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 provides a comprehensive overview of key administrative functions within a medical practice, focusing on both technical and professional skills. The course covers communication, scheduling, basics of managing health information, and an introduction to insurance processing and patient billing. Students will gain proficiency with medical practice management software, providing hands-on skills that reflect real-world application. A focus on professionalism, including effective communication, customer service, and professional ethics, will be integrated throughout the course to prepare students for success in professional healthcare setting.

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

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Demonstrate oral communication skills	Apply professional communication and customer service skills in simulated interactions with patients, providers, and third-party payers to ensure accurate information exchange and a positive patient experience.
Apply abstract ideas to concrete situations
Utilize appropriate technology	Demonstrate proficiency in medical practice management software to effectively manage patient scheduling, health information, and billing processes, simulating real-world medical office tasks.
Apply ethical principles in decision-making	Exhibit professionalism and ethical decision-making in handling sensitive health information, understanding insurance processes, and navigating administrative tasks to support an efficient and compliant healthcare environment.

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 and categorize the types of information contained in the patients records;
• Explain the purpose and components of a medical privacy and security plan to illustrate how it safeguards and protects patient information, staff, and complies with regulatory standards:
• Demonstrate effective revenue cycle steps from patient scheduling, claims processing, denials and payments, to patient statements; and
• Compose professional correspondence using 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
• Employment opportunities
• 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
9. Professionalism
• Attitude, self-esteem, and etiquette
• Communication
• Conflict management
• Customer service
• Diversity Awareness
• Managing change
• Productivity
• Professional ethics
• Team building
• Professional appearance

 

2. Laboratory/Studio Sessions