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134 Cards in this Set
- Front
- Back
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reception area can mk a pt feel
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welcome, nsecure and comfortable
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a brochure
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a. describes services
b.function of medical staff c. measures to take w/ ER d. other issues to consider 4 pt |
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pt feel comfortable discussing condition where
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the providers office
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how to provide privacy
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a. provide space for garments
b. ask if help needed c. always knock before entering d.keep convo low and private |
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ADA applies to
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business w/ 15 or more employees
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NO fresh flowers because
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pt may be allergic and they carry microorganisms
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effective way to check room 4 readiness
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place self as pt
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opening the office for the day
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a.arrive 20 mins before 1st appt.
b.do visual of each room c.mk sure schedule printed for all d.pt charts pulled & ready 4 EMR e. check answerin machine |
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closing office for day
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a.check all rooms(cleanliness, equipment shut dwn, doors/windows are secure).
b.be sure sensitive materials under lock. c.make sure meds are locked up d.petty cash locked e.do days receipts/bank deposit f.contact answerin service notify them office is closed for the day turn on machine. |
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examples of hardware
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a. data input devices(keyboard, mouse, touchscreens).
b.control processing unit (CPU) c.data output devices(printers fax machines modem). |
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storage devices
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a.) ROM b.) Ram
c.) Data storage mem d.) CD e.)Magnet disc drive f.)servers g.)optical drives h.) tape drives i.) flash drives |
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differences in CD-R and CD-Ru
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CD-R u can copy material onto disk. CD-RW u can copy material and then erase and reuse disk for new material
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examples of software
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a.system (required 4 comp)
b.application (office material) c.drivers (mks data compatable) |
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required to use a flash drive
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USB port
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modulated
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voices tone that varies in pitch and intensity
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enunciation
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implies speaking ur words clearly and articulating carefully
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pronunciation
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saying the words correctly
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process for answering phones
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a. facility clearly identified w/ name of person answering
b. use buffer words (good morn) c.ask if this is an ER d.ask 4 callers#, address, DOB e.obtain callers full name f. ask hw can assist them g.follow all office protocols |
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The reason MA's responsibility to screen incoming calls
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a. to sure caller speaks w/ person who can assist
b.to ensure the providers time w/ calls is efficiently managed |
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info for each message
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a. date/time of call
b.who is calling c.caller's name, #, and DOB d.when caller can be reached c.nature/urgency of the call d.action to be taken e. message if any f. ur name/ initials |
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what should u do w/ message before giving to provider?
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attach to pt chart
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administrative MA is responsible for
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a. greeting pt
b. scheduling appts c.fees/ billing questions d.insurance questions e.general question about practice |
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info for new pt
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a.address
b.age/DOB c.employer d.Ins carrier, Ins ID, Ins # e. name of insured f. name of referral source e |
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what type of calls should be referred to provider
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a. other providers
b.STAT reports c.family members d.complaints about medical tx/care |
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issues when dealing w/ older pt
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impaired hearing, confusion, inability to understand
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technique for nonbiligual pts/ MAs
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a. don't assume pt understands
b.speak at normal volume c.avoid complicated words, speak slowly d. ask person to clarify what u said e. be patient |
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standard questions for an emergency
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1. what happened
2.who is pt 3.is pt breathing 4.is there bleeding(where/much) 5.is pt conscious 6.pt temp 7.pt ingested anything a.what did they take b.how much c.poison/overdose inst on bottle |
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open hours
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pt seen at part time frame 1st come 1st serve babses
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double booking
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2 or more pt given a part time appt
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clustering
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pt w/similar problems booked together
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wave schedule
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pt scheduled im 1st 1/2 hr only
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mod schedule wave
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2-3 pt schedule at begin each hr and then 10-20 min after
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practice based
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based on practice specialty diff each day like cost clinic certain time, surg certain times, and reg pt certain times
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stream
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pt scheduled at specific time throughout hour of the day
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what schedule records should be kept for legal purposes
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a. appt book
b. hard copy day sheets c. comp schedule |
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what will schedule show for a malpractice case?
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how many times pt was a no-show, had cancel without reschedule, or to verify pt was seen on date recorded in chart
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Cancellation/ no show appts should be made daily where?
