I. General Information

1. Course Title:
Medical Office Procedures

2. Course Prefix & Number:
HINS 1163

3. Course Credits and Contact Hours:

Credits: 3

Lecture Hours: 3

Lab Hours: 0

4. Course Description:

This introductory course covers medical office careers, medical law and ethics, medical appointments, telephone techniques, travel arrangements, meeting arrangements, business and patient correspondence, patient accounts billing, and an introduction to medical practice finance.  This course will use both manual and computer procedures and processes.

5. Placement Tests Required:

6. Prerequisite Courses:

There are no prerequisites for this course.

9. Co-requisite Courses:

There are no corequisites for this course.

II. Transfer and Articulation

1. Course Equivalency - similar course from other regional institutions:

Ridgewater College, ADS 1320 Medical Office Management, 3 credits
Southeast Technical College, MEDS 1212 Medical Office Procedures, 4 credits

III. Course Purpose

1. Program-Applicable Courses – This course is required for the following program(s):

Health Informatics Coordinator, Diploma
Health Informatics Specialist, AAS Degree

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Analyze and follow a sequence of operations	Identify the steps needed to complete the revenue cycle using practice management principles.
Utilize appropriate technology	Demonstrate the use of medical software for scheduling appointments, billing, and printing reports.
Apply ethical principles in decision-making	Identify specific information that can be released to another party.

2. Course Specific Outcomes - Students will be able to achieve the following measurable goals upon completion of the course:

• Define 5 positive work attitudes that make up work ethic.
• List 3 advantages of professional affiliation and certification.
• Describe the elements of good interpersonal relationships with patients and coworkers
• Describe 4 types of computer software.
• Describe telephone skills in handling incoming and outgoing calls.
• Explain various ways of following through on calls.
• Discuss major methods and protocols for scheduling appointments.
• Discuss ways that an office can keep to the schedule.
• Discuss types of appointments
• Describe medical insurance and coding terms.
• Describe the differences between indemnity and managed care plans.
• List different types of insurance carriers both in private sector and government-sponsored plans
• Describe the difference between participating and nonparticipating providers.
• Compute charges for medical services and create patient statements based on patient encounter forms and physician’s fee schedule.
• Describe the different types of billing options
• Discuss the procedures and options available for collecting delinquent accounts.
• Describe the billing and reimbursement cycle in the medical office.
• Identify four types of information collected during preregistration.
• Discuss the activities completed during patient check-in.
• Discuss the information contained on an encounter form at checkout.
• Describe the information required on an insurance claim.
• List the information contained on a remittance advice.
• Explain the role of patient statements in reimbursement.
• List the reports created to monitor a practice’s accounts receivable.
• Demonstrate proficient use of Medisoft (Practice Management Program) to work through a typical day of a clinic location in regards to the revenue cycle.

V. Topical Outline

Listed below are major areas of content typically covered in this course.

1. Lecture Sessions

1. The Administrative Medical Assistants Career
   • Administrative Medical Assistants personal attributes
   • Employment opportunities
   • Work ethic and professionalism
   • Professional Growth
     • Certifications
     • Industry organizations
   • Interpersonal relationships
2. Medical Ethics, Law & Compliance
   • Ethics
   • Law
   • HIPAA
   • Compliance plans
   • Safeguards against litigation
3. Office Communications
   • Communication cycle
   • Nonverbal communication
   • Written communication
   • Telephone skills
   • Scheduling
     • Entering appointments
     • Booking follow up appointments
     • Cancelling appointments
     • Double booking appointments
   • Incoming and outgoing mail standards and processing
4. Managing Health Information
   • Computer usage
   • Introduction to the medical record
   • Documentation formats
   • Ownership, quality assurance and records retention
   • Filing systems
   • Introduction to electronic health records
   • Introduction to medical terminology and abbreviations
   • Use of technology in physician practice
     • Functions of electronic health record programs
     • Advantages of electronic health records
     • The HITECH Act’s impact on privacy and security
5. Office Management
   • Physical environment
   • Types of management
   • Office managers role
   • Travel and meeting arrangements
   • Patient and employee education
6. Insurance and Coding
   • Insurance terminology
   • Insurance plans – Gov’t and Third Party Payors
   • Participation and payment methods
   • Introduction to procedural and diagnostic coding and compliance
7. Billing, Reimbursement & Collections
   • Charge entry/recording transactions
   • Insurance claims
   • Payments from patients
   • Payments from payors
   • Delinquent accounts
   • Medical Billing Cycle
     • Preregister patients
     • Establishing financial responsibility
     • Check in process
     • Check out process
     • Review coding compliance
     • Review billing compliance
     • Prepare and transmit claims
     • Monitor payor adjudication
     • Generate patient statements
     • Follow up on patient payments/collections
8. Practice Finance
   • Essential financial records
   • Identifying theft and red flag requirements
   • Banking
   • Payroll
9. MediSoft
   • Introduction to Medisoft
   • Entering patient information
   • Working with cases
   • Entering charge transactions and payments
   • Creating claims
   • Creating patient statements
   • Creating reports
   • Collections
   • Scheduling
10. Reports/Printing
    • Day Sheets
      • Patient day sheets
      • Procedure day sheets
      • Payment day sheets
    • Analysis Reports
      • Billing/payment status report
      • Practice analysis report
      • Insurance analysis
      • Referring provider report
      • Referral source report
      • Unapplied payment/adjustment report
      • Co-payment report
    • Patient Lists
    • Aging Reports
    • Custom Reports