Medical Office Assistant Internship

Report

by

Shubham Saini

635201999

[email protected]

Performed at

Bay and College Physiotherapy & Rehab

#790 Suite 105 Bay Street, Downtown, Toronto 2022

In partial fulfillment of the requirements of the Medical Office Assistant Program,

CDI College

Report of Internship for the period June 27th – September 17, 2022

Date Submitted: September 19, 2022

Acknowledgement and Endorsement

This report has been written by me and has not received any previous academic credit at this or

any other institution.

I would like to thank the college staff Mr. Karim, Neela Martin, and Sukhpreet Kaur to guide my

well about the internship. I also would like to express my gratitude to Clinic Director Garima

Chordia to aid me to provide useful data to complete the report.

Shubham Saini
Executive Summary

This report has all the information about the internship that takes place in the Bay and College

Physiotherapy and Rehab.

Tasks performed involves working in the medical record treasury, dealing with a large volume of

medical records arranged by department and patients' check-out dates, and becoming familiar

with the various systems used in the reception desk/copy and print service, reading room,

medical record receiving office, greeting patients, scheduling and arriving them, processing

insurance claims, communicating with insurance companies/ WSIB whenever it is necessary.

Moreover, sanitizing the reception desk, follow-up calls, responding to emails, issuing bills,

completing the managerial tasks and working as a team to make the best coordination between

clinic administration and practitioners such as Physiotherapists, Massage therapists, and

Chiropractors, maintaining the confidentiality of the records, managing meetings, following

OHIP guidelines, accounts settlements.

Jane App website is used to arrive/schedule patients, settlements of bills and issue medical items.

The Webmail website is used for communication. Moreover, the WSIB portal is used to upload

forms and various insurance companies’ portals such as Blue Cross, Sunlife, TELUS, and

Provider Connect are used to process the claims for the patients.
The issue with the present system for getting medical records is reviewed, and a scanning

barcode solution based on health informatics is suggested. In conclusion, the goals of this

internship are mostly achieved by the time it is through. These goals include using various

systems, comprehending data collection and processing, and practising the use of EMR.
Table of the content

1. The Introduction

2. Description of the organization

3. Description of the performed work

3.1. Processing Insurance Claims

3.2. Greeting the patients with smile

3.3. Answering the phone calls

3.4. Dispensing medical items

3.5. Scanning and printing copy/ shredding

3.6. Charging payments

3.7. Checking the mailbox

3.8. Faxing

3.9. Accounts settlements

4. Description of the environment of the office

5. Description of the applications used while carrying out the project

5.1. Microsoft Excel

5.2. Windows 11

5.3. Webmail
 5.4. Jane App

5.5. Insurance claims portals

5.6. Hello sign

5.7. WSIB portals

6. Description of the documents used on workplace

6.1. FAF forms

6.2. Authorization to release the medical notes

6.3. Consent forms

6.4. Prescription document

6.5. Intake form

7. Discussion on a problem and proposed solution.

7.1. Problem description

7.2. Proposed solutions

8. List of the skills used to perform the various task

9. List of Medical Terminology used in the medical environment.

10. Conclusion
1.The Introduction

The internship takes place in Bay and College Physiotherapy and Rehab. It is one of the best

clinics in Downtown, Toronto for Physiotherapy, Massage Therapy, and Chiropractic care.

This internship report's topic is keeping tabs on the whole internship. The report comprises

background information, a precise summary of the project's goals, its applicability, and its

conclusion. The following sections outline the entire internship experience based on

conceptualising, analyses, synthesising, and presenting the overall internship experience,

including a description of the organization, description of performed works, discussion on

relevance, discussion on problem-solving, description of the environment, methods used to carry

out the project, Discussion of the challenges and solutions, conclusion, and recommendation.

The objectives of the project are

· • Acquainting oneself with the department's current information systems.

• Interacting with doctors/therapists and seeing examples of teamwork.

• Knowledge of data processing and collection.

• Seeing how an electronic health record is used.

• Always consider methods to make each activity you undertake better by utilizing the

knowledge of health informatics.

• Developing multitasking skills by taking on several roles

• Recognizing how and where theory and practice converge to close the gap between them.

2. Description of the organization

This section provides a description of the organization and the core business of the specific

department for the internship.

The organization where the internship takes place is Bay and College Physiotherapy & Rehab

located at the intersection of Bay and College Street. Mr. Shoaib Nathani and Miss Garima

Chordia are the head of the clinic where they also work as a physiotherapist. This clinic was

founded by them in 2017.

