Administrative Assisting Study Guide

If a doctor is delayed at the hospital, what should the MA do?

The MA should explain to the patients who are waiting that the doctor is delayed and if they would like to reschedule their appointment due to the delay

disadvantages of practice management software

Disadvantages: takes time and effort to choose a program that will work best for an office, they are expensive to install and maintain, and office staff must be well-trained to use them properly.

Advantages and disadvantages of PHR?

Easily accessible and makes decisions easier for physicians since they have all of the info at hand, but it takes a lot of time and money

What options are available if a patient cannot pay his bill?

Extending credit to pay at a later time

When should payment be received?

When they receive the care

What is a UCR fee?

Which is the amount that physicians in the same geographic area most commonly charge for the same service

What are the roles of healthcare providers?

provide healthcare

What are the roles of pharmacy?

provides prescribed medications and keeps documentation of medications

What are the roles of governmental agencies?

regulate each of the entities and ensure they adhere to healthcare laws

What information is part of an EMR?

Medical and treatment history of a patient

What information is needed to set up an appointment for an outpatient facility?

Name, date of birth, insurance info, reason for test

What are the procedures of checking in new patients?

New patients must complete a notice of privacy practice and release of information forms then register them before they can check in

When do cancellations occur?

When a patient can't come to their appointment

Barriers of EHR

- Cost, compatibility, workflow disruption, training, and patient privacy

Advantages and disadvantages of paper medical records

- Paper records are well established and understood, easier to keep confidential, and no computer malfunctioning can occur - but they can only be used one at a time, can be misplaced or misfiled, and require a lot of storage space

Benefits of EHR

- Present complete and accurate information about a client's health to healthcare providers - Provide better and easier accessibility to health records - Empower clients to take a more active role in their health

What is capitation?

A system where the insurance carrier pays a fixed amount of money per patient

What is meaningful use?

A financial incentive program to encourage national use of EHR technology in order to improve client care

What is Assignment of Benefits?

A form the patient must sign that allows the insurance carrier to reimburse the physician directly. This form saves the office time and money

When do referrals occur?

A referral occurs when a physician seeks the opinion of another physician who may have greater knowledge or expertise about a particular condition and/or body system

What are client privacy rights?

Access, Accuracy, Disclosure, Notice

Advantages of practice management software

Advantages: more than one person can access the schedule at a time and can perform several tasks simultaneously

What is an audit?

An inspection and verification of a facility's records and supporting documentation

What is a superbill?

An itemized bill from one visit

What is a diagnostic code?

Are codes that refer to the physician's diagnosis

What is a procedural code?

Codes that represent the procedure performed in response to the physician's diagnosis

What is a modifier?

Communicate to third-party payers a situation that may alter the way in which payment is made

What should you do when a patient has a long-term delinquent account?

Focus on collecting the money by offering payment solutions and work with them to get the money

What are the procedures of checking out a patient?

Give the patient their bill or schedule their next appointment

What information is found in EHR?

Health care provider documentation, including details of current care and response to treatment, Documentation of additional services for related care, including laboratory reports, radiology reports, and nutrition assessments, Pharmacy notes, prescription records, and medication administration records, other reports and correspondence.

What is practice management software?

Helps manage the daily operations of a medical office by performing a variety of functions electronically.

How do you determine a new patient?

If they haven't seen the physician or was seen more than three years ago

What is preauthorization?

Obtaining approval from the insurance carrier before performing a test or procedure

What is PHR?

Is an electronic record of health and medical information, that can be maintained by the client

What is HIT?

Is the application of technology in the healthcare industry for the purpose of storing, retrieving, and sharing healthcare information

How does HIPAA affect EMR?

Patients must provide written authorization for any info in the EMR to be released to any entity

What are walk-ins?

Patients who come in without an appointment

How are a diagnostic code and a procedural code related?

Procedural codes describe what kind of procedure a patient has received while diagnostic codes describe any diseases, illnesses or injuries a patient may have.

What is an aging report?

Records the age of accounts receivable

What is predetermination?

Relays the specifics of coverage after preauthorization is complete

What are the steps to schedule an appointment?

Scheduling an established patient involves obtaining limited patient information, verifying patient information, offering the patient scheduling choices, and recording the appointment in the appointment book or practice management software

What is the HITECT Act?

Seeks to improve client care and reduce costs through use of EHRs.

What are the benefits of ePrescribing?

Staff spend less time on the phone confirming new prescriptions and refill requests.

What is a guarantor?

The person responsible for paying

What are patients rights in regards to EMR?

They have the right to view them, have copies of them, and request changes to them, and who has access to them

What is EMR?

a digital version of a paper chart of clients's medical history that is stored in one healthcare provider's office.

Advantages and disadvantages of EMR

allow for multiuse, no misplacement, quickly available, no storage space, and organized, but they need a lot of protection and are expensive

Access

clients have the right to access their personal health information

Notice

clients have the right to be notified of specific privacy practices of healthcare providers and facilities.

Accuracy

clients have the right to correct or amend health information

Disclosure

clients have the right to know who their personal health information has been shared with.

What is EHR?

digital record that is created, managed, and consulted by authorized providers and staff from across more than one health care organization.

What are the procedures of checking in established patients?

established patients just show up at their time slot and check in with the medical assistant who notifies the doctor that they are there

what is a ledger?

is a financial book of all financial transactions

What is a fee schedule?

is a list of specified fees

What is an invoice?

is an itemized statement

What are the roles of insurance carrier?

pays for a portion of the costs

Examples of inpatient procedures and outpatient diagnostic tests

x-rays, body fluid tests, ultrasounds, simple blood tests, magnetic resonance imaging (MRI), computer tomography (CT scan), surgery (inpatient)