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pt chart
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primary source of pt's for any provider
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referrals form other providers
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when documenting No-shows
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use red X
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Cnacellation maked w/
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red single line
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minor illness
Routine check-ups Suspicious rash blood pressure check |
15 min
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Complete Physical
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45 min
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New patients
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30 min
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Importance of accurate med record
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a.essential to pt care
b.assist in controlling cast of med care c.needed to make referrals d. they maintain a conscientious record of pt care |
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what are out guides and what's on them
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devices to help track charts they're cardstock/plastic inserts kept in place of the chart when removed from file indicates(name of person who has the chart/date removed)
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what are indexing units
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an organized method of indentifying and separating items to be filed into small sub units
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advantages of manual med record
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1. currently established/understood
2.easier to protect confidentiality 3.no worry of computer malfunction |
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what does SOAP stand for
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S-subjective data
O-objective data A-assesment (diagnosis) P-plan of treatment |
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what does ER add to SOAP
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E-education
R-response to ED/treatment |
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open shelf lateral files
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pull records laterally, used most often w/ color codes filing systems where visual inspec mks it possible to ensure files are kept in proper order
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movable file units
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easy access to large record systems/requires less space then vertical files
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vertical closed
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cabinets that have pull out drawers where files are stored
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horizontal shelves
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shelves that run horizontal on walls not really type of filing file
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EHR
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electronic health record
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EMR
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electronic medical record
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define EMR's
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when EMR are combined from multiple places into one database
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ALphabetic filing system
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quite mangeable for many clinics charts are filed in alphabetic order but there are many people w/ the same name which requires adding sorting to narrow ur search not practical for larger clinics.
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Numerical filing system
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there is only one number assigned to each chart there is an infinite set of numbers most efficient for larger clinics
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how to locate missing files
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1. check folders before/after proper location
2.look at folders w/ similar labels 3.check providers desk, trays/other personnel 4.if using color coding look for folders w/ same coding as the misplaced 5.if using numerics look 4 pass transposition of combination of numbers 6.look for transpotion of 1st/last name 7.alt spelling of name or look alike names |
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what is purge system of records
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sorting through records and removing those that are not active
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nonactive records
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records that need to be retained for pass retrieval of info generally pt has not been seen in 2-3yrs, up to practice as to time frame
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type of data retained in chart
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a. clinical notes
b. correpondance c. Lab/ xray reports d. miscellaneous paperwork |
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proofread
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3 times
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how many lines are keyed between the inside address/ the salutation
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one
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how many lines are keyed between heading and date line
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2-3
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when typing references initials what is to be done
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name o person composing the letter are in caps, the MA typing the letter in lower case
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notation "c" indicates
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a copy of the letter was sent to someone other than the person the letter is addressed to
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4 major styles of letters used in med office
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block style, modified block, modified block indented, simplified
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full
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most time efficient all lines begin at the lft margin it's desired when u want a contemporary looking efficient letter
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mod block stand
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all lines begin at left margin except the date line, comp close/ signature is centered or a few spaces right of center
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modified block indented
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same as modified block stand except para are indented five spaces
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simplified
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omits the salutation/ comp closing
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MA can sign certain letters w/ permission
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1.thank u letters
2.reg pt care as direct by provider 3.announcing new INs/HMOs accepted 4.supplies/subscription orders 5.acknowledgment of speakers 6.annoucement of vac or office closures 7.announcement of new staff 8.reminder letters or payment due or collection procedures |
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size envelopes
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6 3/4-6 1/2 x 3 5/8 and 10- 9 1/2 x 4 1/8
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types of mail that does not need to go to the provider
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checks from pts and invoices for med supplies
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deductible
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the amount of money that the insurd must incur for medical services annually
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coinsurance
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after the deductible has been met te insurance then pay a % of the billed amount and the insured pays remaining
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co-payment
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a specified amount payed for a every visit usually $5-$50, some policies have co-pay/coins clauses such as labs paid at time of service
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preexisting cond
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if a pt had an illness/cond or injury before the inception of ins regardless of where it was treated or not may not be covered
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exclusions
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noncovered services such as elective proced, cosmetic services, immunizations (adult) on ins case bases
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coordination of benefits
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more than one policy covers an individual which is billed second (child birthday rules)
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EOB
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is a statement summarizing how the insurance carrier determined the reimbursement for services received by the pt
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2 insurance plans that are federally funded
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medicare and medicaid
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example of medicare suppliment
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medigap
