Administrative Medical Assisting
Foundations and Practices
Published on 11. March 2009
Book
Paperback/Softback
576 pages
978-0-13-199932-9 (ISBN)
Description
Administrative Medical Assisting includes extensive coverage of the administrative medical assisting profession including the history of the profession, the responsibilities of the administrative medical assistant, responding to emergencies in the medical office, medical practice finances and management of the medical office team, and career strategies for the medical assistant.
More details
Language
English
Place of publication
United States
Publishing group
Pearson Education (US)
Target group
Professional and scholarly
Dimensions
Height: 222 mm
Width: 284 mm
Thickness: 28 mm
Weight
1343 gr
ISBN-13
978-0-13-199932-9 (9780131999329)
Copyright in bibliographic data and cover images is held by Nielsen Book Services Limited or by the publishers or by their respective licensors: all rights reserved.
Schweitzer Classification
Other editions
New editions
Book
11/2014
2nd Edition
Pearson
€119.45
Shipment within 15-20 days
Person
Christine Malone, BS, MHA studied management practice and theory at Henry Cogswell College, receiving her B.S. in Professional Management. She continued her education at the University of Washington, obtaining her Master's Degree in Health Administration. Christine is currently working toward her Ph.D. in Business Administration with a Health Care focus. Christine has over 20 years experience in the healthcare field having spent time working as a dental assistant, a medical receptionist, an x-ray technician, medical clinic director, and as a consultant to healthcare providers focusing on strategic management, efficient office flow, and human resource management. Since 2004, Christine has been teaching within the Health Sciences Department at Everett Community College in Washington State. There she teaches Medical Office Management, Computer Applications in the Medical Office, Medical Practice Finances, Intercultural Communications in Healthcare, and Medical Law and Ethics. In 2006 Christine researched and developed a certificate program in Healthcare Risk Management. This series of three courses is offered via distance learning and provides the student who successfully completes the three courses a Certificate in Healthcare Risk Management. Christine was elected to the Snohomish County Charter Review Commission in Washington State, a 1-year position from 2005-2006. She is the co-chair of the Young Careerists Group within the Business and Professional Women's Association of Greater Everett, a member of the American College of Healthcare Executives (ACHE), a member of the Washington State Healthcare Executive Forum (WSHEF), a member of the American Society for Healthcare Risk Management (ASHRM), a member of the American College of Medical Practice Executives (ACMPE), and is active in healthcare politics on both a local and national level. Christine has been the guest speaker at various events on healthcare issues and in continuing education meetings across Washington State and has received her certification in vocational teaching as well as palliative care training. Christine and her husband have five children and live in a 100-year-old home in Everett, Washington. In 1999, their third child, Ian, was injured due to medical negligence during his birth. Ian lived four and a half years before succumbing to his injuries in 2004. This was the genesis of Christine's work toward improving patient safety in healthcare. Her input has been sought by legislative committees, editorial boards, and many policy makers. A nationally recognized healthcare reform advocate, Christine has appeared on the Today Show, NBC Nightly News, ABC Nightly News, the CBC's The National, in The New York Times, The Los AngelesTimes, and on Salon.com.
Content
SECTION I: INTRODUCTION TO THE ADMINISTRATIVE MEDICAL ASSISTING PROFESSION
Chapter 1: The History of Medicine and Health Care
The Earliest Medical Practices
Early Egyptian Medicine
Early Chinese Medicine
Early Native American Medicine
The Father of Medicine
Early European Medicine
The Turning Points of Modern Medicine
Medical Discoveries
The Beginning of Hand Washing in Health Care
Antisepsis Use in Health Care
The Medical Value of X-rays
Chiropractic Practices in Medicine
Medicine in the 20th Century
Important Organizations in Medical History
The History of American Hospitals
The History of the American Medical Association
The Start of the American Red Cross
Important Women in Health Care
The Work of Marie Curie
The Role of Florence Nightingale
The Contributions of the Blackwell Sisters
The World Health Organization
Medical Care Today
Evidence-based Medicine
Chapter 2: Medical Assisting Today
The History of the Medical Assisting Profession
Education Requirements of the Medical Assistant
Becoming Accredited in Medical Assisting
Achieving Certified Medical Assistant Status
Recertifying in Medical Assisting
Becoming a Registered Medical Assistant
Gaining Multiple Medical Assisting Statuses
The Medical Assistant's Scope of Practice
Procedure 2-1: Adapting to Change
The Requirements of Other Allied Health Associations
The American Medical Technologist (AMT)
The American Academy of Professional Coders (AAPC)
The American Health Information Management Association (AHIMA)
The American Association of Medical Transcriptionists (AAMT)
Chapter 3: The Medical Assisting Career: Roles and Responsibilities
Choosing Medical Assisting as a Career
Understanding Medical Assisting Responsibilities
Identifying Positive Medical Assisting Qualities
Understanding the Medical Assistant's Role Outside of the Office
Managing Time Effectively in the Medical Office
Working in Health Care Today
The Medical Assistant's Career Opportunities
Members of the Health Care Team
Working with Physicians
The Pharmacist's Role
The Role of the Physician's Assistant
The Role of the Nurse Practitioner
The Role of the Nurse
Medical Practice Specializations
Complementary and Alternative Medicine
Applying CAM Approaches
The Role of Dietary Supplements
Chapter 4: Medical Law and Ethics
The Sources of Law
Administrative Law
Comparing Public Law and Private Law
Criminal Law
Civil Law
Tort Law
Understanding and Classifying Consent
Procedure 4-1: Preparing an Informed Consent for Treatment Form
