I. General Information

1. Course Title:
Administrative Procedures II

2. Course Prefix & Number:
MEDA 1137

3. Course Credits and Contact Hours:

Credits: 2

Lecture Hours: 1

Lab Hours: 2

4. Course Description:

This course is a continuation of the Administrative Procedures I duties that are performed by the medical assistant. Emphasis will be on understanding medical insurance and necessary coding for billing, daily financial practices, billing and collections, accounting practices, and the role of the medical assistant as an office and human resources manager.

5. Placement Tests Required:

6. Prerequisite Courses:

9. Co-requisite Courses:

There are no corequisites for this course.

II. Transfer and Articulation

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

Name of Institution	Course Number and Title	Credits
Anoka Technical College, Anoka	MAST 2007 Medical Administrative II	2
Minnesota West Technical College, Luverne	ADSM 1125 Medical Office Procedures II	3

2. Transfer - regional institutions with which this course has a written articulation agreement:

III. Course Purpose

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

Medical Assistant, Diploma

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Demonstrate reading and listening skills	Complete the required insurance forms and understand the importance of having no errors before submitting.
Analyze and follow a sequence of operations	Explain and demonstrate the entire medical office billing cycle process from the beginning to the end by completing the required work products.
Apply abstract ideas to concrete situations	Demonstrate their understanding of managing facility finances by completing the required work products to show proficiency of competencies.

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

Expected Outcome	MnTC Goal Area
Determine the necessity for correct diagnosis/procedure codes before submitting insurance claims.
Examine daily financial practices for accuracy.
Assess the leadership qualities necessary for the Office Manager and Human Resources Manager role.
Analyze accounting practices for large and small outpatient ambulatory care settings.
Apply computer concepts for office procedures.
Differentiate between accounts payable and accounts receivable.
Perform accounts receivable procedures including posting entries, billing procedures, collection procedures, adjustments, and credit balances.

V. Topical Outline

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

1. Lecture Sessions

1. Understanding the Role of Health Insurance
• Medical Insurance Terminology
• Types of Medical Insurance Coverage
• Screening for Insurance
• Referrals and Authorizations
• Determining Fee Schedules
• Legal and Ethical Implications
• Professional Careers in Insurance
2. Medical Insurance Coding
• Coding of Medical Procedures
• Coding Accuracy
• Coding the Claim Form
• Third-party Guidelines
• Completing the CMS-1500
• Submitting Claims Electronically
• Managing the Claims Process
• The Insurance Carrier’s Role
3. Daily Financial Practices
• Patients Fees
• Credit Arrangements
• The Bookkeeping Function
• Recording Patient Transactions
• Banking Procedures
• Purchasing Supplies and Equipment
• Petty Cash
4. Billing and Collections
• Billing Procedures
• Credit and Collection Policies
• Monthly and Cycle Billing
• Past-Due Accounts
• Collection Process
• Aging Accounts
• Collection Techniques
• Special Collection Situations
• Statute of Limitations
5. Accounting Practices
• Bookkeeping and Accounting Systems
• Day-End Summary
• Accounts Receivable Trial Balance
• Accounts Payable
• Cost Analysis
• Financial Records
• Useful Financial Data
• Legal and Ethical Guidelines
6. The Medical Assistant as Office Manager
• Qualities of a Manager
• Management Styles
• Risk Management
• Importance of Teamwork
• Supervising Personnel
• Harassment in the Workplace
• Procedure Manual
• HIPAA Implications
• Travel Arrangements
• Time Management
• Marketing Functions
• Records and Financial Management
• Facility and Equipment Management
• Liability Coverage and Bonding
• Legal Issues
7. The Medical Assistant as Human Resources Manager
• Tasks Performed by the Human Resources Manager
• The Office Policy Manual
• Recruiting and Hiring Office Personnel
• Orienting New Personnel
• Dismissing Employees
• Maintaining Personnel Records
• Complying with Personnel Laws
• Special Policy Considerations
• Providing Employee Training and Education

2. Laboratory/Studio Sessions

The laboratory sessions will involve practice and production of required work products to demonstrate proficiency of required competencies/skills related to the above outlined topics.

1. Medical Insurance:
• Applying Managed Care Policies and Procedures
• Screening for Insurance
• Obtaining Referrals and Authorizations
• Computing the Medicare Fee Schedule
2. Medical Insurance Coding:
• Current Procedural Terminology Coding
• International Classification of Diseases, 9^th Revision, Clinical Modification Coding
• Applying Third-Party Guidelines
• Completing a Medicare CMS-1500 Claim Form
3. Daily Financial Practices:
• Recording/Posting Patient Charges, Payments and Adjustments in a Manual System
• Balancing Day Sheets in a Manual System
• Posting Patient Charges Using Medical Office Simulation
• Insurance Billing Using Medical Office Simulation Software
• Posting Payments and Adjustments Using Medical Office Simulation Software
• Processing Credit Balances and Refunds Using Medical Office Simulation Software
• Preparing a Deposit
• Recording a Nonsufficient Funds Check in a Manual System
• Writing a Check
• Reconciling a Bank Statement
• Establishing and Maintaining a Petty Cash Fund
4. Billing and Collections:
• Explaining Fees in the First Telephone Interview
• Prepare Itemized Patient Accounts for Billing in a Manual System
• Identify Accounts Receivable Using Medical Office Simulation Software
• Preparing Itemized Patient Accounts for Billing Using Medical Office Simulation Software
• Post/Record Collection Agency Adjustments in a Manual System
• Post/Record Adjustments Using Medical Office Simulation Software
5. Accounting Practices:
• Preparing Accounts Receivable Trial Balance in a Manual System
• Preparing Accounts Receivable Trial Balance Using Medical Office Simulation Software