Students enrolled in this course will gain knowledge in Medical Terminology, Medical Billing, Electronic Medical Records and responsibilities of the front office medical assistant. This training also provides 160 hours of extensive hands-on training utilizing Medisoft and EMR. Students will learn about Medicare, Medicaid, Inception/history/present day focus, Information Technology (IT), types of insurance coverage including HMO, PPO, fee-based, health insurance exchanges and government/private plans. Fraud, abuse, HIPAA Compliance and the appeals process will be included. Students will gain knowledge of Microsoft Office 2010 including Excel, Word, PowerPoint, Outlook and much more.
- Demonstrate an understanding of Medical Terminology relating to the primary body systems.
- Demonstrate an understanding of Records Management, EMR/EHR and Office Procedures.
- Demonstrate effective business communication skills, professionalism and telecommunications.
- Identify and demonstrate an understanding of Medical Insurance Billing and Coding
- Navigate various Healthcare Software Applications
- Demonstrate effective business communication skills and professionalism
- Learn and demonstrate appropriate Employability Skills
Week 1-4 --
Medical Terminology
Records Management, Electronic Medical Record, Electronic Health Record (EMR/EHR), Office Procedures
Week 5-7
Medical Insurance Billing and Coding
Week 8-10
Healthcare Software Applications
Medical Terminology
- Understand the Basic Structure of Medical Terms
- Learn Medical Word Parts: Combining Forms, Prefixes and Suffixes
- Understand Spelling Rules and Singular/Plural Forms
- Pronounce and Spell Medical Word Parts
- Pronounce and Spell Medical Terms Including Anatomy
- Pronounce and Spell Diagnostic Tests and Procedures
- Primary Body Systems and Related Organs including Skeletal, Cardiovascular, Respiratory Digestive, Urinary, Nervous, Endocrine, overview Reproductive System and Sense Organs
- Describe the Medical Specialties
- Define Clinical and Laboratory Tests related to Primary Body Systems
- Define and Understand Causes of Pathological Conditions relating to Primary Body Systems
- Define Common Surgical Procedures Related to Primary Body Systems
- Identify and Define Abbreviations Used in the Physical Examination
- Identify and Define Common Laboratory Abbreviations and Body Systems
- Identify and Define Abbreviations used in Prescriptions
Records Management, Electronic Medical Record, Electronic Health Record (EMR/EHR), Office Procedures
- Identify components of the HIPAA Compliance and the Privacy Rule
- Understand Administrative, Technical and Physical Safeguards
- Identify Protected Health Information (PHI) and Notice of Privacy Practices (NPP)
- Understand Authorization Forms, Informed Consent and Surgical Consent Forms
- Recognize Differences Between Authorized and Unauthorized Disclosure with Electronic, and Email Transmission as well as Paper and Verbal
- Understand Meaningful Use and Utilization of Certified EHR Technology
- Review Patient Registration Process/Check In
- Establish Financial Responsibility
- Understand Eligibility Verification Procedures
- Discuss Professional Etiquette, Medical Ethics and Legality
- Understand Responsibilities of Compliance/Privacy Officer
- Demonstrate Understanding of Business Letter and Interoffice Memorandum Formats
- Know Records Management Systems Including Alphabetic, Numeric, Subject and Chronology
- Understand SOAP Notes (subjective, objective, assessment, plan) and Parts of the History and Physical Examination
- Discuss Official Documentation Guidelines for Paper and Electronic Records
- Create Medical Reports Using Documentation Guidelines
- Understand Appointment Scheduling for Routine, Work-In, Emergency Visits
- Understand Responsibilities of Primary Care Physician (PCP), Admitting and Attending Physician, Medical Specialist and Consultant
- Understand Importance of Professionalism in Telecommunications