Medical Malpractice
The Doctrine of Respondeat Superior
Types of Malpractice Insurance Policies
Proving Medical Malpractice
Medical Malpractice Awards
Preventing Medical Malpractice Claims
Defending Against Medical Malpractice Claims
Using Assumption of Risk as a Defense
Contributory and Comparative Negligence
Immunity from Negligence Suits
Res Judicata and Res Ipsa Locuitur
The Standard of Care
Tort Reform
Capping the Money Awarded to Injured Patients
Repeat Offender Providers
The Physician's Public Duties and Consequences
Reporting Vaccine Injuries
Reporting Cases of Abuse
Revoking Medical Licenses
The Physician-Patient Relationship
The Role of the Patient
The Role of the Physician
Contracts in Health Care
Implied Contracts
Expressed Contracts
Terminating Contracts
The Good Samaritan Act
Maintaining Patient Confidentiality through Proper Records Handling
Releasing Medical Records
Procedure 4-2: Obtaining Authorization for the Release of Medical Records
Accommodating Subpoenas of Medical Records
Procedure 4-3: Respond to a Request for Copies of a Patient's Medical Record
Disclosing Minor's Medical Records
Guarding Super-Protected Medical Information
Faxing Medical Records
Disclosing Medical Records Improperly
The Health Insurance Portability and Accountability Act (HIPAA)
Title II of HIPAA
HIPAA and Computer Privacy
The HIPAA Privacy Offer
HIPAA Records Violation
The HIPAA Business Associate Agreement
Penalties for HIPAA Violations
Advance Directives
Employment Law and Health Care
Sexual Harassment
The Americans with Disabilities Act and Healthcare Employment
The Conscience Clause
The Patient's Bill of Rights
OSHA and Ambulatory Care
The Clinical Laboratory Improvement Amendments Act (CLIA) and Ambulatory Care
The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and Ambulatory Care
The Controlled Substances Act
Medical Ethics
Ethical Considerations
Ethical Model
Raising Ethical Issues in Health Care
Bioethics
The Uniform Anatomical Gift Act
Chapter 5: Interpersonal Communication Skills
Verbal Communication
Using Non-verbal Communication
Writing as a Means of Communication
Reading and Using Body Language
Therapeutic Touch
Demonstrating Active Listening
Interviewing the Patient
Procedure 5-1: Using Effective Listening Skills in Patient Interviews
Employing Interviewing Techniques
Identifying Factors that Hinder Communication
Communicating in Special Circumstances
Procedure 5-2: Communicating with a Hearing-impaired Patient
Procedure 5-3: Communicating with Sight-impaired Patients
Procedure 5-4: Communicating with Patients via Interpreters
Maintaining Professional Patient Communication
Communicating with Coworkers
Communicating with Other Facilities
Procedure 5-5: Preparing a Patient's Specialist Referral
Educating the Patient
Working through Miscommunication
Taking Time for Patient Education
Maslow's Hierarchy of Needs
Establishing a Proper Learning Environment
Using Teaching Resources
Appreciating the Patient's Skills and Abilities
Factoring Culture into Patient Education
Factoring Finances into Patient Education
Teaching Patients about Preventive Medicine
Preventing Injuries in the Elderly
Preventing Medication Errors
Providing Dieting or Weight Loss Information
Delivering Information on Exercise
Educating Patients about Stress Reduction
Teaching Patients about Smoking Cessation and Substance Abuse
Using the Internet for Education
Procedure 5-6: Using the Internet to Find Patient Education Materials
Chapter 6: Written Communication
Writing to Patients and Other Health Care Professionals
The Role of Spell-Checking
Reviewing Proper Spelling, Grammar, and Punctuation Use
Numbers in Correspondence
Rules for Medical-term Plurals
The Components of the Business Letter
Styles of Business Letters
Using Fonts in Typed Communication
Procedure 6-1: Composing a Business Letter
Sending Letters to Patients
Procedure 6-2: Sending a Letter to a Patient about a Missed Appointment
Learning How to Proofread
Procedure 6-3: Proofreading Written Documents
Working with Accepted Abbreviations
Creating Memos for the Office
Mailing Written Communication
Window Envelopes
Procedure 6-4: Folding Documents for Window Envelopes
Running and Resetting Postage Meters
Classifying Mail, Size Requirements, and Postage
Buying Postage Online
Using Multiline Optional Character Readers
"Zip + 4 Codes"
USPS-Approved Abbreviations in Addresses
Restricted Materials
Other Delivery Options
Using E-mail to Communicate
Managing Mail and Correspondence
Procedure 6-5: Opening and Sorting Mail
Annotation
Procedure 6-6: Annotating Written Correspondence
SECTION II: ADMINISTRATIVE RESPONSIBILITIES OF THE MEDICAL ASSISTANT
Chapter 7: Telephone Procedures
Telephone System Features
Making Calls with Hands-free Devices
Dialing Numbers Automatically
Redialing Last Numbers Called
Making Conference Calls
Conversing via Speaker Phone
Call Forwarding
Recording Telephone Calls
Direct Telephone Lines
Automatic Routing Units
Placing Callers on Hold
Other Special Features
Using an Answering Service
Patient Telephone Use
Answering the Telephone
Procedure 7-1: Answering the Telephone
Screening Telephone Calls
Directing Patient Calls to Physicians
Prioritizing Telephone Calls
Telephone Triage
Taking Emergency Telephone Calls
Being Professional on the Telephone
Communicating with Hard-to-Understand Callers
Handling Difficult Callers
Receiving Calls from Emotional Patients
Documenting Calls from Patients
Taking Telephone Messages
Procedure 7-2: Taking a Telephone Message
Calling in Prescriptions and Refill Requests
Procedure 7-3: Calling a Pharmacy with Prescription Orders
Calling Patients
Leaving Messages
Calling Other Health Care Facilities
Using a Telephone Directory
Using an Online Directory
Using a Rolodex System
Long Distance or Toll Free Calls
Guarding Patient Confidentiality
Placing Personal Telephone Calls
Using Telecommunication Relay Services
Chapter 8: Front Desk Reception
Characteristics of the Front Desk Receptionist
Opening the Office
Procedure 8-1: Opening the Office
Preparing Patient Files
Greeting and Registering Patients
Using Sign-in Sheets Effectively
Administering Patient Paperwork
Notifying Patients of Delays
Collecting Payments at the Front Desk
Escorting Patients
Managing Difficult Patients in the Reception Area
Keeping Only Appropriate Patients in the Reception Area
