Chapter 1 Review
MATCHING QUESTIONS
1. e 2. h 3. f 4. a 5. j 6. b 7. d 8. c 9. i
10. g
MULTIPLE CHOICE QUESTIONS 1. c 2. a 3. c 4. b 5. b 6. a 7. c 8. b 9. d 10. b
SHORT-ANSWER QUESTIONS
1. accounts receivable
2. electronic health records
3. electronic medical records
4. health information exchange
5. health information technology
6. Health Insurance Portability and Accountability Act
7. Quality Payment Program
8. Personal health record
9. Practice management
10. Revenue cycle management
APPLYING YOUR KNOWLEDGE
1.1 1. a 2. b 3. c
4. d 5. e
6. f 7. g 8. h
1.2
1. preregister patients
2. establish financial responsibility
3. check in patients
4. review coding compliance
5. review billing compliance
6. check out patients
7. prepare and transmit claims
8. monitor payer adjudication
9. generate patient statements
10. follow up payments and collections
1.3
a. Step 5 Review billing compliance
b. Step 4 Review coding compliance
c. Step 1 Preregister patients
d. Step 7 Prepare and transmit claims
e. Step 10 Follow-up payments and collections
f. Step 3 Check in patients
g. Step 8 Monitor payer adjudication
h. Step 2: Establish financial responsibility
i. Step 10 Follow up payments and collections
j. Step 7 Prepare and transmit claims
1.4
a. EHR
b. PM
c. EHR
d. PM
e. PM
CHAPTER 2 CHAPTER REVIEW
MATCHING QUESTIONS
1. b 2. a 3. c 4. j 5. h
6. d 7. g
8. e 9. i
10. f MULTIPLE CHOICE
1. d 2. b 3. c 4. d 5. a 6. c 7. b
8. d
9. a
10. d
SHORT ANSWER
1. electronic health record
2. electronic medical record
3. practice mana
4. computerized medical record
5. personal health record
6. computerized patient records
7. Master Patient Index
8. clinical decision support
9. E-prescribing
10. Computerized physician order entry
APPLYING YOUR KNOWLEDGE
2.1 Hospital electronic health record programs are tailored to provide information relevant to a patient's hospital stay and treatment, whereas outpatient EHRs are designed for a long-term approach to patient care. 2.2
Chapter 1: Patient Care and Reimbursement in the Medical Office
LEARNING OUTCOMES
After completing Chapter 1, the students should be able to:
• Compare practice management (PM) programs and electronic health records (EHRs).
• List the steps in the medical documentation and billing cycle.
• List the eight facts that are documented in the medical record for an ambulatory patient encounter.
• Identify the additional uses of clinical information gathered in patient encounters.
• Compare the roles and responsibilities of clinical and administrative personnel on the physician practice health care team.
• Explain how professional certification and lifelong learning contribute to career advancement in medical administration.
Lecture Outline
Compare practice management (PM) programs and electronic health records (EHRs).
• Lecture Topics
o Describe the wide range of technology tools used in healthcare for a patient encounter.
o Explain practice management software and EHRs and describe how they are different and how they can work together for a robust system.
o Define health informatics.
• Discussion Points
o Review a scenario where technology assists in the healthcare encounter
o EHR advantages/disadvantages compared to paper records.
o The EHR as a communication tool between providers.
• Learning Activities
o Have students view demo videos of PM and EHR software on YouTube.
o Have students do an internet search for popular EHR vendors specific to the medical office.
List the steps in the medical documentation and billing cycle.
• Lecture Topics
o Describe the ten steps of the medical documentation and billing cycle by using the wheel graphic provided in the textbook.
o Explain which steps happen before the encounter, during the encounter, and after the encounter.
o Define the following: cash flow, diagnosis code, procedure code, medical necessity, accounts receivable, accounts payable, revenue cycle management.
o Describe data management concepts: data warehouse, data mining, records retention.
• Discussion Points
o Discuss how each step in the cycle requires certain skills and knowledge.
o Have students think about which areas they may be most interested in and why.
• Learning Activities
o Make sticky notes of each of the ten steps in the process (or make larger cardboard cutouts for each of the ten steps) Divide students into ten groups, or if not enough students, five groups. Give each group an equal number of the sticky notes in random order. Have the students create the cycle wheel of the steps on the wall or white board by having each group take turns putting their sticky note where they believe it belongs in the cycle.
List the eight facts that are documented in the medical record for an ambulatory patient encounter.
• Lecture Topics
o Define encounter.
o Describe the importance of documenting the patient encounter and what should be included in the documentation.
o Review the flow of a patient exam and the documentation involved in the medical record.
o List types of patient encounters.
• Discussion Points
o Discuss a real-world scenario and the importance of the patient record in providing quality care.
• Learning Activities
o View examples of a patient record on paper and then in an EHR and compare and contrast.
Identify the additional uses of clinical information gathered in patient encounters.
• Lecture Topics
o Explain other uses of patient records: Legal, quality, education, research, public health.
o Describe incentive pay programs for physicians
• Discussion Points
o Discuss the idea of pay for performance and what could be the advantages and disadvantages.
o Discuss student opinions on incentive pay programs
• Learning Activities ▪ Watch a video such as this: Patient Advocacy: Inaccurate Health Records https://youtu.be/QKJuU8lolAI and discuss or provide a worksheet with questions
Compare the roles and responsibilities of clinical and administrative personnel on the physician practice health care team.
• Lecture Topics
o Describe the importance of the healthcare team.
o Explain the roles that are part of the care team: physicians, nurses, medical assistants, medical biller/coder, office manager, compliance officer
o Emphasize the medical assistant’s role.
• Discussion Points
o Discuss the importance of teamwork in healthcare.
o Discuss how a breakdown in teamwork can negatively affect patient care.
• Learning Activities
o Read through a patient counter case study and have students identify each person who played a part on the team.
o Have students draw a diagram of boxes scattered on a piece of paper (or this could also be done as a group on the whiteboard). In each box right the name of each provider or staff person described in the case study. Read through the case study again, having students draw a line from person to person every time communication/teamwork is required between those two people. Discuss the web of lines at the end, depicting how many times the team members must engage as a team.
Explain how professional certification and lifelong learning contribute to career advancement in medical administration.
• Lecture Topics
o Describe the administrative careers typical of working with practice management software and the EHR
o Explain AHIMA as a primary source of information about managing patient information.
o Describe the wide variety of certifications available and the importance of certifications/credentials in healthcare
o CEU’s and lifelong learning.
• Discussion Points
o Discuss simple ways to continue learning that do not involve a conference or a fee.
o Discuss ideas for continuing education (Associates Degree, Bachelor’s Degree, Master’s Degree) for students’ career goals.
• Learning Activities
o Have students look at the AAMA website for the requirements for maintaining a CMA credential. Have them also find on the same website any opportunities for earning CEUs.
Resources
Articles
Legal Eye on Medical Assisting Blog. (2022) American Association of Medical Assistants https://aamalegaleye.wordpress.com/
The Importance of Continuing Education in Healthcare. (2017). Health Management, 17(2). https://healthmanagement.org/c/healthmanagement/issuearticle/the-importance-ofcontinuous-education-in-healthcare
