MA Chapter 11 Written Communication
In addition to the copy of correspondence kept for office records, a copy of the letter may be sent to someone other than the addressee. Noted at the bottom left of the letter by typing ______ or ______ before the recipients name.
"c" or "cc"
Every physicians office contains general reference books and medical to dictionaries as well as textbooks related to the physicians specialization. A complete office library should include the following:
A desk dictionary and access to an online dictionary, a medical dictionary, an online medical dictionary, physicians desk reference (PDR) to verify correct spelling and use of drugs, current coding books, Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10-CM), a thesaurus (Roget's International Thesaurus or online thesaurus).
In general, __________ are spelled out the first time they appear in a document, with the abbreviation provided in parentheses. Only accepted medical abbreviations can be used in medical documentation.
Abbreviations
Active verbs generally make writing more interesting and are considered more effective. In the __________ __________, the subject of a sentence performs the action. In the __________ __________ the subject receives the action.
Active voice; passive voice.
When the piece of mail is forwarded, and the sender receives a notice of the new address.
Address service requested
___________ reports can be intended either for internal use or sent to an outside party. Examples include details of an equipment problem sent to manufacturer, description of an employment performance issue, or medical practice financial information for a bank.
Administrative
Some offices use email to confirm office visits. Not efficient for use in emergencies. ___________ are computer files that can be sent with an email message. PDF, DOC, DOCX. When you receive an attachment from someone, use a virus protection program before saving it.
Attachments
Style that is formatted with all lines, from the date through the signature line, flush with the left margin. A blank line separates paragraphs as well as the inside address, salutation, body, and close.
Block style
The _________ is the main text of the letter and conveys the purpose of the letter. Begins two lines before the salutation and is single-spaced, with double spaces between the paragraphs The paragraphs of the body are either blocked (with no indentation) or indented (with the first line set in the five spaces from the left margin). Mostly letters beating a single message are 2 to 3 paragraphs in length.
Body
Make a _________ list of the points to ensure that you overlook anything important. The most important element in writing an organized letter is to make your ________ quickly.
Bulleted; point
A __________ of __________can be obtained at the post office for a small fee. Document serves as proof that mail was posted. Useful for mailing items that need to be postmarked by a certain date, such as tax returns and reports to insurance companies.
Certificate of mailing
Mail that includes contracts, mortgages, birth certificate, deeds, and checks, which are not valuable themselves but would be difficult to replace if lost, can be mailed as the __________ _______. Such items are mailed at first class rate with additional fee. Certified mail requires the signature of the recipient.
Certified mail
When the sender receives a notice of the new address, but the mail piece is neither forwarded nor returned.
Change service requested
The closing consists of a __________ __________ containment a cord to see word, such as "sincerely", "sincerely yours", or "yours truly". Two lines below the end of the body of the letter.
Complimentary close
Every correspondence must have the current ________. The month should not be abbreviated, followed by the numerical date and year. (January 1, 2014). The day is usually placed three lines below the letterhead, or on line 15 if the letter has no letterhead. 4 to 6 clear lines are left after the date.
Date
The format of a medical report is dictated by the type of report in the information needed by the recipient and, in general, should include the following items:
Date, patients name and date of birth, purpose or subject, case history including presenting problem, physical examination and test findings, diagnosis, and treatment provided, medical status of patient, treatment plan, recommendations, name, credentials, and contact information of person preparing the document.
Some of the nailinge actions have fees associated with them in the mail as the mail piece is returned or a new address is provided. The endorsement must be placed in one of four positions:
Directly below the return address, directly above the delivery address area, directly to the left of the postage area and the wall or to the left of any price marking, directly below the postage area and below any price marking
___________ mail must be at least 0.009 inch thick. A further restriction on size requires that mail 1/4 inch or less and thickness must be 3 1/2 inches in height and at least 5 inches long. Or is considered non-standard and is subject to additional fees. Items that are bulky and lightweight are charged a surcharge.
Domestic
Separate ___________ mail from ___________ mail. Separate mail to Canada or Mexico from under international mail
Domestic from international
___________ is the shortened form of electronic mail. Include letters, memos, reports, and pictures. Messages may be sent over phone lines, cables, computers, and satellites. Allows the MA to edit, correct, and transmit documents very quickly. Cannot be used for original signatures required on the document.
___________ involves reading the final material to check for accuracy and quality. You cannot change the content of the report or alter the meaning in anyway. If you believe the meaning is unclear, you must check with the writer of the report before making content changes.
Editing
___________ ___________ can be used to send correspondence without using paper and takes several forms, including email, instant messages, text messages and fax.
Electronic technology
__________ __________ messages are generally linked to an account that is purchased from an Internet service provider.
External instant
The _______ __________ is another way to send a written. The fax is an exact duplication of a document that is transmitted to another location via the facsimile (fax) machine. Looks identical to telephone numbers.
Fax machine
Face all letter-size envelopes in the same direction. Make sure none are upside down. When mailing letter-size envelopes, _________ must be sealed or tucked in.