Maintaining the Reception Area
Providing Adequate Seating and Decoration
Choosing Reading Material for the Reception Room
Managing Children in the Reception Room
Accommodating Patients with Disabilities
Serving Patients with Service Animals
Caring for Patients as They Leave the Office
Closing the Office
Procedure 8-2: Closing the Office
Chapter 9: Patient Scheduling
Scheduling New Patient Appointments
New and Established Patients
Allowing Appointments Adequate Time
Creating an Appointment Matrix
Balancing Patient and Office Needs in Scheduling
Paper and Electronic Scheduling
Procedure 9-1: Scheduling a New Patient
Methods of Appointment Scheduling
Cluster Scheduling
Double Booking
Fixed Appointment Scheduling
Scheduling with Open Hours
Wave Scheduling
Leaving Slack or Buffer Time
Conducting Triage and Appointment Scheduling
Procedure 9-2: Scheduling a Patient Appointment
Using Patient Reminder Systems
Correcting the Appointment Schedule
Documenting No-show Appointments
Procedure 9-3: Rescheduling a Missed Patient Appointment
Following up on No-Show Appointments
Managing the Physician's Professional Schedule
Scheduling Hospital Services and Admissions
Procedure 9-4: Scheduling a Hospital Procedure
Procedure 9-5: Scheduling an Inpatient Admission
Arranging for Language Interpreters
Arranging Transportation for Patients
Achieving Efficiency in Scheduling
Chapter 10: Medical Records Management
Information Contained in the Medical Record
Procedure 10-1: Preparing the Medical Chart
The Purpose of the Medical Record
Signing Off On Medical Records
Forms of Charting
The Narrative Style
Charting with SOAP
Problem-Oriented Medical Record Charting
Inserting Flow Charts in Medical Records
Progress Notes
Using Abbreviations in Charting
Charting Patient Communication
Procedure 10-2: Charting Patient Telephone Calls
Filing Information via Filing Systems
Alphabetic Filing
Procedure 10-3: Filing Documents in Patient Medical Records
Shingling Items for Medical Records
Numeric Filing
File Storage Systems
Active, Inactive, and Closed Patient Files
Converting Paper Records to Electronic Storage
Retaining Medical Records
Correcting Medical Records
Adding to Medical Records
Procedure 10-4: Correcting Errors in the Patient Medical Record
Charting Conflicting Orders
"Owning" the Medical Record
Documenting Prescription Refill Requests
Releasing Information When a Medical Practice Closes
Conducting Research with Medical Records
Chapter 11: Electronic Medical Records
Electronic Medical Records are Easily Accessible
How Does Paper Charting Differ from Electronic Charting?
Making the Conversion from Paper to Electronic Medical Records
Training
Electronic Health Records and HIPAA Compliance
Backing up Computers and Electronic Medical Records
Using Personal Digital Assistants with Electronic Medical Records
Other Benefits of Electronic Medical Records
Electronic signatures
Using Electronic Records to Avoid Medical Mistakes
Saving Time with Electronic Medical Records
Using Electronic Medical Records for Health Maintenance
Using Electronic Medical Records with Diagnostic Equipment
Using Electronic Medical Records for Marketing Purposes
Making Corrections in the Electronic Medical Record
Chapter 12: Computers in the Medical Office
Components of the Computer System
Computer Hardware
Surge Protection
Backing Up Computer Systems
Computer Peripherals
Scanners
Digital Cameras
Bar-code Readers
Electronic Sign-in Sheets
Maintaining Computer Equipment
Computer Software
Training Staff on Medical Software
Types of Software Packages
Computer Security
Computer Viruses
Internet Search Engines
Procedure 12-1: Using an Internet Search Engine
Finding Appropriate Web Resources
Procedure 12-2: Verifying Preferred Provider Status on an Insurance Company Web Site
Buying Medications Online
Allowing Personal Computer Use in the Office
Personal Digital Assistants
Computer Ergonomics
Chapter 13: Equipment, Maintenance, and Supply Inventory
Working with Medical Office Equipment
Training Employees to Use Medical Office Equipment
Keeping a Maintenance Log for Medical Office Equipment
Procedure 13-1: Taking Inventory of Administrative Equipment
Procedure 13-2: Perform Routine Maintenance of a Computer Printer
Replacing or Buying Medical Office Equipment
Weighing Equipment Leasing against Buying
Using Fax Machines in the Medical Office
Procedure 13-3: Faxing a Document
Using Copy Machines in Health Care Work
Adding Health Care Data with Machines
Medical Transcription
Finding Outside Transcription Services
Logging Medical Office Supplies
Inventorying Supplies
Procedure 13-4: Preparing a Purchase Order
Checking for the Next Day's Supplies
Storing Supplies Upon Arrival
Procedure 13-5: Receiving a Supply Shipment
Handling Drug Samples
Stocking Clerical Supplies
Tracking Supplies with Computer Software
Chapter 14: Office Policies and Procedures
Creating Patient Information Pamphlets
Procedure 14-1: Creating an Office Brochure
Creating a Personnel Manual
Creating Policies and Procedures for the Medical Office
Writing a Mission Statement
Preparing an Organizational Chart
Mapping Out Clinical Procedures
Outlining Administrative Procedures
Procedure 14-2: Creating a Procedure for the Procedure Manual
Documenting Infection Control Procedures
Creating Quality Improvement and Risk Management Procedures
Writing Other Office Procedures
SECTION III: RESPONDING TO EMERGENCIES IN THE MEDICAL OFFICE
Chapter 15: Handling Medical Office Emergencies
The Medical Assistant's Role in an Emergency
Preventing Accidents and Injuries
Preparing for Medical Emergencies
Managing Medical Emergencies
Procedure 15-1: Performing Adult Rescue Breathing and Cardiopulmonary Resuscitation
Procedure 15-2: Responding to a Patient Who Has Fainted
Emergency Equipment and Supplies
Administering Oxygen in Emergencies
Procedure 15-3: Administering Oxygen to a Patient
Automated External Defibrillator (AED)
Procedure 15-4: Using an Automated External Defibrillator (AED)
The Signs and Symptoms of Heart Attack
The Signs and Symptoms of Choking
Procedure 15-5: Removing an Airway Obstruction
When Infants and Children are Choking Victims
Procedure 15-6: Removing an Airway Obstruction in an Infant
Controlling Bleeding
Procedure 15-7: Controlling Bleeding
Assisting Patients in Shock
Caring for Patients with Fractures
Assisting Patients with Burns
