MEDA 131 Medical Office Procedures

Students in Medical Office Procedures will study medical law and ethics, communication, human relations, telephone procedures, scheduling appointments, and medical records management. The course also includes the study of coding and billing professional fees and credit, collection, financial records, and health insurance.

Credits

4 Credits

Semester Contact Hours Lecture

60

Semester Contact Hours Lab

0

Semester Contact Hours Clinical

0

Prerequisite

Must be majoring in the Medical Assistant Program

MEDA 131Medical Office Procedures

Please note: This is not a course syllabus. A course syllabus is unique to a particular section of a course by instructor. This curriculum guide provides general information about a course.

I. General Information

Department

II. Course Specification

Course Type

{D7A8FC71-978F-4003-9933-512C476323B2}

Credit Hours Narrative

4 Credits

Semester Contact Hours Lecture

60

Semester Contact Hours Lab

0

Semester Contact Hours Clinical

0

Prerequisite Narrative

Must be majoring in the Medical Assistant Program

III. Catalog Course Description

Students in Medical Office Procedures will study medical law and ethics, communication, human relations, telephone procedures, scheduling appointments, and medical records management. The course also includes the study of coding and billing professional fees and credit, collection, financial records, and health insurance.

IV. Student Learning Outcomes

Upon completion of this course, a student will be able to:

  • Have obtained current Provider Level CPR and First Aid training.
  • Apply basic math computations to solve equations.
  • Demonstrate effective communication skills in the medical assistant role.
  • Demonstrate administrative medical assisting skills used in a medical office for scheduling appointments, utilizing and EMR, and inventory.
  • Demonstrate knowledge of the financial practices required of medical assistants.
  • Apply sensitivity, tactful knowledge about insurance reimbursement when dealing with patients, providers, or third party payers.
  • Perform medical procedural and diagnostic coding.
  • Demonstrate knowledge of legal issues with which medical assistants may encounter.
  • Apply knowledge of appropriate responses with ethical issues faced by medical assistants.
  • Demonstrate knowledge of guidelines for protective practices of a medical assistant.

V. Topical Outline (Course Content)

I. Anatomy & Physiology (C=Cognitive,  P=Psychomotor, A=Affective) 

1. List principles and steps of healthcare provider CPR  I. C 13 

2. Describe basic principles of first aid as they pertain to the ambulatory healthcare setting  I. C 14 

3.  Produce up-to-date documentation of provider/professional CPR I. P 12 

4. Perform first aid for: bleeding, diabetic come or insulin shock, fractures, seizures, shock, syncope I. P 13 

 

 II. Applied Mathematics (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Demonstrate knowledge of basic math computations II. C 1 

2. Apply Mathematical computations to solve equations II. C 2 

 

V. Concepts of Effective Communication (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Identify styles and types of verbal communication  V. C 1 

2. Identify nonverbal communication  V. C 2 

3. Recognize communication barriers  V. C 3 

4. Identify techniques for overcoming communication barriers  V. C 4 

5. Recognize the elements of oral communication using a sender-receiver process V. C 5 

6. Define coaching a patient as it relates to: health maintenance, disease prevention, compliance with treatment plan, community resources,  

     and adaptations relevant to individual patient needs V. C 6 

7. Recognize elements of fundamental writing skills V. C 7 

8. Discuss applications of electronic technology in professional communication V. C 8 

9. Define principles of self-boundaries V. C 11 

10. Define patient navigator V. C 12 

11. Describe the role of the medical assistant as a patient navigator V. C 13 

12. Relate the following behaviors to professional communication: assertive, aggressive, passive V. C 14 

13. Differentiate between adaptive and non-adaptive coping mechanisms   V. C 15 

14. Differentiate between subjective and objective information   V. C 16 

15. Discuss the theories of: Maslow, Erikson, Kubler-Ross    V. C 17 

16. Discuss examples of diversity: cultural, social, ethnic   V. C 18 

17. Use feedback techniques to obtain information including: reflection, restatement, clarification   V. P 1 

18. Respond to nonverbal communication  V.  P 2 

19. Use medical terminology correctly and pronounced accurately to communicate information to providers and patient’s  V.  P 3 

20. Coach patients regarding: office policies, health maintenance, disease prevention, treatment plan  V.  P 4 

21. Coach patients appropriately considers: cultural diversity, developmental life stage, communication barriers  V.  P 5 

