Access Instructions Evolve* 1 The Career of a Medical Administrative Assistant Career Description Job Duties A Typical Day at the Office Personal Qualities Professional Appearance Professional Skills Student Portfolio Places of Employment Earnings Employment Trends and Forecasts Professional Organizations American Association of Medical Assistants American Medical Technologists American Academy of Professional Coders International Association of Administrative Professionals Association for Healthcare Documentation Integrity American Health Information Management Association Additional Certifications Continuing Education Summary Review Exercises SimChart for the Medical Office Applications Activities You are the Medical Administrative Assistant Suggested Readings 2 The Healthcare Team Healthcare Providers Physician Physician Assistant Nurse Practitioner Certified Nurse Midwife Podiatrist Psychologist Chiropractor Optometrist Nurse Anesthetist Nursing Professionals Registered Nurse Licensed Practical Nurse Certified Nursing Assistant Allied Health Professionals Medical Administrative Assistant Medical Assistant Health Documentation Specialist Medical Coder Medical Biller Health Information Professionals Physical Therapist Physical Therapy Assistant Occupational Therapist Occupational Therapy Assistant Respiratory Therapist Radiology Technologist Clinical Laboratory Technologist and Technician Pharmacist Social Worker Licensure, Certification, and Registration Professional Organizations Health Care Facilities Clinic Private Practice Hospital Emergency Room Urgent Care Center Outpatient (Ambulatory) Surgery Center Home Health Hospice and Palliative Care Nursing Home and Assisted Living Public Health Summary Review Exercises SimChart for the Medical Office Applications Activities You are the Medical Administrative Assistant 3 Medical Law and Ethics Legal Concepts and Terms What Is Law? Origin of Law Administrative Law Civil and Criminal Law Standards of Care Respondeat Superior Res Ipsa Loquitur Contract Law Legal Action Against a Medical Practice Legal Proceedings Legal Topics Related to the Medical Office The Practice of Medicine Consent Confidentiality Advance Directives Uniform Anatomical Gift Act Controlled Substances Act of 1970 Good Samaritan Statutes Health Insurance Portability and Accountability Act of 1996 Emergency Medical Treatment and Labor Act of 1986 Risk Management Medical Ethics Concepts and Terms Definition of Ethics Law Versus Ethics History of Ethics Ethical Behavior for Physicians The American Medical Association Council on Ethical and Judicial Affairs Ethics Opinions of the Council on Ethical and Judicial Affairs Failure to Abide by Ethical Standards Ethical Behavior for Medical Administrative Assistants Ethical Issues in Healthcare The Study of Ethical Issues in Healthcare Abortion Reproductive Rights Issues Near the End of Life Acquired Immunodeficiency Syndrome, Human Immunodeficiency Virus Summary Review Exercises SimChart for the Medical Office Applications Activities You are the Medical Administrative Assistant 4 The Diverse Community of Patients Influence of Culture Interactions With Patients of Different Cultures Expectations When Serving Patients Language Barriers English as a Second Language Speech Difficulty Medical Terminology Specific Patient Groups Elderly Patients Children Patients With Disabilities Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Angry Patients Violent Patients Anxious Patients Depressed Patients Dying or Grieving Patients Summary Review Exercises Activities You are the Medical Administrative Assistant Suggested Readings 5 Interpersonal Communications Communication Concepts Communication Basics Communicating Effectively Nonverbal Communication Personality Styles Communication Within the Healthcare Team Communicating With Your Supervisor Telephone Communication Proper Telephone Technique Incoming Calls Outgoing Calls Written Communication Business Letters Memos Email U.S. Postal Service Delivery Services Summary Review Exercises SimChart for the Medical Office Applications Activities 6 Appointment Scheduling Computerized Appointment Scheduling Software Packages for Appointment Scheduling Concerns When a Computerized Appointment System Is Used Manual System for Appointment Scheduling Concerns When a Manual Scheduling System Is Used Appointment Scheduling Methods Double-Booking (Overbooking) of Appointments Walk-in Patients Group (Block) Scheduling Series of Appointments Multiple Appointments Virtual Visits Appointment Scheduling Procedures Establishing Appointment Parameters Components of an Appointment Prioritizing Appointments No-Show Appointments Canceled and Rescheduled Appointments Ancillary and Referral Appointments Surgical Appointments Pharmaceutical and Other Sales Representatives’ Appointments Wait Lists Appointment Reminders Accessing the Schedule Planning for the Unexpected Summary Review Exercises SimChart for the Medical Office Applications Activities 7 Patient Reception and Registration Exceptional Patient Service Patient Informational Materials Getting the Office Ready Unlock the Door Review the Day’s Schedule Start and Check Office Equipment Switch on Television or Music System Count Cash Drawer Welcoming Patients Patient Registration Registration Information Reception Area Layout and Design of the Reception Area Reception Area Maintenance Emergency Situations What Is an Emergency? Common Medical Emergencies What a Medical Administrative Assistant Should Do Other Situations Planning for Emergencies Summary