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Center for Curriculum and Transfer Articulation
Fundamentals of Administrative Medical Assisting
Course: MDC104

First Term: 2020 Fall 1
Clock Hours:    185
Grading Basis: CLK






Description: This course explores fundamental administrative procedures in various healthcare settings. Overview of the daily operations, principles and procedures for administrative skills including: medical record management, introduction to the electronic health record (EHR), and application of insurance, coding and billing. Basic administrative office policies, procedures, appointment scheduling, telephone etiquette, patient reception, financial practices, third party payers, health insurance, and basic understanding of medical billing and coding. Health organization structure, patient rights and quality care. Definition and importance of values, basic understanding of medical law and ethics.
This course provides tools and strategies for gainful employment.



MCCCD Official Course Competencies
1. Explore the career and labor market to access information about career employment opportunities. (I)
2. Describe the different types of health care delivery systems and services. (I)
3. Describe major US health care payment sources and the type of populations they cover. (I)
4. Describe the general structure of health care organizations. (I)
5. Explain patient rights measures used in health care. (I)
6. Identify common departments found in health care organizations. (I)
7. Identify selected department and treatment abbreviations and symbols. (I)
8. Describe personal and health care values that influence health care workers and their relationships with others in the health care setting. (II)
9. Describe the professional work ethic necessary of a healthcare professional. (II)
10. Apply effective job application strategies. (II)
11. Explain successful job interviewing techniques. (II)
12. Identify laws and key concepts specific to worker`s rights and responsibilities. (II)
13. Describe dimensions of wellness and decision making needed to achieve a wellness lifestyle. (III)
14. Describe select Occupational Safety and Health Administration (OSHA) standard precautions. (III)
15. Describe basic laws and regulations which govern health care and health care employment. (IV)
16. Describe regulatory requirements and agencies which relate to health care professionals, occupations, and facilities. (IV)
17. Identify legal guidelines related to documenting, authenticating, and correcting medical records. (IV)
18. Apply legal guidelines in a variety of health care situations. (IV)
19. Describe the process in compliance reporting. (IV)
20. Describe current issues related to Health Information Technology. (V)
21. Differentiate between specific types of thinking. (V)
22. Describe the steps in a decision making model applied to health care situations. (V)
23. Apply the decision making model to health care situations. (V)
24. Explain ethical decision making and its influence on health care facilities, the professional`s role and in client situations. (V)
25. Define process improvement and customer service. (V)
26. Identify process improvement techniques and activities used to improve customer service/satisfaction. (V)
27. Apply the steps of process improvement to selected situations. (V)
28. Define principles of self-boundaries. (V)
29. Describe the role of the medical assistant in the front office. (VI)
30. Explain appropriate telephone techniques. (VII)
31. Apply techniques of written communication in simulated exercises. (VIII)
32. Describe scheduling methods and protocols. (IX)
33. Review methods to process correspondence and mail. (X)
34. Identify and apply Health Insurance Portability and Accountability Act (HIPAA) regulations in a healthcare provider`s office. (XI)
35. Describe types of patient insurance and usage in various medical settings (XII)
36. Describe compliance with public health statues. (XIII)
37. Discuss legal and ethical guidelines affecting insurance claims and medical records. (XIII, XIV)
38. Recognize principles in diagnostic and procedural coding. (XV, XVI)
39. Recognize the correct Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. (XV, XVI)
40. Apply the key components of the various types of electronic health records. (XVII)
41. Identify and apply documentation and HIPAA guidelines used for accurate healthcare documentation and electronic health records (EHR). (XVII)
42. Apply security guidelines in the use of the electronic health record. (XVIII)
43. Identify employment search strategies for potential employment as a medical assistant. (XIX)
44. Develop a resume and personal employment plan. (XIX)
 