- Practice Incoming/Outgoing Calls, Screening, Routine, Emergency, Prescription Refills and Complaint Calls
Week 5-7
Medical Insurance Billing and Coding
- Understand Professional/Physician Billing and Outpatient Billing Services
- Define Insurance Terms such as Benefits, Guarantor, Insured, Subscriber, Dependent, Eligibility, Assignment of Benefits, Premium, Deductible, Co-payment, Coinsurance
- Verify Patient Demographic Information and Insurance Information on Registration Form
- Differentiate Types of Health Insurance Plans: Government (Medicare, Medicaid, TRICARE and CHAMPVA), Workers’ Compensation, Managed Care, Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO), Group and Commercial
- Understand Payment and Reimbursement Methods: Fee Based, Capitation, Participating
- Discuss Practice Management Programs (PMPs) and Benefits to Practice
- Enter Patient Demographic and Insurance Information
- Understand Medical Necessity, the Criterion of Insurance Payers
- Establish Medical Necessity by Matching Patient Services/Procedures with Appropriate Condition/Diagnoses
- Review Coding Compliance
- Recognize Procedure Codes (CPT –Current Procedural Terminology) relating to Evaluation and Management, Surgical, Radiology, Laboratory and Pathology and Medicine Codes
- Abstract Patient Services from Medical Records
- Discuss the Use of Modifiers to Append Appropriate Services
- Assign appropriate CPT Codes for Routine Physician Services, Diagnostic and Surgical Procedures, Vaccines and Preventive Services
- Recognize HCPCS (Healthcare Common Procedure Coding System) Codes relating to Supplies, DME (Durable Medical Equipment), and Vaccines
- Discuss Use of HCPCS Modifiers
- Recognize Diagnostic Codes (ICD-9-CM – International Classification of Diseases, Ninth Revision and ICD-10-CM Tenth Revision)
- Learn Official Guidelines and Coding Conventions for ICD-9-CM
- Enter Charge Transactions, Insurance Payments, Patient Payments and Adjustments
- Abstract Diagnoses from Medical Records
- Assign Appropriate ICD-9-CM codes to Common Medical Conditions and Diseases identified in Physician Practices and Outpatient Facilities
- Discuss Differences of Electronic Claim X12 837 and Paper CMS 1500
- Learn Mandatory Blocks and Conditional Blocks
- Understand Importance of Accurate Patient/Insurance Data Entry Which Populates Other Documents, Statements and Claims
- Create Insurance Claim Forms
- Review Completed Claims for to Identify Missing Data Fields, Edit as Necessary
- Generate Rebills
- Understand Various Business Reports and the Revenue Cycle
- Comprehend Importance of Aging of Reports
- Analyze Accounts that Require Immediate Attention and Use Reports to Track Revenue
- Understand Business Summary Reports relating to the Revenue Cycle
- Discuss the Collection Process for Current and Overdue Accounts and Payment Plans
- Generate Patient Statements with Zero and Remainder Balances
- Discuss the Affordable Care Act (ACA) and the impact on patients, medical practices and businesses
Week 8-10
Healthcare Software Applications
- Review and Compare Features of EMR, EHR and Programs Used in Industry
- Review Meaningful Use
- Review HIPAA Compliance and Privacy Rules Relating to Electronic Transmission
- Understand Use of Passwords, Access Rights, Confidentiality of Protected Health Information and Technical Safeguards
- Navigate Menus and Toolbars to Enter, Edit, Save and Delete Patient Data
- Navigate Menus and Toolbars to Enter, Edit, Save and Delete Financial Data
- Demonstrate Ability Generate Practice Analysis Reports and Related Business Summary Reports
- Generate Appointment Schedule for Individual Physician or Group Practices
- Review Patient Encounter Forms to Determine Patient Services and Appropriate Diagnoses to Comply with Insurance Carrier Requirements
- Utilize Practice Management Software (PMP) to Maintain Patient Medical Records
- Utilize PMP to Manage Patient Appointments
- Utilize PMP to Manage Financial Activities and the Revenue Cycle