcome Assessment Strategies
Students will demonstrate these learning outcomes by tasks conducted individually and in cooperation with other students:
1. Answer theoretical and application multiple choice, matching, ordering and open-ended questions on information covered in lecture.
2. Critical thinking activities with small and large groups.
3. Team based projects.
4. 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 types of verbal/nonverbal communication
-
Recognize barriers to communication
-
Identify techniques for overcoming communication barriers
-
Identify techniques for coaching a patient related to specific needs
-
Identify the steps in the sender-receiver process
-
Identify different types of electronic tech used in communication
-
Identify the role of the MA as a patient navigator
-
Identify coping mechanisms
-
Identify concepts of: Maslow, Erikson & Kubler-Ross
ADMINISTRATIVE FUNCTIONS
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Identify different types of appt scheduling methods
-
Identify critical info required for scheduling pt procedures
-
Recognize the purpose for routine maintenance of equipment
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Identify steps involved in completing inventory
-
Identify the importance of data back up
-
Identify the components of an EMR & PMS
BASIC PRACTICE FINANCES
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Define the following bookkeeping terms: charges, payments, accounts receivable and payable, adjustments, reconciliation
-
Identify precautions for accepting: cash, check, cc, debit card
-
Identify types of adjustments for: NSF, collections, credit balance, 3rd party
-
Identify pt financial obligation 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
-
Identify: insurance verification, preauth, tracking unpaid claims, claims denials & appeals
-
Identify fraud & abuse as they relate to 3rd party reimbursement
-
Define: bundling/unbundling of codes, ABN, allowed amount, deductible, co-insurance, co-pay
-
Identify the purpose and components of EOB, RA statements
PROCEDURAL & DIAGNOSTIC CODING
-
Identify current procedural and dx coding systems including HCPCS level II
-
Identify the effects of upcoding & downcoding
-
Define medical necessity
-
Identify medical necessity guidelines
LEGAL IMPLICATIONS
-
Identify scope of practice and standards of care for MA's
-
Identify the provider role in terms of standard of care
-
Identify components of HIPAA
-
Identify the standards outlined in The Patient Care Partnership
-
Identify licensure & certifications as they apply to healthcare providers
-
Identify criminal & civil laws as they apply to the MA
PROTECTIVE PRACTICES
-
Identify fire safety issues in a healthcare environment
-
Identify emergency practices for evacuation of a healthcare setting
-
Identify the purpose of SDS
-
Identify principles of: body mechanics & ergonomics
-
Identify critical elements of and emergency plan for a response to a natural disaster or other
PATIENT-CENTERED MEDICAL HOME MODEL
-
Define PCMH
-
Identify the attributes of the PCMH model
-
List the impacts of each attribute to the Triple Aim
-
Explain how each PCMH attribute impacts the work of a Medical Assistant
PATIENT-CENTERED COMMUNICATION
-
欧洲杯决赛竞猜app_欧洲杯足球网-投注|官网 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
TEAM BASED CARE
-
欧洲杯决赛竞猜app_欧洲杯足球网-投注|官网 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: 20- Follow standard practices for general financial management in a healthcare setting.
- Conduct accurate billing and coding and adjustments for insurance claims.
- Apply knowledge of banking terms and skills in accounting.
- Explain components of an EOB
- 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 complete insurance claim forms.
Communication
Hours: 45- Communicate appropriately and in a caring manner in a medical setting.
- Conduct a health history interview and accurately document medical information.
- Recognize and apply appropriate accommodations for special needs and cultural differences within the healthcare setting.
- Demonstrate a clear understanding of the patient-centered guidelines when interacting with patients.
- 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.
- Demonstrate best practices for communication during a patient encounter.
- 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 results email to patient.
- 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.
- Understand various communication barriers and strategies to overcome them.
Human Relations
Hours: 20- Follow Health Insurance Portability and Accountability Act (HIPAA) security regulations for all patient clinical records.
- Identify barriers to patient outcomes and apply strategies to address social determinants of health (SDOH).
- Understand components of Maslow's Hierarchy, Erickson's stages of development and Kubler-Ross' stages of grief and how they impact a patient's overall health status.
- List the various elements of SDOH
- Discuss the impact of SDOH on patients overall health outcomes
- Explain how race and ethnicity have an impact on a patients overall health status
- Define healthcare disparities
- Discuss best ethical considerations when HIPAA has been violated by a co-worker
- Complete compliance reporting due to a breach of HIPAA
- Discuss ways in which to overcome cultural barriers
- Identify the impacts of health literacy
- Map out various communication strategies for the stages of development
- Explain the elements of Maslow's Hierarchy and discuss the impact to health outcomes
- Explain the elements of Maslow's Hierarchy and discuss the impact to health outcomes