MCCCD Official Course Outline
I. Health care today
   A. Employment in the health care field
      1. Career opportunities and employment trends
         a. Health care careers
         b. Internet
   B. Employment resources
      1. Newspaper classified advertisements
      2. Job placement/career counselors
      3. Employment agencies
      4. Health career facility bulletin boards
      5. Internet
      6. Networking with professionals in the field
      7. Instructors
      8. Health care hotlines
      9. Library resources
   C. World wide web
      1. Terminology
      2. Student information
      3. Health career information
   D. Health care delivery systems and services
      1. Examples of health services
         a. Acute
         b. Chronic
         c. Long term/rehabilitation
         d. Home health
         e. Women and children
         f. Community health
         g. Hospice
   E. Continuum of care delivery system
      1. Primary
      2. Secondary
      3. Tertiary
   F. United States health care payment sources
      1. Third party payers
         a. Medicare
         b. Medicaid (Arizona Health Care Cost Containment System) (AHCCCS)
         c. Indemnity insurance
         d. Managed care
         e. Worker`s compensation
   G. Populations served
   H. Health care organizations
      1. Ownership
         a. Proprietary (for profit)
         b. Voluntary (not for profit)
         c. Government
      2. Mission
      3. Governing board
         a. Function
         b. Personnel
      4. Administration
         a. Titles
         b. Responsibilities
      5. Medical staff
         a. Organization
         b. Specialties
      6. Departments
   I. Patient rights
      1. Sources
         a. Omnibus Budget Reconciliation Act (OBRA) 1987
         b. American Hospital Association (AHA)
      2. Content
      3. Comparison
   J. Selected department and treatment abbreviations and symbols
      1. Organizational abbreviations
      2. Health care symbols
II. Workplace behaviors and values
   A. Personal and health care values
      1. Definition of values
      2. Values clarification
      3. Life values
         a. Personal values
         b. Respect of other values
         c. Acceptance of others
         d. Different perspectives
   B. Workplace ethic behaviors
      1. Definition of ethics
      2. Work ethic behaviors
         a. Attendance
         b. Punctuality
         c. Hygiene
         d. Personal appearance
         e. Time management
         f. Attitude
         g. Accountability
         h. Conduct
   C. Job application and interviewing skills
      1. Preparing a job application
      2. Preparing for the interview
      3. Interviewing techniques
      4. Appearance and behavior
   D. Worker`s rights and responsibilities
      1. Discrimination
         a. Civil Rights Act of 1964
         b. Protected class
         c. Other criteria
         d. Bona fide occupational qualifications
         e. Disparate impact and treatment
      2. Harassment
         a. Retaliation
         b. Whistle blower
         c. Protection
         d. Types of harassment
         e. Response process to harassment
      3. Violence in the workplace
         a. Potential situation
         b. Response
      4. Employment issues
         a. Implied consent
         b. Contracts/negotiation
         c. Unions vs. at-will
         d. Employee drug screening
         e. Fingerprinting
         f. Communicable disease testing
         g. Annual in-services
         h. Employee review of records
         i. Termination
         j. Due process
III. Personal and workplace safety
   A. Dimensions of wellness
      1. Physical
      2. Exercise
      3. Emotional
      4. Intellectual
      5. Spiritual
      6. Interpersonal
      7. Environmental
      8. Stress management
      9. Wellness lifestyle
      10. Personal decision making
   B. Occupational Safety and Health Administration (OSHA) standards
      1. OSHA precautions
      2. Personal protection equipment (PPE)
IV. Ethical/legal issues and decision making
   A. Health care laws and regulations
      1. Terminology
         a. Accountability
         b. Assault
         c. Battery
         d. Fraud
         e. Law
         f. Legislation
         g. Liability
         h. Malpractice
         i. Negligence
         j. Regulation
         k. Responsibility
         l. Slander
      2. Health care employment concepts
         a. Personal
         b. Patient
         c. Physician
      3. Patient abuse reporting requirements
         a. Children
         b. Elder
         c. Domestic
      4. Compliance reporting
         a. Unsafe activities
         b. Errors in patient care
         c. Conflict of interest
         d. Incident reports
         e. Public health statutes
            (1) Communicable diseases
            (2) Abuse, neglect, and exploitation
            (3) Wounds of violence
      5. Risk management
         a. Role
         b. Function
         c. Reporting procedure
   B. Regulatory requirements and agencies
      1. Professional certification, licensure and registration
      2. Institutional certification/licensure
         a. Federal certification/Medicare
         b. State licensure
   C. Federal regulations and standards
      1. Americans with Disabilities Act (ADA)
      2. Medicare/Health Care Financing Administration (HCFA)
      3. Health and Human Services (HHS)
      4. Food and Drug Administration (FDA)
   D. Voluntary accreditation
      1. Joint Commission on Accreditation of Hospitals (JCAH)
      2. National Council for Quality Assurance (NCQA)
      3. Others
   E. Legal guidelines for medical documentation
      1. Ownership of medical record
      2. Access
      3. Release of information