This clinic provides physiotherapy, chiropractic care, massage therapy, psychiatric treatment,

acupuncture, dry needling, vestibular rehabilitation, concussion management, and shockwave

therapy at Bay and College Physiotherapy and Rehab, an all-in-one rehabilitation facility. Most

insurance companies are billed directly by the clinic. This clinic also takes care of victims of

auto accidents. Additionally, it also specializes in Compression stockings, Bracing, and Custom-

Made Orthotics. The total number of employees are 16 and 5 intern working there including me.
Miss Garima is the supervisor of the clinic, and she is the clinic director also. She is a

physiotherapist by profession. The work of Miss Garima inspired me a lot. She is the very tough

woman I have ever seen. She gives a hand in the management role, administrator role and clinic

director role apart from her profession.

The clinic is very close to the University of Toronto so many students come each day to visit the

place and get the therapies done. It also offers special discounts to students who are enrolled in

the universities under Student Network Care. Moreover, if a student university is not enrolled in

the Student Care Network, still the clinic offers a discount under the Student/Senior Category.

Many seniors who have age above 65 can get the advantage of the discounts at the place. This

organization share the reception with the Dental staff which is becoming the best source of

traffic for both organizations.

3. Description of the performed work

This section describes the internship work, including the job description, duties,

accomplishments, and other employment-related information.

The major area of the internship is the reception desk where all administrative tasks are

performed. I performed the role of receptionist and covered all administrative tasks. The clinic
has several departments, such as a reception area, a chiropractic room, physiotherapy rooms, and

a massage room, an office room for health professionals, a medical record treasury. All

departments are involved in this internship. There is a period for becoming familiar with all the

work, which takes around one week at the beginning of the internship.

3.1 Processing Insurance Claims

During weeks 2nd and 3rd of the internship, patients’ insurance claims are processed and

familiarized with different kinds of insurances such as GSC (Green Shield Canada), Manulife,

BlueCross, Empire life, and Canada life. The primary portals used to process insurance claims

are Telus, Provider Connects, Sunlife, and BlueCross. Telus have various insurance companies

registered on their portal including Canada life, and Manulife. Another online portal is provider

connect which has insurance companies registered for example Green Shield Canada, and

Empire Life. Patients who are injured in their workplace benefit from free treatment in

healthcare and these patients come under the category of WSIB (Workplace Safety and

Insurance Board). WSIB patients receive free treatment and WSIB pays the expenses to the

clinic. Similarly, MVA (Motor vehicle Accidents) patients have a free treatment plan and

insurance companies pay for their expenses. According to the clinic policy, discounts are given

to the students and seniors (who are above 65) under the students/senior category. Many

colleges/universities are enrolled in the student care network which helps students to get the

sessions at a discounted price. However, students whose universities and colleges are not
enrolled in the student care network are still getting discounts but under the category of

student/senior.

3.2 Greeting the patients with a smile

Greeting the patients with a smile and arriving them on the jane app is another role during the

week 4th, All patients are asked about the insurance they do have if they are visiting for the first

time in the clinic. All the insurance information is noted in the Jane app under the patient profile.

Therefore, patients are directed to the waiting area politely. All patients are requested to fill out

the patient intake form before coming to the clinic. This intake form does have all the rules and

regulations and policies. Patients are asked about their feedback on the treatment and charged

their copayment that is not covered by the insurance companies. In the meanwhile, health

professionals are updated if any anomaly is occurring for example if a patient is running late,

they should be updated to the related practitioners.

3.3 Answering the phone calls

Answering phone calls and booking appointments is the 5th phase of the internship. Patients call

to book their appointment. Resolving patient queries over calls is one of the main tasks. Patients

are called to book follow-up sessions. Some patients give the deadline to call them on a specific

date, so they can book follow-up sessions. I was taught to book patients on the jane app and
things to consider while booking. After patient sessions, all patients are booked and resolved

their queries quickly, so the next patient can be assisted soon.

3.4 Dispensing medical items

During the 6th and 7th week, dispensing medical items is the main area of expertise. Some

patients are recommended for braces and orthotics by a physiotherapist. Bracing is a therapeutic

strategy that involves applying an external bridge to offer further stability to ligaments or joints

that are unstable. Custom-made orthotics are used to align the foot and ankle into the most

anatomically effective posture. The physiotherapist assistant measures the size of the brace and

orthotics and passes it to the administrative assistant. Administrative assistants order the medical

items with the consent of the patient. For custom-made orthotics, orthotics consultation is crucial

that is done by the chiropractor. When a patient is ready for custom-made orthotics then the

patient is booked with a chiropractor for orthotics consultation. Patients must pay a down

payment of 200 Canadian dollars to order the orthotics and the rest of the amount is paid after the

orthotics arrived which is discounted in the case of students and seniors. For brace, Patients must

pay the full amount. Once the brace and orthotics arrived, patients are notified to book for the

medical items fitting. Braces are given to the physiotherapist when a patient comes for fittings

and that is only given by the physiotherapist to patients. In the case of orthotics, patients are

booked for orthotics fitting and can be given by the receptionist. The next step is to release all

the documents to the patients through e-mail, so they can reimburse the amount from the
insurance companies. Other medical items such as TheraBand, massage guns, and bam gels are

billed and dispensed to the patient along with the invoice.