Flaps
When the same letter is sent once or repeatedly to multiple recipients, a __________ __________ can save time for the Medical Assistant. Contains standard content that is used repeatedly, then personalized with the patients name, appropriate details such as dates, and the signatures on the position.
Form letter
When the mail piece is forwarded for 12 months; in months 13 through 18, the mail piece is returned to the sender the new address attached.
Forwarding service requested
Inappropriately indicating either male or female in the language used when referring to people in general.
Gender bias
The ___________ and ___________ provide patient consent for any information needed for treatment, payment, and operations (TPO), such as a referral request or treatment report.
HIPAA and NPP
Words that have a same or similar pronunciations but very different meanings and spellings. "Same sounds" Ex. Affect and effect
Homophones
___________ ___________, also called memos, or written communications send it to people within the office organization. Used to inform personnel about meetings, general changes that affect employees, special projects, or news items. Do not require postage and are delivered through inner office mail. May contain a heading much like letterhead stationery. Contain the word memorandum at the top of the form. Also include DATE:, TO:, FROM:, RE:, or SUBJECT:.
Inneroffice memoranda
The __________ __________ contains the name, title, company name (if applicable), and address of the recipient of the correspondence. It's typed at the left margin and is single-spaced. Words, such a street name are fully spelled out. The name of the city is followed by a comma, two letter state abbreviation, then ZIP Code. Include a title with the receivers name.
Inside address
__________ __________ are a way to communicate via computer with another person in real time. Content appears on the recipients computer screen immediately after it is sent. Some offices allow users to use internally (within the office) or externally.
Instant messages (IMs)
___________ can be purchased for packages and priority mails. The sender is then reimbursed for the content if the mail is lost or damaged. The sender receives a receipt at the time of purchasing the insurance.
Insurance
The __________ __________ message format is usually connected to the office computer server in allows messages to be sent quickly from one person to another.
Internal instant
All envelopes ____________ than a number 10 must be sealed before being sent.
Larger
The __________ __________ that contains the city, two-letter state abbreviation, and ZIP Code cannot exceed 27 characters in length. Margin of the number 10 envelope should be 5/8 inch with 1 inch margins on the left and right sides. The number 6 3/4 envelope should have a 2 inch margin on the left side with the address 12 lines from the top of the envelope. The return address should be placed in the upper left corner.
Last line
__________ __________ refers to the physical appearance of the letter. Styles vary depending on the purpose. The four letter styles generally used ate block, modified block (standard), modified block with indented paragraphs, and simplified. Block and modified block are used most often in the medical office.
Letter style
Medical office letters are usually typed on __________, which is stationery bearing the name of the physician or practice, address, telephone number and fax number. If the physician does not use letterhead, the letter should be printed on good quality one paper with the return address typed above the date on the upper left side of the paper.
Letterhead
__________ __________, which contains the name and address of the sender, comes in three commonly used sizes. These are standard, monarch or executive, and baronial. Standard is used for most office correspondence. Monarch or executive style is slightly smaller. Used by some physicians. Baronial is half the size of a standard sheet and is used for brief letters and memoranda. Envelopes are sized to match the letter sizes.
Letterhead stationery
__________ from a medical office must be professional, courteous, businesslike, positive and tone, and protective of the confidentiality of the physician and the patient. This requires some diplomacy.
Letters
__________ should have a five or nine digit ZIP Code. The five digit zip (zone improvement plan) code was introduced in 1963 to increase efficiency in mail handling. USPS added four more digits to the ZIP Code 1983.
If mail has been placed in a mailbox or given to a post carrier by mistake, it can be recalled by the sender. The sender can call the Post office and request that the item has been held for pick up. The sender can reclaim the mail at the post office, will complete a "senders application for recall of mail. "
Male recall
Where the style, the date, complimentary closing, and signature line begin at the center and continue towards the right margin. The lines are flush with the left margin. Often preferred because it has a professional, neat appearance.
Modified block style (standard)
Style with indented paragraphs is identical to the modified block style except that the paragraphs are consistently indented by a designated amount.
Modified block style with indented paragraphs
All correspondence should be error-free because errors reflect __________ on the professionalism of the entire medical office.
Negativity
Gender __________ __________ are preferred. When writing, do not refer to physicians as males or to nurses and medical assistants as females.
Neutral terms
When other documents are included along with the letter, a ___________ is made on the letter indicating the ___________. Examples of enclosures are x-ray films, medical records, and brochures. Use abbreviation ENC or spell out enclosure.
Notation; enclosure
__________ __________ __________ equipment used by the USPS scans, read, and sorts envelopes. Typed using single spacing in all capital letters with no punctuation.
Optical Character Recognition (OCR)
Composing letters can be simple when you use an __________ approach.
Organized
The classes of mail are designated by the USPS very according to weight, type, and destination. Mail is weighed in __________ and __________. First class, priority, priority express, and package services.
Ounces in pounds
Handling mail quickly and accurately is __________.
Paramount
English grammar recognizes eight parts of speech noun, pronoun, verb, adjective, adverb, preposition, conjunction, and interjection. Many words function as more than one part of speech. Ex. "The cut is fresh" or "The surgeon cut into the organ".