Review Exercises SimChart for the Medical Office Applications Activities 8 Health Information Management What is Health Information Management? Purposes of Recordkeeping Types of Records Confidentiality Confidentiality Agreements Confidentiality and Computerized Medical Records Health Insurance Portability and Accountability Act of 1996 Notice of Privacy Practices Failure to Comply With HIPAA Components of the Medical Record in a Medical Office Summary Sheet Medical History Encounters/Progress Notes Medication Records Immunizations Laboratory and Pathology Reports Radiology Reports Other Specialized Reports and Documents Correspondence Hospital Reports Medical Transcription and Documentation Skills Needed Equipment Used Signature Organizing the Medical Record Charting Methods Chart Order Documentation Guidelines What Does Not Belong in the Record Records Flow Quantitative Analysis Filing Supplies Charts Labels Outguides Filing Methods Numeric Filing Systems Alphabetical Filing Color Coding Records Retention and Disposal Tickler File File Storage and Protection Disaster Plan Medical Offices With Multiple Locations Legal and Ethical Issues Release of Information Ownership Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome Records The Future of Health Records Summary Review Exercises SimChart for the Medical Office Applications Activities 9 Procedure and Diagnosis Coding Medical Coding Procedure Coding-Current Procedural Terminology Sections of the Current Procedural Terminology Manual Procedure Coding-HCPCS Level II-National Codes Diagnosis Coding-International Classification of Diseases, 10th Revision, Clinical Modification Legal and Ethical Issues in Coding Ethics Compliance The Coding Profession Summary Review Exercises SimChart for the Medical Office Applications 10 Medical Billing The Billing Process Registration Superbill Billing Office Processes Computerized Billing Systems Credit Statements of Account Aging Accounts Collection Collection Methods Billing Topics What Does the Doctor Charge? Assignment of Benefits Fees for Medical Care Legal and Ethical Issues in Medical Billing Medical Debt Confidentiality Billing Fraud Identity Theft Fee Splitting Charges for Minors Estate Claims Missed Appointments-To Bill or Not to Bill Medical Records Summary Review Exercises SimChart for the Medical Office Applications Activities 11 Health Insurance and Health Benefits Programs Insurance Terminology Centers for Medicare and Medicaid Services CMS-1500 Claim Form The Insurance Claim Process Electronic Claims Processing Paper Processing of CMS-1500 Coordination of Benefits Troubleshooting Claims Timelines for Filing Filing an Appeal Types of Insurance Plans Fee-for-Service Health Maintenance Organizations Preferred Provider Organizations Government Health Insurance Programs Medicare Children’s Health Insurance Program Tricare Champva Workers’ Compensation Private Health Insurance Insurance Coverage Blue Cross/Blue Shield Disability Insurance Long-Term Care Insurance Insurance Resources Current Topics in Health Insurance Insurance Fraud and Abuse Confidentiality Cobra Insurance Industry Statistics Summary Review Exercises SimChart for the Medical Office Applications Activities 12 Business Operations of the Medical Office Organizational Structure of the Medical Office Types of Ownership Organizational Hierarchy Healthcare-Related Organizations The Joint Commission Occupational Safety and Health Administration Clinical Laboratory Improvement Amendments Program Other Office Support Responsibilities Office Supplies Office Meetings and Communications Summary Review Exercises SimChart for the Medical Office Applications Activities 13 Financial Management Bookkeeping and Accounting Procedures in a Medical Office Financial Reports Accounts Receivable Receiving Payments on Account Preparing a Bank Deposit Refunding Overpayment of a Patient’s Account Processing Returned Checks Petty Cash Accounts Payable Purchase Orders Banking Procedures for Accounts Payable Reconciling the Bank Account Business Record Retention Summary Review Exercises SimChart for the Medical Office Applications Activities 14 Human Resource Management Participatory Management Style The Employment Process Posting an Open Position The Interview Hiring a New Employee Employee Training and Probationary Period Policy Manuals Procedure Manuals Payroll Timekeeping Employee Compensation Record Payroll Deductions Human Resource Records Employee Evaluation Employee Discipline or Termination Separation of Employment References for Former Employees Employee Health Adapting to Change Labor Laws and Legal Issues Labor Law Enforcement Fair Labor Standards Act Family and Medical Leave Act Americans With Disabilities Act Sexual Harassment Workers’ Compensation Information on Employment Matters Summary Review Exercises Activities 15 Job Search Essentials Preparation for Employment Social Media Applying for a Position Developing a Winning Résumé Heading Career Objective Education Work Experience or Work History Achievements, Awards, Interests, or Skills References Cover Letter Finding Out About Job Openings Internet Job Search Networking Academic Placement Services Professional Employment Services Classified Ads Professional Organizations Cold Calls Internship Opportunities An Application for Employment Preparing for a Great Interview The Interview Choosing The Right Position Summary Review Exercises Activities Appendix A Answers to Think About It Questions Appendix B Competency Assessment Checklist Appendix C Using SimChart Glossary Index