Portland Community College | Portland, Oregon

Required course which fulfills a portion of the curriculum for the Certificate in Medical Assisting.
Students must also enroll in Medical Office Administrative Procedures Lab (MA 118) concurrently for laboratory practice of materials covered in this course.
 

Upon successful completion of the course students should be able to:

1. Communicate appropriately and in a caring manner in a medical setting.
2. Complete a health history interview and accurately document medical information.
3. Apply Health Insurance Portability and Accountability Act (HIPAA) security regulations for all patient clinical records.
4. Recognize and apply appropriate accommodations for special needs and cultural differences within the healthcare setting.
5. Examine the Patient-Centered Medical Home model and its effect on the delivery of healthcare.
6. Identify barriers to patient outcomes and apply strategies to address social determinants of health (SDOH).
7. Describe components of Maslow's Hierarchy, Erickson's stages of development and Kubler-Ross' stages of grief and how they impact a patient's overall health status.
8. Apply standard practices for general financial management in a healthcare setting. 
9. Conduct accurate billing and coding and adjustments for insurance claims. 

Throughout the course regular discussion will ensure an understanding of the healthcare system and what role a Medical Assistant has within a Patient Centered Medical Home. 

This course is designed as a flipped classroom model, in which students will be learning content on their own time. During class there will be numerous activities in which students are solidifying the content information, such as group discussions, role playing, team projects and review games. 

Students will demonstrate these learning outcomes by tasks conducted individually and in cooperation with other students:

1.  Answer theoretical and application multiple choice, matching, ordering and open-ended questions on information covered in lecture.

2. Critical thinking activities with small and large groups.

3. Team based projects.

4. Peer assessment of work within small groups. 
 

The following list outlines the concepts, themes, and issues you need to understand and be able to use appropriately. You will have the opportunity to demonstrate your understanding in written and oral form, individually and in groups.

CONCEPTS OF EFFECTIVE COMMUNICATION 

• Identify types of verbal/nonverbal communication

• Recognize barriers to communication

• Identify techniques for overcoming communication barriers

• Identify techniques for coaching a patient related to specific needs

• Identify the steps in the sender-receiver process

• Identify different types of electronic tech used in communication

• Identify the role of the MA as a patient navigator

• Identify coping mechanisms

• Identify concepts of: Maslow, Erikson & Kubler-Ross

ADMINISTRATIVE FUNCTIONS

• Identify different types of appt scheduling methods

• Identify critical info required for scheduling pt procedures

• Recognize the purpose for routine maintenance of equipment

• Identify steps involved in completing inventory

• Identify the importance of data back up

• Identify the components of an EMR & PMS

BASIC PRACTICE FINANCES 

• Define the following bookkeeping terms: charges, payments, accounts receivable and payable, adjustments, reconciliation 

• Identify precautions for accepting: cash, check, cc, debit card

• Identify types of adjustments for: NSF, collections, credit balance, 3rd party

• Identify pt financial obligation for services rendered

THIRD PARTY REIMBURSEMENT 

• Identify: types of third party plans, information required to file a third party claim, the steps for filing a third party claim

• Outline managed care requirements for patient referral

• Identify: insurance verification, preauth, tracking unpaid claims, claims denials & appeals

• Identify fraud & abuse as they relate to 3rd party reimbursement

• Define: bundling/unbundling of codes, ABN, allowed amount, deductible, co-insurance, co-pay

• Identify the purpose and components of EOB, RA statements

PROCEDURAL & DIAGNOSTIC CODING

• Identify current procedural and dx coding systems including HCPCS level II

• Identify the effects of upcoding & downcoding

• Define medical necessity

• Identify medical necessity guidelines

LEGAL IMPLICATIONS 

• Identify scope of practice and standards of care for MA's

• Identify the provider role in terms of standard of care

• Identify components of HIPAA

• Identify the standards outlined in The Patient Care Partnership

• Identify licensure & certifications as they apply to healthcare providers

• Identify criminal & civil laws as they apply to the MA

PROTECTIVE PRACTICES

• Identify fire safety issues in a healthcare environment

• Identify emergency practices for evacuation of a healthcare setting

• Identify the purpose of SDS

• Identify principles of: body mechanics & ergonomics

• Identify critical elements of and emergency plan for a response to a natural disaster or other

PATIENT-CENTERED MEDICAL HOME MODEL

• Define PCMH

• Identify the attributes of the PCMH model

• List the impacts of each attribute to the Triple Aim

• Explain how each PCMH attribute impacts the work of a Medical Assistant 

PATIENT-CENTERED COMMUNICATION 

• Develop knowledge on the importance of effective, patient-centered communication relating to quality care; understand ethical implications necessary for informed consent, effective patient engagement, means to avoid errors, improve quality, and achieving better health outcomes

TEAM BASED CARE

• Develop knowledge and skills to understand the importance of team collaboration within the medical group; understand clear roles of each team member and health professional; importance of mutual trust and effective communication; understanding and application of measurable outcomes