Training Manual for Certified Medical Administrative Assistants

Training Manual for Certified Medical Administrative Assistants Preview
As the result of the increase in the complexities of the patient care and the practice management, the role of Certified Medical Administrative Assistant (CMAA) has been on the rise. It is the reason why most of the physicians are employing CMAA to assist in improving service delivery in their clinics. The CMAA help in the implementation of the cost effectiveness and efficiency. It is imperative to remember that the roles and responsibilities of the certified medical assistants can be tailored to the needs of the practice.

Some of the core responsibilities of the certified medical assistants are the management of the front office functions, management of the patient flow.

Additionally, the CMAA have been involved in handling of wide range of tasks at the clinic such as conveying of the clinical information on behalf of the physicians. They are also required to adhere to the clinical protocol when interacting with the patients. However, they are not allowed to make any independent judgment. The CMAA improve the efficiency and the effective of the physician’s work since assist in optimizing patient flow and enable the practice physicians to attend to many patients. Due to the increase in the number of medico-legal issues in health care, there is the need to prepare the Certified Medical Administrative Assistants on major issues affecting health. In order to address these challenges, the training manual was developed so as to assist in equipping the CMAA with knowledge, skills, and expertise on how to handle diverse issues affecting health.

Introduction

The training manual contains the overview of the health facility with a focus on the mission, services, and the health care delivery model. Additionally, the organization structure of the clinic will be highlighted. Additionally, the uniqueness of the facilities shall be explained in the training manual. Additional information that shall be explained in the training manual is the basic procedures involving the office, and the financial aspects of the clinic shall be explained. The Certified Medical Administrative trainee is required to take a keen interest on how such activities are carried out in the organization.

Overview of the Health Facility

The health facility where the Certified Medical Administrators will be deployed is referred to as Sunning Hill Medical Clinic. The Clinic is located at Downtown Street Opposite the Great Canyon Tower. The hospital was founded in the year 1997 by Dr. Frank Rander. Frank Rander is a consultant Gastroenterologist. The hospital mission is to provide comprehensive health care services to all individuals regardless of their age, gender, race, sexuality or political affiliation. The health care delivery model used at the Sunning Hill Medical Clinic is that of Disease Management. Since it is a clinic, the primary goal to attend to the patients who visit the clinic for the consultation services, the clinic focuses on the treatment of the patient’s presenting illness. The health care delivery model is different from others clinic in the region owing to the size, the medical specialty and the kind of the patients the clinic handles. Having being established in 1997, the organization has grown with better financial health and more advanced equipment. The organization is, therefore, bigger as compared to other facilities in the region. Additionally, the organization also handles patients of all ages. Other facilities have specialized in providing services to a specific segment of the population. Finally, the organization has better equipment as compared to other facilities in the region.

The organization structure is unique in its right. The leadership structure of the organization has Dr. Rander at the top as the Chief Executive Officer and the chairman of the Clinic. Below the chairman is Dr. Steve Howe, a resident physician at the clinic. Below Dr. Howe is the Certified Medical Administrative Assistant.  The other individuals are the departmental heads such Finance, Procurement, Human Resource, biomedical engineering and the quality assurance. Finally, below the organization structures are the junior employees.

Office procedures

The training model will provide the overview of the Practice Management System and other Software Systems. The practice management system used at the Sunning Hill Medical Clinic is the Hospital Management Integrated System. Hospital Management Integrated System is medical practice management software that integrates ambulatory health care solutions. The system assists in improving service delivery at the clinic. The system also provides the integration of all services at the medical clinic. The primary aim is to ensure that all services in the organization are interlinked. Each head of the department has unique username and password that they use to log into the system. The Hospital Management Integrated System also facilitates all services at the organization.

The administrative role of the Hospital Management and Integrated System is significant in the organization. Each head of the department can follow up on the progress of their department. Additionally, the system is tamper proof and only allows the specific individuals who have the passwords and usernames to alter any data that has been put in. Moreover, the practice management system also facilitates the improvement of the monitoring tools that the top administration of the clinic has put in place. The system also enables the administration to quickly identify the gaps in the organization and the areas that may be none performing in the clinic. Therefore, the management may easily put in place strategies that seek the reverse the trend.  Finally, the other administrative role of the practice management system is that it facilitates most of the activities in the organization and thereby improving transparency. The training on the utilization of the system will be provided at the departmental level.

The practice management system used at the clinic comes beneficial to the organization since it plays a bigger role in billing and coding. Initially, the organization payment system involved a lot of paperwork. Since the installation of the hospital management system, the paperwork has highly been reduced. Before the delivery of the services, the person who is to provide the service should log in into the system and bill accordingly. Therefore, the implementation of the practice management system is essential in improving the accuracy and the integrity of billing. The system also assists in coding. It eliminates the need for the coding books. Any individual with the login details to the system can code their data at the system. The system has analysis tools that analyze the information code. Therefore, it is easier to identify the performance of each department at the clinic.

The process of checking patients in and out

As the result of the increase medical- legal issues involving the delivery of health care, there is the need to ensure that patient information is handled in a better manner. The hospitals target better performance about documentation from all staff involved at the Clinic. However, individuals directly involved in the patient care such as Certified Medical Assistant are required to promote accurate documentation at all levels in the organization. The recording of the patient demographic and insurance information should be top not and error free. Since most of the patient who visits the facility have an active insurance policy, accurate documentation of the demographic and insurance data will assist in the follow-up of the compensation from different insurance companies for the services delivered to their clients. The Certified Medical Administrative Assistant is required to take the patient’s name, age, residence, the insurance company and the insurance number. Verification of the same information from the patients’ insurance cards is mandatory. Moreover, the Certified Medical Administrative Assistant is also required to have all the documents bearing the client’s details.