22. Demonstrate professional telephone techniques  V.  P 6 

23. Document telephone message accurately  V.  P 7 

24. Compose professional correspondence utilizing electronic technology  V.  P 8 

25. Report relevant information concisely and accurately V.  P 11 

26. Demonstrate: empathy, active listening, and nonverbal communication V.  A 1 

27. Demonstrate the principles of self-boundaries V.  A 2 

28. Demonstrate respect for individual diversity including: gender, race, religion, age, economic status, appearance      V.  A 3 

29. Explain to a patient the rationale for performance of a procedure V.  A 4 

 

VI. Administrative Functions (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Identify different types of appointment scheduling methods  VI. C 1 

2. Identify advantages and disadvantages of the following appointment systems: manual, electronic  VI. C 2 

3. Identify critical information required for scheduling patient procedures  VI. C 3 

4. Define types of information contained in the patient’s medical record  VI. C 4 

5. Identify methods for organizing medical records based on: problem-oriented medical record (POMR), source-oriented medical record     

     (SOMR) VI. C 5 

6. Identify equipment and supplies needed for medical records in order to: create, maintain, and store VI. C 6 

7. Describe filling indexing rules  VI. C 7 

8. Differentiate between electronic medical records (EMR) and a practice management system  VI. C 8 

9. Explain the purpose of routine maintenance of administrative and clinical equipment  VI. C 9 

10. List the steps involved in completing an inventory  VI. C 10 

11. Explain the importance of the data back-up  VI. C 11 

12. Explain meaningful use as it applies to EMR  VI. C 12 

13. Manage appointment schedule using established priorities   V. P 1 

14. Schedule a patient procedure   VI. P 2 

15. Create a patient’s medical record   VI. P 3 

16. Organize a patient’s medical record   VI. P 4 

17. File a patient’s medical record   VI. P 5 

18. Utilize and EMR  VI.P  6 

19. Input patient data utilizing a practice management system   VI. P 7 

20. Perform routine maintenance of administrative or clinical equipment  VI. P 8 

21. Perform an inventory with documentation  VI. P 9  

22. Display sensitivity when managing appointments  VI. A 1 

 

 

VII. Basic Practice Finances (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Define the following bookkeeping terms: charges, payments, accounts receivable, accounts payable,  

     and adjustments  VII. C 1 

2. Describe banking procedures as related to the ambulatory care setting  VII. C 2 

3. Discuss precautions for accepting the following types of payments: cash, checks, credit card, debit card  VII. C 3 

4. Discuss types of adjustments that may be made to a patient accounts including: non-sufficient funds (NSF) check, collection agency      

     transaction, credit balance, third party  VII. C 4 

5. Identify types of information contained in the patient’s billing record  VII. C 5 

6. Explain patient financial obligations for services rendered  VII. C 6 

7. Perform accounts receivable procedures including posting: charges, payments, adjustments VII. P 1 

8. Prepare a bank deposit VII. P 2 

  9. Obtain accurate patient billing information  VII. P 3 

10. Inform a patient of financial obligations for services rendered  VII. P 4 

11. Demonstrate professionalism when discussing patient’s billing record VII. A 1 

12. Display sensitivity when requesting payment for services rendered  VII. A 2  

 

VIII. Third Party Reimbursement (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Identify: types of third party plan, information required to file a third party claim, the steps for filing a third party claim VIII. C 1 

2. Outline managed care requirements for patient referral  VIII. C 2 

3. Describe processes for: verification of eligibility for services, precertification, preauthorization  VIII. C 3 

4. Define patient-centered medical home (PCMH) VIII. C 4 

5. Differentiate between fraud and abuse  VIII. C 5 

6. Interpret information on an insurance card  VIII. P 1 

7.  Verify eligibility for services including documentation  VIII. P 2 

8. Obtain precertification or preauthorization including documentation  VIII. P 3 

9. Complete insurance claim form  VIII. P 4 

10. Interact professionally with third party representatives  VIII. A 1 

11. Display tactful behavior when communicating with medical providers regarding third party requirements VIII. A 2 

21. Show sensitivity when communicating with patients regarding third party requirements  VIII. A 3 

 

 

IX. Procedural and Diagnostic Coding (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Describe how to use the most current procedural coding system  IX. C 1 

2. Describe how to use the most current diagnostic coding classification system  IX. C 2 

3. Describe how to use the most current HCPCS level II coding system  IX. C 3 

4. Discuss the effects of: upcoding, downcoding   IX. C 4 

5. Define medical necessity as it applies to procedural and diagnostic coding   IX. C 5 

6. Perform procedural coding IX. P 1 

7. Perform diagnostic coding  IX. P 2 

8. Utilize medical necessity guidelines  IX. P 3 

9.  Utilize tactful communication skills with medical providers to ensure accurate code selection  IX. A 1 

 

