Homework 2.2
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ScribdTranslationsHomework 2.2
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ScribdTranslationsNation to the University College Online Division
GA Medical Billing and Coding
Task 2.2
“Basic Knowledge about Electronic Billing Programs”
Isoannette Falcón Martínez
#its T. 1808088420
MEBC 1020-3130ONL
Prof. Noeimee Rodríguez Rivera
January 20, 2019
INTRODUCTION
In this writing I am going to explain the back and front office responsibilities of administrative staff in a
medical office. The importance of the appointment scheduling process, the factors that can affect this
scheduling and what complications can cause it. I will also talk to you about how it can affect administrative
staff who do not have knowledge, training on the tasks and functions in a medical practice. I will indicate what
the steps are in collecting information and preparing files. I will elaborate on the steps of the arrival and
departure registration of the Pte. in a medical office, (Check-In & Check-Out). Finally, I will be explaining
what the refund process (Reimbursement) consists of.
1. Using what you learned in unit 3 of the textbook, answer the following:
a. Explains what the responsibilities of administrative staff in a medical office are. (Back and
Front office Responsibilities)
In the clinical area ( back office ), patients are examined, diagnostic tests and medical procedures are
performed. The medical team may include physician assistant, nurses, laboratory and x-ray technicians.
His primary focus is direct patient care.
In the administrative area ( front office ), there are several tasks such as receiving and registering
patients, taking payments, following up on appointments, answering the phone, and billing. This team of
administrative people includes reception staff, medical secretary, medical administrative assistant,
medical transcriptionist, billers, and office administrators.
b. Explains the importance of the appointment scheduling process (Appointment Scheduling)
It is one of the first opportunities the administrative team has to collect patient information. A distinction
is made between a medical consultation and a referral, inquiring about the medical plan coverage,
confirming with the patient if they have diagnostic test results, and obtaining basic information about the
patient.
c. What factors can affect appointment scheduling? Mention an example.
The number of rooms, staff and equipment have a direct impact on the scheduling of patient
appointments. In addition, personal preferences, medical specialties, and physicians' habits should be
taken into consideration because some physicians require more or less time for consultations and some
procedures. Other factors that may affect scheduling an appointment are the doctor's work routines, as
some have responsibilities outside of the office. They also depend on the patients themselves. Some
require fasting, many request hours after their children's classes end, and patients who have jobs with
irregular hours.
Example: “Based on the Textbook”
Office A is a small group with two doctors. The office has three exam rooms and a clinical
medical assistant for both doctors. Due to the small office space, only one doctor can see patients during
a block of time. All blood tests, procedures, and minor tests, such as electrocardiograms (ECGs), must
be performed in the exam rooms, as there is no separate procedure area.
d. What factors can cause complications in scheduling appointments?
Sometimes, there are situations that cause complications in scheduling appointments at a doctor's office.
For a patient to arrive without an appointment, even if they are already an established patient, they did
not call to request an appointment. A 'work-in' patient, who calls the day before or the same day to
request an appointment. And unexpected emergencies and delays may arise in the office, causing
disruption to the established routine of that specific day.
e. What type of method or tool is used to document appointment scheduling in medical
practices that do not have a computerized electronic system?
Offices that use a manual system must maintain an appointment book appropriate for the medical
practice environment.
f. What tool can be used to remind the Pte. of a follow-up appointment?
When a patient needs a follow-up appointment, they are usually provided with an appointment reminder
card, the size of a business card, that contains information for the next appointment.
g. How do you think it can affect an administrative staff with little or no training in the tasks
and functions of a medical practice?
An administrative staff with little or no training can affect the entire flow of a medical office since all
steps and/or procedures are established to maintain order in the office. A billing error can result in
losses for the office, or even a denial of a patient claim. Poor appointment management can cause a
patient with an urgent care condition to miss their appointment and even have their condition
complicated.
h. Indicates the steps for collecting information and preparing files.
The collection of information and preparation of established patient records includes the following: Date
of the patient's last visit, verifying that the patient's account has no outstanding balance, that all
documents are properly filed, verifying the patient notes page progress to ensure there is enough space
for clinical staff to write notes. When the patient arrives for their appointment, a blank 'superbill', also
known as an encounter form, is prepared. Finally, patients are contacted to confirm their scheduled
medical appointments.
i. It indicates the steps in registering the arrival ( check-in ) and departure ( check-out ) of
patients in a medical office.
Check-In: * When new patients arrive and register at the office, they are given a registration sheet to fill
out. * Information is updated if necessary for established patients when they arrive. *Referrals for
managed care patients are verified to ensure services are authorized.
Check-Out: * Payments are collected. * Tests or referrals are ordered if necessary. * A follow-up visit
is scheduled if necessary. * Any final information, if required, is addressed before the patient leaves the
office.
j. What is the reimbursement process?
Once the patient receives the doctor's services, the reimbursement process begins with a medical claim.
The first step is to complete the Superbill. An explanation of benefits accompanies payments received
from the insurer. The biller or other authorized personnel uses the explanation of benefits to post
payments corresponding to customer accounts. After the medical office receives payment from the
insurer, two steps are taken: if there is an outstanding balance, it is billed to the secondary plan or an
invoice is sent to the client. The last step in the refund process is to collect late payments.
2. Then, read and study chapter 2 titled Dashboard , of the Secure claim : User Manual and briefly
summarize what it is about.
In this chapter we find a brief explanation of what we can find on the Inmediata home page; from
announcements, information about the HIPAA 5010 transaction format, news, laws, changes, etc. It also
briefly explains the Toolbar, the Menu Bar, indicates which version of the program is being used, and
notifies users about version changes, features, and announcements about the program.
CONCLUSION
According to what I offered in this writing, I was able to understand and learn the importance and
responsibilities of staff in a medical office. In addition, I also learned the utmost importance of appointment
scheduling.
REFERENCES
Text book
Getting Started in the Computerized Medical Office “Fundamentals and Practice” By: Cindy
Correa 2nd Edition
User's manual