SECTION IV: PRACTICE FINANCES AND MANAGEMENT OF THE MEDICAL OFFICE
Chapter 16: Insurance Billing and Authorizations
The History of Health Insurance
Types of Health Insurance Plans
Employer-Sponsored Health Plans
COBRA Coverage
Individual Health Insurance Policies
Flex-Spending and Health Care Savings Accounts
Fee-for-Service Plans
Consumer-Directed Health Care Plans
Health Savings Accounts
Medical Savings Accounts
Flexible Spending Accounts
Managed Care Plans
Capitation Plans
Insurance Coverage Terminology
Out-of-Pocked Expenses
Waiting Periods and Exclusions
Elective Procedures
Prescription Drug Coverage
Types of Provider Organizations
Preferred Provider Organizations
Health Maintenance Organizations
Exclusive Provider Organizations
National Commercial Carriers
Medicare Coverage
Medicare Part A
Medicare Part B
Medicare Part C- Advantage Plan
Medicare Part D
Secondary Insurance with Medicare
Medicare for the Employed
Providers Participating in Medicare
Medicaid
Covered Medicaid Services
State Children's Health Insurance (SCHIP)
TRICARE
CHAMPVA
The National Provider Identifier (NPI)
Workman's Compensation Insurance
Accidental Injuries
Disability Insurance
Processing Claims
The Patient Identification Number
Keeping Patient Information Up-to-Date
The Birthday Rule
Verifying Eligibility
Preparing Referrals, Authorizations, and Precertifications
Procedure 16-1: Obtaining a Managed Care Referral
Procedure 16-2: Obtaining Authorization from an Insurance Company for a Procedure
Documenting Insurance Company Calls
Health Insurance Claim Forms
The CMS-1500 Claim Form
Procedure 16-3: Completing an Insurance Claim Form
Accommodating Filing Timelines
Billing Insurance Companies Electronically
Working within Fee Schedules
Posting Payments
Reconciling Payments and Rejections
Procedure 16-4: Handling a Denied Insurance Claim
Sending Supporting Documentation
The Office of the Insurance Commissioner
Tracing Claims
Projecting Health Insurance Costs in the Future
Chapter 17: ICD-9-CM Coding
The History of Diagnostic Coding
Coding with the ICD-9- CM Book
The Volumes of ICD-9- CM
Volume I
ICD-9-CM Appendices
Volume II
Diagnosis-Related Group (DRG) Coding
Determining the Correct Code
Primary Diagnoses
Coding Conventions
Procedure 17-1: Perform Diagnostic Coding
Multiple Diagnostic Codes
Coding Late Effect Diagnoses
Suspected Conditions
Signs and Symptoms Codes
Coding for Drugs and Chemicals Causing Poisonings or Adverse Effects
Coding for Fractures
Coding Burns
Documenting Diagnostic Codes
Chapter 18: Procedural Coding
The History of Procedural Coding
The CPT-4 Book
Categorizing Main Health Care Codes
Procedure Codes
Evaluation and Management Codes
New and Established Patients
Selecting the Proper Level of E&M Service
Using Coding Modifiers Appropriately
Procedure 18-1: Coding for a Procedure
Place of Service Codes
Anesthesia Codes
Postoperative or Follow-up Days
Coding for Wound Repair
Coding for Same-day Multiple Procedures
Radiology Codes
Pathology and Laboratory Codes
Medicine Codes
The Health Care Common Procedure Coding System (HCPCS)
Ensuring Proper Reimbursement
Fraud in Medical Coding
Chapter 19: Billing, Collections, and Credit
Identifying Payment Basics
Manual Billing Systems
Procedure 19-1: Posting and Entry on a Day Sheet
Computerized Billing Systems
Fee Schedules
Participating Provider Agreements
Credit and Collections
Procedure 19-2: Explaining Professional Fees to a Patient
Verifying Patient Identification
Managing Accounts Receivables
Procedure 19-3: Calling a Patient Regarding an Overdue Account
Collection in Managed Care
Forgiving Deductibles or Copayments
Patients Who File Bankruptcy
Professional Courtesy
Patient Billing Statements
Procedure 19-4: Sending a Patient a Billing Statement
Dismissing Patients Due to Nonpayment
Charging Interest on Medical Accounts
Addressing Checks that Fail to Clear
Procedure 19-5: Posting a Non-sufficient Funds Check
Contacting Nonpaying Patients
Sending Patients Collection Letters
Procedure 19-6: Posting an Adjustment to a Patient Account
Procedure 19-7: Posting a Collection Agency Payment
Uncollectible Accounts
Collecting from Estates
Overpaying on Accounts
Procedure 19-8: Processing a Patient Refund
Procedure 19-9: Processing an Insurance Company Overpayment
Collections through Small Claims Court
Chapter 20: Payroll, Accounts Payable, and Banking Procedures
Processing Payroll
The History of Payroll
Present Day Employment Issues
Payroll Processing
Creating New Employee Records
Updating Employee Records
The W-4 Form
Recording Employee's Work Hours
Calculating Payroll
Computing Payroll Deductions
The Circular E
Other Deductions
Procedure 20-1: Calculating an Employee's Payroll
Using Software to Calculate Payroll
Garnishing Wages
Accounts Payable
Procedure 20-2: Writing Checks to Pay Bills
The Checkbook Register
Ordering and Receiving Supplies
Procedure 20-3: Paying an Office Supply Invoice
Preparing a Deposit Slip
Procedure 20-4: Completing a Deposit Slip
Endorsement Stamps
Accessing Bank Accounts via the Internet
Petty Cash
Procedure 20-5: Accounting for Petty Cash
Reconciling Bank Statements
Procedure 20-6: Reconcile a Bank Statement
Chapter 21: Managing the Medical Office
Characteristics of the Medical Office Manager
Responsibilities of the Medical Office Manager
Leadership Styles
Conducting Effective Staff Meetings
Creating Staff Meeting Agendas
Procedure 21-1: Directing a Staff Meeting
Staff Meeting Minutes
Staffing the Medical Office
Writing Job Descriptions
Procedure 21-2: Writing a Job Description
Creating Job Advertisements
Recruiting and Interviewing Candidates
Procedure 21-3: Conducting an Interview
Calling for Employee References
Procedure 21-4: Calling Employee References
Hiring New Staff
Training New Staff
Supervising Staff
Overcoming Scheduling Issues
Performance Evaluations
Procedure 21-5: Perform an Employee Evaluation
Disciplining and Terminating Staff
Procedure 21-6: Disciplining an Employee
Procedure 21-7: Terminating an Employee
Sexual Harassment in the Medical Office
Employment Resources
Providing Employee References
Improving Quality and Managing Risk in the Medical Office
Creating a Quality Improvement Program
Working to Ensure Patient Safety
Reporting Office Incidents
Procedure 21-8: Filing a Medical Incident Report
Using Protective Equipment
Procedure 21-9: Using Personal Protective Equipment
Disposing of Hazardous Waste