Parts of speech
When possible, avoid the use of __________ ___________ __ in professional writing. It is better to use you and we, less threatening and includes the reader in a mutual effort.
Personal pronoun I
Keep the top right corner of each mailing piece clear of markings. This is where the ___________ appears.
Postmark
The __________, a courteous greeting, is typed at the left margin and placed two lines below the inside address. The name in the salutation must agree with the line name in the inside address. Ex. "Dear Shania:" or "Dear Shania,"
Salutation
When writing to medical __________, the use of medical terminology is appropriate, however when writing to __________, medical terminology should not be used because they may not be familiar with it and may feel intimidated by it.
Professionals; patients
___________ your document by rereading it to check for errors in content and keying. Critical step in the correspondence process to help ensure accuracy. Do this at least _______.
Proofread; twice
Avoid being __________ repeating the same idea and similar words, expressions, or statements. Ex. Avoid: each and every, first and foremost, and physicians patient. Use: each, first, the patient.
Redundant
The medical professional uses a __________ __________ to indicate who keyed or typed the letter. Are placed at the lower left margin in lowercase.
Reference initials
___________ _________ is the safest way to send first class or priority mail because It is checked at each stage as it moves throughout the mail system. Is insured for the value declared at the time of registration. A few is paid for the service. USPS includes a tracking number on the receipt when you mail something from the post office by priority, priority express, or register mail.
Registered mail
The medical office often needs to prepare medical or administrative ___________ to share information needed by other people or organizations. Medical reports provide patient specific health information whereas administrative reports to not.
Reports
___________, ___________ results, and other correspondence received from outside health providers should be stamped with the date received, scanned into the patient's EMR, and routed to the appropriate position for review without delay.
Reports; test
Certified mail with a __________ __________ requested is used and when documentation is needed that the patient did not indeed receive the letter. Requires a signature of the recipient when it is delivered. Allows the sender to receive and actually see the signature of the recipient, which can then be kept on file. This protects the physician and the practice.
Return receipt
Well the mail piece is returned to the sender with the new address attached.
Return service requested
When mail has been returned and marked "undeliverable", new package must be applied before remaining to the new address. It is advisable to place the contents into a new envelope with the correct address and new postage.
Returned mail
Try not to over stuff letter-size envelopes. If this is not possible, ___________ the envelopes with tape.
Seal
Abbreviations are formed into plurals by adding an ____ (ECG's, DRGs). Plurals of nouns are formed by adding an ____ or an ____
S; s or es
When the letter is too long to fit on one page, a __________ __________ of plain stationery paper is used. Letterhead stationery is used only for the top sheet. The second sheet should be a plain bond paper, same quality and color of the letterhead stationery. A margin of 1 inch is left at the bottom of the first page. The second page and others must begin with the date and the subject line of the letter.
Second sheet
__________, __________ sentences and paragraphs are preferred in medical writing. Sentence length should never exceed 20 words. One paragraph equals one point. 2 to6 sentences.
Short, concise
The __________ __________ is typed four lines below the complementary close. Contains the name and title of the writer which is divided by a comma if written on the same line. Mr. and Ms. not included. The handwritten signature of the writer is entered above the printed signature line before the letter is sent.
Signature line
Style where all lines are flush with the left margin. The salutation line is omitted. In its place is a subject line, which appears on the third line below the inside address. The subject line is in capital letters and draws the readers attention to the purpose. Complimentary closing is also omitted. Signature is also typed in all capital letters on the fifth line below the body. Abbreviated style of writing letters.
Simplified style
___________ ___________ ___________ can assist the medical office to identify the current address for patients who have moved, ensuring that they receive correspondence and bills. These services, called ___________ ___________ ___________, enable you to get the USPS specific instructions for how to handle mail that is undeliverable. Use this to be informed of the recipients new address.
Special address services; ancillary service endorsements
Appropriate word choice includes the following errors:
Technical terms, gender bias, overly long sentences and paragraphs, excessive use of the personal pronoun eye, incorrect incorrectly used abbreviations, and passengers
General, the numbers 1 to 10 are spelled out one to ten. For numbers greater than _______, it is acceptable to use the number designation, such as 32, 128, and 1020. The only exception to this rule is when the number is at the beginning of the sentence. It should then be spelled out.
Ten
__________ __________ are written messages sent and received via your cell phone number. The recipient can read the message on the phone screen and reply. Text messaging should be used with caution to communicate with patients because information is not secure.
Text messages
If the mail has not arrived after a reasonable period of time, the post office will attempt to trace it upon request. However, first class mail is not easy to trace because no receipts exist.
Tracing lost mail
The Medical Assistant should always consult the ___________ for specific mailing, size, weight, and pricing requirements to assure the outgoing mail is properly prepared.
USPS
A computer can individualize the form letter. Body of the letter, the constant information, is retained in a computer desk or storage device. The areas of the letter that require personalization, such as the day, inside address, and salutation, are called the __________. Can be stored on a separate CD.
Variables
__________ __________ allows the writer to display the document on the computer screen, enter the information, and make necessary changes. The document is saved and printed. If errors occur then make changes, save it, and reprint.
Word processing