      4. Documenting in record
      5. Alteration
   F. Health care legal situations
      1. Privacy
      2. Confidentiality
      3. Privileged communication
V. Decision making in the health care setting
   A. Classifications of thinking
      1. Logical
         a. Deductive
         b. Inductive
      2. Critical
      3. Creative
      4. Directed
      5. Undirected
   B. Decision making model
      1. Elements
      2. Process
      3. Application of decision making model
   C. Ethical health care decisions
      1. Principles
         a. Beneficence
         b. Malfeasance
         c. Veracity
         d. Fidelity
         e. Justice
      2. Standard of conduct
         a. Code of ethics
         b. Scope of practice
         c. Self-boundaries
      3. Ethical decision making
         a. Process
         b. Identification
         c. Facility policy
         d. Responsibility
         e. Ethics committee
         f. Allocation of medical resources
      4. Life and death issues
         a. Individual choices
         b. Influences of religion/culture
         c. Patient`s family/significant other
         d. Health care facility
         e. State/federal laws
         f. Advance directives
   D. Process improvement
      1. Definition
      2. Elements of process improvement
      3. Customer service/satisfaction
         a. Internal
         b. External
      4. Methodologies
         a. Continuous quality improvement (CQI)
         b. Total quality improvement (TQM)
         c. Quality assurance (QA)
         d. Quality control
      5. Process improvement steps
      6. Application of steps
VI. Role of medical administrative assistant
   A. Patient relation responsibilities
   B. Maintenance of physical space
   C. Oral and written communication
   D. Manage patient records
   E. Receive, organize, and prioritize information
   F. Operate specialized equipment
      1. Scanning
      2. Copying
      3. Faxing
   G. Professionalism
   H. Patient education
   I. Patient navigator
VII. Telephone management
   A. Screening and referrals
   B. HIPAA confidentiality
   C. Data gathering skills
   D. Retrieving and documenting messages
   E. Telephone techniques and etiquette
   F. Managing challenging callers
VIII. Written communication
   A. Supplies
   B. Types and styles of letters
IX. Appointment scheduling
   A. Scheduling guidelines
   B. Methods
      1. Open hours
      2. Wave
      3. Modified wave
      4. Double booking
      5. Practice based
   C. Protocol
      1. New, established, and follow-up visits
      2. Patient considerations
      3. Referrals
      4. Appointment reminders
   D. Electronic appointment scheduling
   E. Related ethical and legal implications
      1. Healthcare provider canceled appointments
      2. Acutely ill patients
      3. Overbooking
      4. Prolonged waiting
X. Correspondence and mailing processing
   A. Incoming
   B. Outgoing (types)
   C. Handling and sorting
   D. Electronic
XI. HIPAA
   A. Overview
   B. Regulations
   C. Application
      1. Procedures
      2. Documentation
XII. Insurance policies
   A. Federal
      1. Medicare
      2. Military
   B. State
      1. Medicaid
   C. Private
      1. Workers` compensation
      2. Fee for service
      3. Capitation
      4. Supplemental insurance
   D. Types
      1. Group
      2. Individual
   E. Payment types
      1. Prepayment
      2. Co-payment
      3. Deductibles
   F. Insurance processes
      1. Preauthorization
      2. Predetermination
      3. Precertification
      4. Clearinghouse
      5. Referrals
XIII. Legal issues
   A. Subpoena of witness and records
   B. Types of insurance fraud and abuse
   C. Arbitration/appeals
   D. Medical professional liability prevention and malpractice
   E. State Board of Medical Examiners (BOMEX) and Insurance Commissioners
   F. Types of consent
      1. Informed
      2. Implied
      3. Expressed
   G. Medical-legal terms
      1. Emancipated minor
      2. Patient compliance/noncompliance
      3. Patient competency/incompetency
      4. Good Samaritan Laws
      5. Subpoena duces tecum
      6. Respondent superior
      7. Res ipsa loquitur
      8. Locum tenens
      9. Defendant - plaintiff
      10. Deposition
      11. Arbitration - mediation
      12. Malfeasance
      13. Misfeasance
      14. Nonfeasance
XIV. Ethical practices within insurance, coding, and billing
   A. Importance of insurance claim accuracy
   B. Importance of coding and billing
XV. Procedural coding
   A. Terminology
   B. Evaluation and management (E & M) codes
XVI. Diagnostic coding
   A. Terminology
XVII. Electronic health records in various healthcare settings
   A. Data entry and retrieval
   B. Components
   C. Security
   D. Accuracy
   E. Qualified users
   F. Management within electronic health records
      1. Correcting errors
      2. Electronic signature
      3. Reporting functions
      4. Patient communication
      5. Reminders and alerts
      6. Release of information
XVIII. Privacy and security of electronic health records
   A. Firewalls
   B. Password use and management
   C. HIPAA provisions
   D. Release and transmission of personal health information
   E. Backup of data
   F. Data storage provisions
XIX. Employment search strategies
   A. Resume
   B. Personal employment plan
      1. Interview techniques
      2. Professionalism
 
Clock Curriculum Committee Approval Date: 3-4-2020

All information published is subject to change without notice. Every effort has been made to ensure the accuracy of information presented, but based on the dynamic nature of the curricular process, course and program information is subject to change in order to reflect the most current information available.