Procedure 21-10: Developing an Exposure Control Plan
Ensuring Employee Safety
Procedure 21-11: Using Proper Lifting Techniques
SECTION V: CAREER STRATEGIES
Chapter 22: Competing in the Job Market
The Externship Experience
Understanding the Extern Site's Responsibilities
Outlining the Student's Responsibilities
The Responsibilities of the Medical Assisting Program
Writing an Effective Resume
Procedure 22-: Writing an Effective Resume
Preparing a Cover Letter
Procedure 22-2 Composing a Cover Letter
Identifying Places to Look for Employment
Completing Employment Applications
The Successful Interview
Preparing for the Interview
Dressing for the Interview
Presenting the Right Image
Following Up After the Interview
Procedure 22-: Following Up After the Interview
Changing Jobs
Appendix A: CAAHEP Standards for Curriculum: Correlation of Text to CAAHEP Standards
Appendix B: Correlation of Text to AAMA Role Delineation Chart
Appendix C: Registered Medical Assistant (RMA) [AMT] Medical Assisting Task List
Appendix D: Tips on How to Become a Successful Student
Appendix E: Preparing for the CMA and RMA Certification Exams
Appendix F: Translation of English-Spanish Phrases
Appendix G: Common Medical Abbreviations
Appendix H: Answers to Chapter Case Studies/Critical Thinking Questions
Appendix I: Answers to In-Practice Scenarios
Glossary
References
Chapter 1: The History of Medicine and Health Care
The Earliest Medical Practices
Early Egyptian Medicine
Early Chinese Medicine
Early Native American Medicine
The Father of Medicine
Early European Medicine
The Turning Points of Modern Medicine
Medical Discoveries
The Beginning of Hand Washing in Health Care
Antisepsis Use in Health Care
The Medical Value of X-rays
Chiropractic Practices in Medicine
Medicine in the 20th Century
Important Organizations in Medical History
The History of American Hospitals
The History of the American Medical Association
The Start of the American Red Cross
Important Women in Health Care
The Work of Marie Curie
The Role of Florence Nightingale
The Contributions of the Blackwell Sisters
The World Health Organization
Medical Care Today
Evidence-based Medicine
Chapter 2: Medical Assisting Today
The History of the Medical Assisting Profession
Education Requirements of the Medical Assistant
Becoming Accredited in Medical Assisting
Achieving Certified Medical Assistant Status
Recertifying in Medical Assisting
Becoming a Registered Medical Assistant
Gaining Multiple Medical Assisting Statuses
The Medical Assistant's Scope of Practice
Procedure 2-1: Adapting to Change
The Requirements of Other Allied Health Associations
The American Medical Technologist (AMT)
The American Academy of Professional Coders (AAPC)
The American Health Information Management Association (AHIMA)
The American Association of Medical Transcriptionists (AAMT)
Chapter 3: The Medical Assisting Career: Roles and Responsibilities
Choosing Medical Assisting as a Career
Understanding Medical Assisting Responsibilities
Identifying Positive Medical Assisting Qualities
Understanding the Medical Assistant's Role Outside of the Office
Managing Time Effectively in the Medical Office
Working in Health Care Today
The Medical Assistant's Career Opportunities
Members of the Health Care Team
Working with Physicians
The Pharmacist's Role
The Role of the Physician's Assistant
The Role of the Nurse Practitioner
The Role of the Nurse
Medical Practice Specializations
Complementary and Alternative Medicine
Applying CAM Approaches
The Role of Dietary Supplements
Chapter 4: Medical Law and Ethics
The Sources of Law
Administrative Law
Comparing Public Law and Private Law
Criminal Law
Civil Law
Tort Law
Understanding and Classifying Consent
Procedure 4-1: Preparing an Informed Consent for Treatment Form
Medical Malpractice
The Doctrine of Respondeat Superior
Types of Malpractice Insurance Policies
Proving Medical Malpractice
Medical Malpractice Awards
Preventing Medical Malpractice Claims
Defending Against Medical Malpractice Claims
Using Assumption of Risk as a Defense
Contributory and Comparative Negligence
Immunity from Negligence Suits
Res Judicata and Res Ipsa Locuitur
The Standard of Care
Tort Reform
Capping the Money Awarded to Injured Patients
Repeat Offender Providers
The Physician's Public Duties and Consequences
Reporting Vaccine Injuries
Reporting Cases of Abuse
Revoking Medical Licenses
The Physician-Patient Relationship
The Role of the Patient
The Role of the Physician
Contracts in Health Care
Implied Contracts
Expressed Contracts
Terminating Contracts
The Good Samaritan Act
Maintaining Patient Confidentiality through Proper Records Handling
Releasing Medical Records
Procedure 4-2: Obtaining Authorization for the Release of Medical Records
Accommodating Subpoenas of Medical Records
Procedure 4-3: Respond to a Request for Copies of a Patient's Medical Record
Disclosing Minor's Medical Records
Guarding Super-Protected Medical Information
Faxing Medical Records
Disclosing Medical Records Improperly
The Health Insurance Portability and Accountability Act (HIPAA)
Title II of HIPAA
HIPAA and Computer Privacy
The HIPAA Privacy Offer
HIPAA Records Violation
The HIPAA Business Associate Agreement
Penalties for HIPAA Violations
Advance Directives
Employment Law and Health Care
Sexual Harassment
The Americans with Disabilities Act and Healthcare Employment
The Conscience Clause
The Patient's Bill of Rights
OSHA and Ambulatory Care
The Clinical Laboratory Improvement Amendments Act (CLIA) and Ambulatory Care
The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and Ambulatory Care
The Controlled Substances Act
Medical Ethics
Ethical Considerations
Ethical Model
Raising Ethical Issues in Health Care
Bioethics
The Uniform Anatomical Gift Act
Chapter 5: Interpersonal Communication Skills
Verbal Communication
Using Non-verbal Communication
Writing as a Means of Communication
Reading and Using Body Language
Therapeutic Touch
Demonstrating Active Listening
Interviewing the Patient
Procedure 5-1: Using Effective Listening Skills in Patient Interviews
Employing Interviewing Techniques
Identifying Factors that Hinder Communication
Communicating in Special Circumstances
Procedure 5-2: Communicating with a Hearing-impaired Patient
Procedure 5-3: Communicating with Sight-impaired Patients
Procedure 5-4: Communicating with Patients via Interpreters
