I. General Information

1. Course Title:
Medical Office Procedures

2. Course Prefix & Number:
HINS 1163

3. Course Credits and Contact Hours:

Credits: 2

Lecture Hours: 2

4. Course Description:

This course covers specific administrative responsibilities in the medical practice. The course covers office communication, scheduling, basics of managing health information, basics of insurance and patient billing. The course uses simulations to expose students to a clinic scenario to include patient interaction, third-party payer interaction, and provider interaction. Students will use medical office software to provide hands-on learning to reflect real-world experiences.

5. Placement Tests Required:

Accuplacer (specify test):

No placement tests required

Score:

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

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

MSU - Moorhead, Articulation agreement signed Spring 2019 (MSU-M Electives)

III. Course Purpose

1. Program-Applicable Courses – This course fulfills a requirement for the following program(s):

Healthcare Administrative Specialist, AAS Degree
Healthcare Accounting, AAS Degree
Healthcare Administrative Specialist, Diploma
Healthcare Administrative Specialist, Certificate
Medical Scribe, Certificate

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Demonstrate oral communication skills	Demonstrate effective and clear communication with patients and others within the medical practice.
Analyze and follow a sequence of operations	Identify the steps in the revenue cycle and explain how each medical office position affects the practice finances.
Apply abstract ideas to concrete situations	Identify three ways the healthcare administrative specialist helps to ensure the financial success of the physician practice.

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

• Describe the tasks and skills required of the healthcare administrative specialist;
• Differentiate between electronic medical records (EMR) and practice management system;
• Define the types of information contained in the patients records;
• Explain the purpose of a medical privacy and security plan and how it protects the medical office, employees, and patients; 
• Demonstrate appointment scheduling and claim submission utilizing established priorities and critical information requirements; and
• Compose professional correspondence utilizing electronic technologies.

 

 

V. Topical Outline

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

1. Lecture Sessions

1. Career opportunities and pathways
• Personal attributes
• Employment opportunities
• Work ethic and professionalism
• Professional growth
• Certifications
• Industry organizations
• Roles
2. Privacy and Security
• Access controls
• Auditing capabilities 
• Safeguards 
3. Office communications
• Communication cycle
• Nonverbal communication
• Written communication
• Telephone skills
4. Managing health information
• Introduction to Practice Managment (PM)
• Introduction to the Electronic Medical Records (EMR)
• Documentation formats
• Ownership, quality assurance, and records retention
• Filing systems
• Introduction to electronic health records
5. Computers in health information
• Administrative Information Systems
• Financial information systems
• Master Patient Index (MPI)
• Patient registration
• Functionality of Admission, Discharge, Transfer (ADT)
• Scheduling system for new and established patients
• Schedule, reschedule and cancel appointments
• Insurance eligibility
• Check-in and copay collection
• Clinical information systems
• Ancillary and department information systems
• Vital signs and clinical encounters
• ePrescription and refills
• Provider orders
• Laboratory requisitions
• Referrals to providers
• Identify patients for preventative visits and screenings
• Prepare electronic encounter forms for billing
• Manage and document patient/provider communications
6. Insurance and coding
• Insurance terminology
• Insurance plans
• Government
• Third-party payers
• Workers' compensation, auto and liability 
• Participation and payment method
• Introduction to procedural and diagnostic coding and compliance
7. Billing, reimbursement, and collections
• Charge entry/recording transactions
• Batch bill electronic claims
• Remittance Advice
• Payments from payers
• Posting denials, non-covered services and deductibles
• Track pending payments
• Batch invoicing to patients
• Delinquent accounts
• Medical billing cycle
• Preregister patients
• Establish 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
• Journal/day sheet
• Patient collection
• Collection letters
• Collection company/outside collections
• Regulations and laws
• Non-Sufficient Funds (NSF)
• Identify theft and red flag requirements

 

2. Laboratory/Studio Sessions