X. Legal Implications  (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Differentiate between scope of practice and standards of care for medical assistants  X. C 1 

2. Compare and contrast provider and medical assistant roles in terms of standard of care  X. C 2 

3. Describe components of the Health Information Portability & Accountability Act (HIPAA)  X. C 3 

4. Summarize the Patient Bill of Rights  X. C 4 

5. Discuss licensure and certification as it applies to healthcare providers  X. C 5 

6. Describe liability, professional, personal injury, and third party insurance  X. C 6 

6. Compare criminal and civil law as it applies to the practicing medical assistant.  X. C 7 

7. Define:  X. C 7 

a. Negligence 

b. Malpractice 

c. Statute of Limitations 

d. Good Samaritan Act(s) 

e. Uniform Anatomical Gift Act 

f. Living will/Advanced directives 

g. Medical durable power of attorney 

h. Patient Self Determination Act (PSDA) 

i. Risk Management 

8. Describe the following types of insurance: liability, professional (malpractice), personal injury  X. C 8 

9. List and discuss legal and illegal interview questions  X. C 9 

10. Identify: Health Information for Economic and Clinical Health Act (HITECH), Genetic Information Nondiscrimination Act. Of 2008 (GINA), Americans with Disabilities Act Amendments Act (ADAAA)  X. C 10 

11. Describe the process in compliance reporting:  unsafe activities, errors in patient care, conflicts of interest, and incident reports X C. 11 

12. Describe compliance with public health statutes: communicable diseases, abuse, neglect, and exploitation, wounds of violence  X. C 12 

13. Define the following medical legal terms:   X. C 13 

a. informed consent 

b. implied consent 

c. expressed consent 

d. patient incompetence 

e. emancipated minor 

f. mature minor 

g. subpoena duces tecum 

h. respondent superior 

i. res ipsa loquitor 

j. locum tenens 

k. defendant-plaintiff 

l. deposition 

m. arbitration-mediation 

n. Good Samaritan laws 

14. Locate a state’s legal scope of practice for medical assistants  X. P 1 

15. Apply HIPAA rules in regard to privacy/release of information  X. P 2 

16. Document patient care accurately in the medical record  X. P 3 

17. Apply Patient’s Bill of Rights as it relates to: choice of treatment, consent for treatment, refusal of treatment X. P. 4 

18.  Perform compliance reporting based on public health statues  X.P 5 

19. Report illegal activity in the healthcare setting following proper protocol  X. P 6 

20. Complete and incident report related to an error in patient care  X. P 7 

21. Demonstrate sensitivity to patient rights  X. A 1 

22. Protect the integrity of the medical record  X. A 2 

 

 

 

 

 

XI. Ethical Considerations (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Define: ethics and morals  XI. C 1 

2. Differentiate between personal and professional ethics  XI. C 2 

3. Identify the effect of personal morals on professional performance  XI. C 3 

4. Develop a plan for separation of personal and professional ethics  XI. P 1 

5. Demonstrate appropriate response(s) to ethical issues  XI. P 2 

6. Recognize the impact personal ethics and morals may have on the delivery of healthcare  XI. A 1 

 

XII. Protective Practices (C=Cognitive,  P=Psychomotor, A=Affective) 

1. Identify: safety signs, symbols, labels  XII. C 1 

2. Identify safety techniques that can be used in responding to accidental exposure to: blood, other body fluids, needle stick, chemicals  XII.C2 

3. Discuss fire safety issues in an ambulatory healthcare environment   XII. C 3 

4. Describe fundamental principles for evacuation of a healthcare setting  XII. C 4 

5. Describe the purpose of a Safety Data Sheet (SDS) in a healthcare setting  XII. C 5 

6. Discuss protocols for disposal of biological chemical materials  XII. C 6 

7. Identify principles of: body mechanics, ergonomics  XII. C 7 

8. Identify critical elements of an emergency plan for response to a natural disaster or other emergency  XII. C 8 

9. Comply with: safety signs, symbols, labels  XII. P 1 

10. Demonstrate proper use of: eyewash equipment, fire extinguishers, sharps disposal containers  XII. P 2 

11. Use proper body mechanics  XII. P 3 

12.  Participate in a mock exposure event with documentation of specific steps  XII. P 4 

13. Evaluate the work environment to identify unsafe working conditions  XII. P 5 

14. Recognize the physical and emotional effects on persons involved in an emergency situation  XII. A 1 

15. Demonstrate self-awareness in responding to an emergency situation  XII. A 2 

 

VI. Delivery Methodologies