Maintaining Professional Patient Communication
Communicating with Coworkers
Communicating with Other Facilities
Procedure 5-5: Preparing a Patient's Specialist Referral
Educating the Patient
Working through Miscommunication
Taking Time for Patient Education
Maslow's Hierarchy of Needs
Establishing a Proper Learning Environment
Using Teaching Resources
Appreciating the Patient's Skills and Abilities
Factoring Culture into Patient Education
Factoring Finances into Patient Education
Teaching Patients about Preventive Medicine
Preventing Injuries in the Elderly
Preventing Medication Errors
Providing Dieting or Weight Loss Information
Delivering Information on Exercise
Educating Patients about Stress Reduction
Teaching Patients about Smoking Cessation and Substance Abuse
Using the Internet for Education
Procedure 5-6: Using the Internet to Find Patient Education Materials
Chapter 6: Written Communication
Writing to Patients and Other Health Care Professionals
The Role of Spell-Checking
Reviewing Proper Spelling, Grammar, and Punctuation Use
Numbers in Correspondence
Rules for Medical-term Plurals
The Components of the Business Letter
Styles of Business Letters
Using Fonts in Typed Communication
Procedure 6-1: Composing a Business Letter
Sending Letters to Patients
Procedure 6-2: Sending a Letter to a Patient about a Missed Appointment
Learning How to Proofread
Procedure 6-3: Proofreading Written Documents
Working with Accepted Abbreviations
Creating Memos for the Office
Mailing Written Communication
Window Envelopes
Procedure 6-4: Folding Documents for Window Envelopes
Running and Resetting Postage Meters
Classifying Mail, Size Requirements, and Postage
Buying Postage Online
Using Multiline Optional Character Readers
"Zip + 4 Codes"
USPS-Approved Abbreviations in Addresses
Restricted Materials
Other Delivery Options
Using E-mail to Communicate
Managing Mail and Correspondence
Procedure 6-5: Opening and Sorting Mail
Annotation
Procedure 6-6: Annotating Written Correspondence
SECTION II: ADMINISTRATIVE RESPONSIBILITIES OF THE MEDICAL ASSISTANT
Chapter 7: Telephone Procedures
Telephone System Features
Making Calls with Hands-free Devices
Dialing Numbers Automatically
Redialing Last Numbers Called
Making Conference Calls
Conversing via Speaker Phone
Call Forwarding
Recording Telephone Calls
Direct Telephone Lines
Automatic Routing Units
Placing Callers on Hold
Other Special Features
Using an Answering Service
Patient Telephone Use
Answering the Telephone
Procedure 7-1: Answering the Telephone
Screening Telephone Calls
Directing Patient Calls to Physicians
Prioritizing Telephone Calls
Telephone Triage
Taking Emergency Telephone Calls
Being Professional on the Telephone
Communicating with Hard-to-Understand Callers
Handling Difficult Callers
Receiving Calls from Emotional Patients
Documenting Calls from Patients
Taking Telephone Messages
Procedure 7-2: Taking a Telephone Message
Calling in Prescriptions and Refill Requests
Procedure 7-3: Calling a Pharmacy with Prescription Orders
Calling Patients
Leaving Messages
Calling Other Health Care Facilities
Using a Telephone Directory
Using an Online Directory
Using a Rolodex System
Long Distance or Toll Free Calls
Guarding Patient Confidentiality
Placing Personal Telephone Calls
Using Telecommunication Relay Services
Chapter 8: Front Desk Reception
Characteristics of the Front Desk Receptionist
Opening the Office
Procedure 8-1: Opening the Office
Preparing Patient Files
Greeting and Registering Patients
Using Sign-in Sheets Effectively
Administering Patient Paperwork
Notifying Patients of Delays
Collecting Payments at the Front Desk
Escorting Patients
Managing Difficult Patients in the Reception Area
Keeping Only Appropriate Patients in the Reception Area
Maintaining the Reception Area
Providing Adequate Seating and Decoration
Choosing Reading Material for the Reception Room
Managing Children in the Reception Room
Accommodating Patients with Disabilities
Serving Patients with Service Animals
Caring for Patients as They Leave the Office
Closing the Office
Procedure 8-2: Closing the Office
Chapter 9: Patient Scheduling
Scheduling New Patient Appointments
New and Established Patients
Allowing Appointments Adequate Time
Creating an Appointment Matrix
Balancing Patient and Office Needs in Scheduling
Paper and Electronic Scheduling
Procedure 9-1: Scheduling a New Patient
Methods of Appointment Scheduling
Cluster Scheduling
Double Booking
Fixed Appointment Scheduling
Scheduling with Open Hours
Wave Scheduling
Leaving Slack or Buffer Time
Conducting Triage and Appointment Scheduling
Procedure 9-2: Scheduling a Patient Appointment
Using Patient Reminder Systems
Correcting the Appointment Schedule
Documenting No-show Appointments
Procedure 9-3: Rescheduling a Missed Patient Appointment
Following up on No-Show Appointments
Managing the Physician's Professional Schedule
Scheduling Hospital Services and Admissions
Procedure 9-4: Scheduling a Hospital Procedure
Procedure 9-5: Scheduling an Inpatient Admission
Arranging for Language Interpreters
Arranging Transportation for Patients
Achieving Efficiency in Scheduling
Chapter 10: Medical Records Management
Information Contained in the Medical Record
Procedure 10-1: Preparing the Medical Chart
The Purpose of the Medical Record
Signing Off On Medical Records
Forms of Charting
The Narrative Style
Charting with SOAP
Problem-Oriented Medical Record Charting
Inserting Flow Charts in Medical Records
Progress Notes
Using Abbreviations in Charting
Charting Patient Communication
Procedure 10-2: Charting Patient Telephone Calls
Filing Information via Filing Systems
Alphabetic Filing
Procedure 10-3: Filing Documents in Patient Medical Records
Shingling Items for Medical Records
Numeric Filing
File Storage Systems
Active, Inactive, and Closed Patient Files
Converting Paper Records to Electronic Storage
Retaining Medical Records
Correcting Medical Records
Adding to Medical Records
Procedure 10-4: Correcting Errors in the Patient Medical Record
Charting Conflicting Orders
"Owning" the Medical Record
Documenting Prescription Refill Requests
Releasing Information When a Medical Practice Closes
Conducting Research with Medical Records
Chapter 11: Electronic Medical Records
Electronic Medical Records are Easily Accessible
How Does Paper Charting Differ from Electronic Charting?