3.5 Scanning and printing copy/ shredding

The other administrative tasks that applied from theory to practical life are shredding copying,

and printing during the 8th week. The documents which are uploaded to the patient profile are

taken for shredding. The shredding machine is used to shred the documents and the remaining

are put in the garbage bin. Patient prescriptions, consent forms and other medical documents are

scanned to keep in the patient’s file. Sometimes patients ask for the printed/hard copy of the

invoice otherwise invoices are sent via e-mail to each patient.

3.6 Charging payments

The amount received in the cash is deposited in the safe immediately (during the 9th week). The

clinic has an almirah which has safe and important files, and invoices of monthly expenditures.

These almirah keys were found at the reception desk and handled by the receptionist. At the end

of the day, all cash amount that is deposited in the cash is brought to the attention of the

manager.

3.7 Checking the mailbox

In the following week of the internship, the mailbox keys are received, and the receptionist was

tasked to check them daily. All the letters received in the mailbox are presented to the manager.

Most of the letters are received in the mailbox from insurance companies.

3.8 Faxing

Receiving and sending the fax are the tasks performed during week 11th. Some patients want to

share their medical history from another clinic. For that, a form is signed by the patient to release

the medical notes which are sent to the clinic through e-mail with mentioning clinic fax number.

Once the fax is received, it is uploaded to the patient file.

3.9 Accounts settlements

On the week 12th accounts settlements task is completed. The amount received from the patients

on the card machine and payment posted on the jane app should be equal at the end of the day. It

helps to cross-check the total amount.

4. Description of the environment of the office

Bay and college physiotherapy and rehab share the premises with Bay college dental. The

reception area is split between both organizations and has a shared waiting area, patients and

staff members' washrooms, and a kitchen area. Bay and college physiotherapy and rehab have

two offices: the main office (bigger in the size) is extensively used by the practitioners where

they make all patient's notes, and another office is used to see patients sometimes.

The clinic has a big and a small physio room. The big physio room is equipped with physio

machines, and exercising materials such as dumbbells, and balloon balls. It does have one chiro

room and one massage room which is used by a chiropractor and registered massage therapist

consequently.

The staff is very friendly and hard-working and believes in teamwork. Here is a picture of the

teamwork of Bay and College Physiotherapy and Rehab. The receptionist arrives the patients on

the jane app on the computer and the physiotherapist assistant is equipped with a smartphone tab.

The physiotherapist's assistant sees the arrival on their tab and takes the patient inside the

physiotherapist's room. Thereafter, the physiotherapist enters the physio room and gives the

therapy. The next step is providing therapies by machines and recommended exercises that are

given by physiotherapist assistants. Until then, the physiotherapist makes the notes for the

patients and is ready to see the next patient.

5. Description of the applications used while carrying out the project

5.1 Microsoft Excel

Excel is used to provide patient data to the manager. The manager asks very frequently to fetch

the data of the specific year and the month in the excel file along with the patient’s name, mobile

number, address, date of birth, and insurance details. All my schedule for the internship is also

given in the Microsoft Excel file.

5.2 Windows 11

The operating system used at the receptionist desk is windows 11. There are two computers for

administrators at the front desk. Both computers have Dropbox storage. All the processed

insurance claims are saved under the drop box. Medical receptionists must make a date folder

daily under the EHC claims 2022 with the name of the month followed by the day, so all the

insurance copies are saved in this folder.

5.3 Webmail

Webmail is the application used for communication with patients and insurance companies.

Medical Administrative assistants need to log in daily in the webmail and respond to the e-mail

accordingly.
5.4 Jane App

Jane App is used for all administrative tasks related to arriving, scheduling, posting payments,

and making notes for patients. 70% of the work is carried out on this app.

5.5 Insurance claims portals

There are so many insurance claims portals where insurance companies are registered, for

example, Green Shield Canada is registered under provider connect where all Green Shield

Canada insurances are processed. Similarly, Manulife and Canada life are enrolled in Telus.

5.6 Hello sign

Hello sign is the online application used to sign on the documents. if administrator sign is needed

so this portal can be used to sign the documents.