The Certified Medical Administrative Assistant is also required to ensure that all the Health Insurance Portability and Accountability (HIPAA) are reviewed by the first time patients. The primary objective of the legislations is to provide data privacy and security provisions for safeguarding the medical information. Therefore CMAA is required that adhere to the principles of the privacy, confidentiality, and disclosure as enshrined in the HIPAA. All new patients are required to review the HIPAA forms and signed them accordingly. The primary purpose of the review is to ensure that the patients’ rights get protected by the clinic.

The According to Berglund (2012) professional individuals in the health care delivery fields has the legal and moral responsibility of maintaining privacy. Privacy calls for the safeguarding of the patients’ information from third parties. The information may include but not limited to diagnosis, biography, course of treatment and personal numbers such as insurance numbers. All individuals have the legal rights for their information to be safeguarded regardless of their age. Privacy is one of the desired practices from the health care professionals while handling patient’s information. According to Sheehan (2009), privacy is closely related to the privacy since it requires that health care professionals should keep patient’s information secret. Additionally, patients should have their personal information held in confidence by the relevant health care personnel. The HIPAA provides the guidelines for considering when to disclose the patient’s information. The Certified Medical Administrative Assistants and other workers at the clinic should adhere to the patients’ privacy right so as to avoid ethical and legal consequences of non-adherence.

The interaction and the communication between the patients and the Certified Medical Administrative Assistants should be professional. The CMAA are called to exercise professionalism and etiquette when communicating with the patients. The primary goals are to ensure that the clients feel respected and value at the facility. Therefore, communication and the interaction between all employees and the staff at the organization should be professional. Any breach of the professionalism standards shall lead to a disciplinary action that may call for the termination of the individual’s relationship with the facility.

Scheduling of the patients is the role of the Certified Medical Administrative Assistant. Therefore, CMAA is required to ensure that the channels of communication between the physician and the office are open. Scheduling of the patients at the Sunning Hill Medical Clinic is based on the conditions. Patients requiring general consultation are scheduled on Monday and Wednesday. Patients who needed Colonoscopy and endoscopy are scheduled on Tuesday and Thursday. All patients requiring barium enema are scheduled on Saturday. A reasonable number of patients should be scheduled at a specific time.

Other Office Procedures related to Patient Care

There are various community and patient resources. They include magazines, wheelchairs and other support services. The CMAA should ensure that these patient resources are handled appropriately. The patients should be received warmly, triaged and the appropriate route call made. The triage finding should be recorded, and coding made appropriately depending on their severity. Red, yellow and orange and black color coding meaning the emergency, urgent, can wait and dead priorities. All patients with advanced directives should be directed to the psychologist for counseling. All documents should be appropriately being signed. It is also the responsibility of the CMAA to ensure medical records are properly stored. The storage of the files should be done according to facilitate easy retrieval. It is also essential that CMAA is familiar with the office procedures and guidelines for various forms of documentation. The primary motive is to ensure that CMAA understands circumstances involving the release of the information and the use of the electronic health record.

Financial Procedures

The financial procedures at the clinic involved the accounting department. The cashier is responsible for handling all the payments at the organization. All payments should be accompanied by the receipt of the receipt as the proof of payment. The accounting and bookkeeping procedures and the processes at the clinic are the sole responsibility of the accounts department. One of the reimbursement models that the Sunning Hill Medical Clinic uses is the fee- for service. The fee- for service involves the payment of all services before the delivery of the service. The clients should show proof of payment before they get any service from the organization. All payment should be channelled to the cashiers.

The other reimbursement model that the organization uses is the Pay-for-Performance. The pay for performance model is also referred to as value-based reimbursement. All individuals working in the organization are compensated when they meet certain metrics for quality and efficiency. The reimbursement is tied to the quality of the services provided to the clinic’s clients. The billing policy and procedures call for billing of all services provided at the clinic through the hospital management and integrated system. The procedures are that individuals with the billing powers have unique usernames and passwords that help them facilitate billing using the system. All the individuals with claims of reimbursement should submit their request to the cashier, fill the reimbursement forms and have the forms signed by the specific department they had paid for the services. There is also the need to have the records reviewed for the medical necessity. The essence is to promote privacy, confidentiality and disclosure elements of the HIPAA (Lossifova & Meyer-Goldstein, 2013). The review of the records for the medical necessity is also to ensure that no patients’ records are lost in the process of fillings.  Finally, The Certified Medical Administrative Assistant is required to ensure that there are clean claims submission and clearinghouse. The primary goals are to promote organization at the clinic.

References

Berglund, C. A. (2012). Ethics for health care. South Melbourne, Vic: Oxford University Press.

Lossifova, A. R., & Meyer-Goldstein, S. (2013). Impact of standards adoption on healthcare transaction performance: the case of HIPAA. International Journal of Production Economics, 141(1), 277-285.

Sheehan, M. N. (2009). Ethical Issues in Rural Health Care. JAMA, 301(20), 2162. doi:10.1001/jama.2009.730

 

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