Making the Conversion from Paper to Electronic Medical Records
Training
Electronic Health Records and HIPAA Compliance
Backing up Computers and Electronic Medical Records
Using Personal Digital Assistants with Electronic Medical Records
Other Benefits of Electronic Medical Records
Electronic signatures
Using Electronic Records to Avoid Medical Mistakes
Saving Time with Electronic Medical Records
Using Electronic Medical Records for Health Maintenance
Using Electronic Medical Records with Diagnostic Equipment
Using Electronic Medical Records for Marketing Purposes
Making Corrections in the Electronic Medical Record
Chapter 12: Computers in the Medical Office
Components of the Computer System
Computer Hardware
Surge Protection
Backing Up Computer Systems
Computer Peripherals
Scanners
Digital Cameras
Bar-code Readers
Electronic Sign-in Sheets
Maintaining Computer Equipment
Computer Software
Training Staff on Medical Software
Types of Software Packages
Computer Security
Computer Viruses
Internet Search Engines
Procedure 12-1: Using an Internet Search Engine
Finding Appropriate Web Resources
Procedure 12-2: Verifying Preferred Provider Status on an Insurance Company Web Site
Buying Medications Online
Allowing Personal Computer Use in the Office
Personal Digital Assistants
Computer Ergonomics
Chapter 13: Equipment, Maintenance, and Supply Inventory
Working with Medical Office Equipment
Training Employees to Use Medical Office Equipment
Keeping a Maintenance Log for Medical Office Equipment
Procedure 13-1: Taking Inventory of Administrative Equipment
Procedure 13-2: Perform Routine Maintenance of a Computer Printer
Replacing or Buying Medical Office Equipment
Weighing Equipment Leasing against Buying
Using Fax Machines in the Medical Office
Procedure 13-3: Faxing a Document
Using Copy Machines in Health Care Work
Adding Health Care Data with Machines
Medical Transcription
Finding Outside Transcription Services
Logging Medical Office Supplies
Inventorying Supplies
Procedure 13-4: Preparing a Purchase Order
Checking for the Next Day's Supplies
Storing Supplies Upon Arrival
Procedure 13-5: Receiving a Supply Shipment
Handling Drug Samples
Stocking Clerical Supplies
Tracking Supplies with Computer Software
Chapter 14: Office Policies and Procedures
Creating Patient Information Pamphlets
Procedure 14-1: Creating an Office Brochure
Creating a Personnel Manual
Creating Policies and Procedures for the Medical Office
Writing a Mission Statement
Preparing an Organizational Chart
Mapping Out Clinical Procedures
Outlining Administrative Procedures
Procedure 14-2: Creating a Procedure for the Procedure Manual
Documenting Infection Control Procedures
Creating Quality Improvement and Risk Management Procedures
Writing Other Office Procedures
SECTION III: RESPONDING TO EMERGENCIES IN THE MEDICAL OFFICE
Chapter 15: Handling Medical Office Emergencies
The Medical Assistant's Role in an Emergency
Preventing Accidents and Injuries
Preparing for Medical Emergencies
Managing Medical Emergencies
Procedure 15-1: Performing Adult Rescue Breathing and Cardiopulmonary Resuscitation
Procedure 15-2: Responding to a Patient Who Has Fainted
Emergency Equipment and Supplies
Administering Oxygen in Emergencies
Procedure 15-3: Administering Oxygen to a Patient
Automated External Defibrillator (AED)
Procedure 15-4: Using an Automated External Defibrillator (AED)
The Signs and Symptoms of Heart Attack
The Signs and Symptoms of Choking
Procedure 15-5: Removing an Airway Obstruction
When Infants and Children are Choking Victims
Procedure 15-6: Removing an Airway Obstruction in an Infant
Controlling Bleeding
Procedure 15-7: Controlling Bleeding
Assisting Patients in Shock
Caring for Patients with Fractures
Assisting Patients with Burns
SECTION IV: PRACTICE FINANCES AND MANAGEMENT OF THE MEDICAL OFFICE
Chapter 16: Insurance Billing and Authorizations
The History of Health Insurance
Types of Health Insurance Plans
Employer-Sponsored Health Plans
COBRA Coverage
Individual Health Insurance Policies
Flex-Spending and Health Care Savings Accounts
Fee-for-Service Plans
Consumer-Directed Health Care Plans
Health Savings Accounts
Medical Savings Accounts
Flexible Spending Accounts
Managed Care Plans
Capitation Plans
Insurance Coverage Terminology
Out-of-Pocked Expenses
Waiting Periods and Exclusions
Elective Procedures
Prescription Drug Coverage
Types of Provider Organizations
Preferred Provider Organizations
Health Maintenance Organizations
Exclusive Provider Organizations
National Commercial Carriers
Medicare Coverage
Medicare Part A
Medicare Part B
Medicare Part C- Advantage Plan
Medicare Part D
Secondary Insurance with Medicare
Medicare for the Employed
Providers Participating in Medicare
Medicaid
Covered Medicaid Services
State Children's Health Insurance (SCHIP)
TRICARE
CHAMPVA
The National Provider Identifier (NPI)
Workman's Compensation Insurance
Accidental Injuries
Disability Insurance
Processing Claims
The Patient Identification Number
Keeping Patient Information Up-to-Date
The Birthday Rule
Verifying Eligibility
Preparing Referrals, Authorizations, and Precertifications
Procedure 16-1: Obtaining a Managed Care Referral
Procedure 16-2: Obtaining Authorization from an Insurance Company for a Procedure
Documenting Insurance Company Calls
Health Insurance Claim Forms
The CMS-1500 Claim Form
Procedure 16-3: Completing an Insurance Claim Form
Accommodating Filing Timelines
Billing Insurance Companies Electronically
Working within Fee Schedules
Posting Payments
Reconciling Payments and Rejections
Procedure 16-4: Handling a Denied Insurance Claim
Sending Supporting Documentation
The Office of the Insurance Commissioner
Tracing Claims
Projecting Health Insurance Costs in the Future
Chapter 17: ICD-9-CM Coding