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part A
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covers hospital stays, home healthcare. hospice
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part B
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out pt expenses- PCP, x-ray,labs, urgent care
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part C
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services at an HMO, Medicare advantage plan
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part D
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drug coverage
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age group for medicare
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65 and older/ pt thats disabled or hv kidney failure
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what is medicaid for
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the indigent population low-income
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what is tricare insurance
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active duty activated gaurd, retired members of the military and their families and survivors
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what is self insurance used for
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large company
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what is a point of service plan
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it's the best that describes the mMCO model the enroller has the freedom of obtaining med services from an HMO provider or self-referral to non HMO providers
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what is a PPO plan
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enrollers obtain serv from a network of providers and hospital that have contracted their services at a discounted fee to an ins company on a nonexclusive basis
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regular referrals
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usually takes 3-10 working days to review proced and approve
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urgent referrals
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usually takes about 24hr for approval
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STAT referrals
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may be approved via telephone by faxing the information to the utilization review
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which referral is most common
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regular
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why is it important for MA to understand med coding
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serves as basis for the information on the claim form
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name of coding book for specific services and procedures
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CPT code book
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book for diagnosis codes
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ICD-9-CM
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lacerations (where in code book)
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surgery
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Hep B surface antigen (where in code book)
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pathology and laboratory
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CT scan (where in code book)
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radiology
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EKG (where in code book)
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medicine
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modifers 22
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unusual procedures
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modifers 50
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bilateral procedures
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modifers 51
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multiple procedures
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modifers 62
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2 surgeons
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modifers 66
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surgical team
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modifers 76
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repeat procedures by some provider
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E codes (ICD-9)
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when visit is an injury poisoning
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v codes (ICD-9)
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if pt seen for something other than a sickness or injury use a vcode
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m code (ICD-9)
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morphology primarily cancer diagnosis for types of treatment
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what is 3rd party billing
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1st party=person receiving the contracted service
2nd party=the person or org providing the service 3rd party=the person not involved in the above but is responsible for reimbursment of the procedures or services |
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up-coding
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when an insurance carrier deliberately billed a higher rate service than what was performed to obtain a greater reimbursement
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what helps keep track of claims filed
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a claim register
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advanced beneficiary notification or waiver form used for and by whom?
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it is to notify pts on medicare/medicaid of procedure not covered by ins and what their total responsibility of charges will be ABN medicare
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restrictive endorsement
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usually for deposit
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most important rule of purchasing
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never place an order or pay for an order w/ a purchase order
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advantages for office to accept credit cards
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1. monies are available to the provider within 24hrs
2.Dr. is releaved of responsibility to collect debts from pts 3. covient for pts to pay charges |
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what's the disadvantage of credit cards
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provider must pay a fee to credit card company for every transaction made
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accounts receivable at the end of the month u run a trial balance, what does this include?
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totaling debit balances and credit balances to confirm that total debits equal total credit
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what accounts receivable
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any money owed to the provider for services rendered by pts
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what are accounts payable
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the outstanding accounts owed and paid for office expenses and services (bills, supplies, payroll ext...)
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elements that a ledger or journal entry contain
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a. date of transaction
b.account names involved c.dollar amount of the charges d.brief explanation of the transaction |
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examples of fixed cost in the office
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a. loan payments/rent
b.depreciation of building/equip c. insurance d. property taxes |
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what is monthly billling
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when 1 or 2 day are devoted to billing and mailing all statements
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when collecting on delinquent accounts what is the last result
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sending to collection agency
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what is included in a peg board system and what is another name for it?
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write it once
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examples o variable costs in an office
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a. salaries both staff/ dr.
b. asupplies both clinical/clarical c.lab procedures d. collections cost |
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what is bonding
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insurance for the office to protect the prctice from embezzlement or other financial loss, the provider can purchase fidelity
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3 types of bonds
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a. position schedule band covers the position rather than a specific individual
b. blanket position band covers all employees regardless of their position c. personal band covers specific individuals by name and generally requires a personal background investigation |
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to decrease opportunity 4 embezzlement
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a. conduct reg and irreg audits of the practice accounts
b. separate duties among several employees c. only one person should use the signature stamp d.seek employees whose personal honesty sets a good example for everyone |
