Assignment 1 - Basic Management Concepts for Medical Administrative Staff
Assignment: Reviewing Computer Operations
When patient files are pulled in preparation for patient hours, describe four major items each file should be checked for.
Explain the difference between an established patient and a new patient.
Describe at least three factors that may affect scheduling patients for appointments.
Explain why confirming patient appointments, especially for new patients and long visits for established patients, is a good practice for medical offices.
Describe the steps to take when patient appointments must be rescheduled due to an emergency or a delay on the part of the medical office.
Assignment 2 - Fundamentals of Medical Insurance
Describe the difference between Original Medicare and Medicare Advantage plans.
Explain why it is useful for patients to understand their coverage, limitations, and exclusions, as well as financial responsibilities, as they relate to medical insurance coverage.
When comparing indemnity plans to HMOs, PPOs, and POS plans, which one offer.
More flexibility in terms of access to health care? Explain your answer.
Lower out-out-pocket costs? Explain your answer
Discuss some of the advantages and disadvantages of Health Reimbursement Arrangements (HRAs).
The physical has rendered services to a new patient at the hospital. The only information available is the patient's name, location, and diagnosis.
Describe some examples where patient information can be obtained for registration and medical billing purposes.
Explain the requirements of HIPAA for requesting and using information from medical providers and facilities.
Assignment 3 - Procedure Posting Routines
Assignment: Reviewing Computer Operations
Explain the purpose of having sequential reference numbers on a superbill (encounter form).
Besides the physician's office, describe some locations where patients receive medical services from the doctor.
A physician has treated a patient who has a diagnosis that is not listed on the superbill. How is this handled by the physician? The medical biller?
Explain the purpose of the Advance Beneficiary Notice (ABN).
Explain the importance of having authorization from a health plan when providing and billing for services.
Assignment 4 - Procedure Posting Routines
Name the three steps involved in the claims management process.
Provide examples where paper claims might be necessary over electronic claims submissions.
There are a number of items insurance companies require in order to process medical billing claims. List at least eight (8) of these items.
Describe the NPI number, implementation advantages of it NPI number, and what type of provider must use the NPI.
Describe two specific factors that greatly reduce denied claims and limits the amount of insurance follow-up and tracing to be done.
Describe some ways reimbursement may be affected by a patient who receives services from an out-of-network provider.
Give examples of times when Medicare is the secondary payer (MSP).
A patient with Medicare is working at a small business with fewer than 20 employees. She has a group plan with this employer. Which insurance is primary for services? Explain your answer.
Medicare
Employer group plan