The History of Diagnostic Coding
Coding with the ICD-9- CM Book
The Volumes of ICD-9- CM
Volume I
ICD-9-CM Appendices
Volume II
Diagnosis-Related Group (DRG) Coding
Determining the Correct Code
Primary Diagnoses
Coding Conventions
Procedure 17-1: Perform Diagnostic Coding
Multiple Diagnostic Codes
Coding Late Effect Diagnoses
Suspected Conditions
Signs and Symptoms Codes
Coding for Drugs and Chemicals Causing Poisonings or Adverse Effects
Coding for Fractures
Coding Burns
Documenting Diagnostic Codes
Chapter 18: Procedural Coding
The History of Procedural Coding
The CPT-4 Book
Categorizing Main Health Care Codes
Procedure Codes
Evaluation and Management Codes
New and Established Patients
Selecting the Proper Level of E&M Service
Using Coding Modifiers Appropriately
Procedure 18-1: Coding for a Procedure
Place of Service Codes
Anesthesia Codes
Postoperative or Follow-up Days
Coding for Wound Repair
Coding for Same-day Multiple Procedures
Radiology Codes
Pathology and Laboratory Codes
Medicine Codes
The Health Care Common Procedure Coding System (HCPCS)
Ensuring Proper Reimbursement
Fraud in Medical Coding
Chapter 19: Billing, Collections, and Credit
Identifying Payment Basics
Manual Billing Systems
Procedure 19-1: Posting and Entry on a Day Sheet
Computerized Billing Systems
Fee Schedules
Participating Provider Agreements
Credit and Collections
Procedure 19-2: Explaining Professional Fees to a Patient
Verifying Patient Identification
Managing Accounts Receivables
Procedure 19-3: Calling a Patient Regarding an Overdue Account
Collection in Managed Care
Forgiving Deductibles or Copayments
Patients Who File Bankruptcy
Professional Courtesy
Patient Billing Statements
Procedure 19-4: Sending a Patient a Billing Statement
Dismissing Patients Due to Nonpayment
Charging Interest on Medical Accounts
Addressing Checks that Fail to Clear
Procedure 19-5: Posting a Non-sufficient Funds Check
Contacting Nonpaying Patients
Sending Patients Collection Letters
Procedure 19-6: Posting an Adjustment to a Patient Account
Procedure 19-7: Posting a Collection Agency Payment
Uncollectible Accounts
Collecting from Estates
Overpaying on Accounts
Procedure 19-8: Processing a Patient Refund
Procedure 19-9: Processing an Insurance Company Overpayment
Collections through Small Claims Court
Chapter 20: Payroll, Accounts Payable, and Banking Procedures
Processing Payroll
The History of Payroll
Present Day Employment Issues
Payroll Processing
Creating New Employee Records
Updating Employee Records
The W-4 Form
Recording Employee's Work Hours
Calculating Payroll
Computing Payroll Deductions
The Circular E
Other Deductions
Procedure 20-1: Calculating an Employee's Payroll
Using Software to Calculate Payroll
Garnishing Wages
Accounts Payable
Procedure 20-2: Writing Checks to Pay Bills
The Checkbook Register
Ordering and Receiving Supplies
Procedure 20-3: Paying an Office Supply Invoice
Preparing a Deposit Slip
Procedure 20-4: Completing a Deposit Slip
Endorsement Stamps
Accessing Bank Accounts via the Internet
Petty Cash
Procedure 20-5: Accounting for Petty Cash
Reconciling Bank Statements
Procedure 20-6: Reconcile a Bank Statement
Chapter 21: Managing the Medical Office
Characteristics of the Medical Office Manager
Responsibilities of the Medical Office Manager
Leadership Styles
Conducting Effective Staff Meetings
Creating Staff Meeting Agendas
Procedure 21-1: Directing a Staff Meeting
Staff Meeting Minutes
Staffing the Medical Office
Writing Job Descriptions
Procedure 21-2: Writing a Job Description
Creating Job Advertisements
Recruiting and Interviewing Candidates
Procedure 21-3: Conducting an Interview
Calling for Employee References
Procedure 21-4: Calling Employee References
Hiring New Staff
Training New Staff
Supervising Staff
Overcoming Scheduling Issues
Performance Evaluations
Procedure 21-5: Perform an Employee Evaluation
Disciplining and Terminating Staff
Procedure 21-6: Disciplining an Employee
Procedure 21-7: Terminating an Employee
Sexual Harassment in the Medical Office
Employment Resources
Providing Employee References
Improving Quality and Managing Risk in the Medical Office
Creating a Quality Improvement Program
Working to Ensure Patient Safety
Reporting Office Incidents
Procedure 21-8: Filing a Medical Incident Report
Using Protective Equipment
Procedure 21-9: Using Personal Protective Equipment
Disposing of Hazardous Waste
Procedure 21-10: Developing an Exposure Control Plan
Ensuring Employee Safety
Procedure 21-11: Using Proper Lifting Techniques
SECTION V: CAREER STRATEGIES
Chapter 22: Competing in the Job Market
The Externship Experience
Understanding the Extern Site's Responsibilities
Outlining the Student's Responsibilities
The Responsibilities of the Medical Assisting Program
Writing an Effective Resume
Procedure 22-: Writing an Effective Resume
Preparing a Cover Letter
Procedure 22-2 Composing a Cover Letter
Identifying Places to Look for Employment
Completing Employment Applications
The Successful Interview
Preparing for the Interview
Dressing for the Interview
Presenting the Right Image
Following Up After the Interview
Procedure 22-: Following Up After the Interview
Changing Jobs
Appendix A: CAAHEP Standards for Curriculum: Correlation of Text to CAAHEP Standards
Appendix B: Correlation of Text to AAMA Role Delineation Chart
Appendix C: Registered Medical Assistant (RMA) [AMT] Medical Assisting Task List
Appendix D: Tips on How to Become a Successful Student
Appendix E: Preparing for the CMA and RMA Certification Exams
Appendix F: Translation of English-Spanish Phrases
Appendix G: Common Medical Abbreviations
Appendix H: Answers to Chapter Case Studies/Critical Thinking Questions
Appendix I: Answers to In-Practice Scenarios
Glossary
References