5.7 WSIB portals

All the WSIB patient’s documents are uploaded in the WSIB portals.
6. Description of the documents used on workplace

6.1 FAF forms

These forms are used to get the sessions assigned from WSIB. All the WSIB patients need to

sign this document to update WSIB that they are getting the treatment. The clinic has a unique

provider number that is filled out in the FAF forms before sending to the WSIB. This provider

number is kept confidential.

6.2 Authorization to release the medical notes

This document is signed by the patient who wants to share the medical history from another

clinic. After signing this document, it is sent to the related clinic with our fax number. Therefore,

the clinic can fax the medical notes of the patient.

6.3 Consent forms

This document is the consent from the patient that they are getting the treatment from the clinic

of their own will. This consent form is to be uploaded to the patient files after getting their

signature on the consent form. This document is filled out at the first visit of the patient.
6.4 Prescription document

Some patients need the prescription to reimburse their session fees. For that, they need to bring

the prescription from their physicians. For example, if a student studying at the University of

Toronto wants a massage session so the student must bring the prescription to get the claim for

the session.

6.5 Intake form

Patients who come for their first visit to the clinic are recommended to fill out the patient intake

form. In this intake form, patients must fill out their personal information including insurance

information. The form also aware the patients of the clinic policy.

7. Discussion on a problem and proposed solution

This section discusses a problem that was encountered while working for the organisation, a

critical examination of the issue, and a health informatics remedy.

7.1 Problem description

All new medical record numbers are recorded on notebooks that are grouped by the department

at the medical record reception office. Then, each is manually entered one at a time into the

database. This procedure is required for further searching and validation, but it is highly time-

consuming to complete and prone to errors (such as erroneous numbers and missing

information). Patient misidentification will result from using the incorrect patient's medical

record number. During the internship, it is noteworthy that many of the incoming medical

records include barcodes on the front page. The scanning process is not applied here, though.

7.2 Proposed solutions

In the medical environment course, it is learnt that scanning barcodes are a popular and very

effective method of data entry. Reducing human mistakes in other processes may be

accomplished with the help of the electronic barcode system. These academic works can

substantiate the validity of the barcode scanning technique. The scanning approach would be

preferable for entering record numbers into the system since each medical record may have a

distinct barcode. In the event of errors, evaluation is necessary before applying the scanning

procedure. If the assessment of the findings is satisfactory, the scanning barcode technique may

be utilised to reduce waiting time and boost productivity.

8. List of the skills used to perform the various task

I. Writing skills
 II. Typing speed

III. Microsoft Office

IV. Multitasking

V. Claiming insurances

VI. Time management

VII. Customer services

9. List of Medical Terminology used in the medical environment.

I. Brace: Bracing is a therapeutic approach that employs external braces on different

limbs to offer extra support for ligaments or joints that are unstable.

II. Orthotics: The foot and ankle are aligned into the most anatomically effective posture

with the use of a bespoke orthotic.

III. Rx: Rx stands for prescription which is a written order from a doctor allowing a patient

to get a drug or therapy.

IV. The Vertebral Restriction: The phrase "vertebral limitation" refers to a vertebra

that no longer moves or moves abnormally in comparison to its neighbours.

V. Vestibular physiotherapy: A vestibular physiotherapist is qualified to identify

balance issues, vertigo, and other symptoms, as well as to administer the proper therapies

to alleviate symptoms.

VI. Acupuncture: Acupuncture points are believed to stimulate the central nervous

system. This, in turn, releases chemicals into the muscles, spinal cord, and brain. These
 biochemical changes may stimulate the body's natural healing abilities and promote

physical and emotional well-being.

VII. Dry needling: Physical therapists who have received specialised training and

certification in the use of dry needling administer the treatment. To treat underlying

muscle trigger points and control neuromusculoskeletal discomfort and mobility

problems, a small monofilament needle is inserted through the skin.

10. Conclusion

The conclusion provides a discussion on how the objectives stated in the introduction are met.

During the internship, the goal of being familiar with the department's current information

systems was attained since the student got the opportunity to use all the various systems in each

sector. Since all work is done with coworkers, including clinicians and experts, engaging with

clinicians, and experiencing teamwork are also satisfied. The student had the opportunity to

comprehend every component of medical records and how to computerise them into a system

based on standards, therefore the objectives of knowing data collection and processing insurance

claims and using an electronic health record are both satisfied. All administrative duties are

performed along with handling the receptionist role at the front desk. This leads to the fulfilment

of the goal and involves playing many roles while multitasking. After the entire internship, a

better understanding of how and where theory meets practice to bridge the gap between theory

and practice is achieved.

The work completed during the internship are strongly tied to academic learning experiences in

health informatics.