ICBS 120ICBS 120 MEDICAL OFFICE MEDICAL OFFICE

PROCEDURESPROCEDURES

Health Care Settings and the Health Care Settings and the Healthcare TeamHealthcare Team

Healthcare is ever-changingHealthcare is ever-changing

Dynamic and stimulating industryDynamic and stimulating industry Encourage healthcare professionals Encourage healthcare professionals

to constantly develop new skills and to constantly develop new skills and stay on top of new technology.stay on top of new technology.

Scope of healthcare includes: more Scope of healthcare includes: more than 25 specialties, over 20 kinds of than 25 specialties, over 20 kinds of allied health professionals, and allied health professionals, and increasing non-traditional increasing non-traditional practitioners.practitioners.

Forms of Medical Practice MgmtForms of Medical Practice Mgmt

Sole Proprietorships:Sole Proprietorships: Entitles the physician to hold executive rights to all Entitles the physician to hold executive rights to all

aspects of the practice (profits/debts).aspects of the practice (profits/debts). May employ other physiciansMay employ other physicians

Partnerships:Partnerships: Several physicians who share a facility.Several physicians who share a facility.

Corporation:Corporation: Allows income and tax advantages to all Allows income and tax advantages to all

employees.employees. Professional employees only liable for “OWN” acts.Professional employees only liable for “OWN” acts. Provides fringe benefits such as health Provides fringe benefits such as health

insurance/vacation.insurance/vacation.

Ambulatory Healthcare SettingsAmbulatory Healthcare Settings Individual and Group Practices Individual and Group Practices

Individual/Solo Practice: treats all patients in the practiceIndividual/Solo Practice: treats all patients in the practice

Physician is responsible for all cost of running the practice.Physician is responsible for all cost of running the practice.

Group PracticesGroup Practices Two or more physicians share the operating costs of the practice.Two or more physicians share the operating costs of the practice.

Physicians learn and consult with each otherPhysicians learn and consult with each other

Travel between one or more officesTravel between one or more offices

Has a larger patient base and able to offer lower pricesHas a larger patient base and able to offer lower prices

Urgent Care CentersUrgent Care CentersUsually private, for-profitUsually private, for-profit

Services for primaryServices for primary care,care, routine injuries, illnesses, androutine injuries, illnesses, and minorminorsurgerysurgery

Managed Care OperationsManaged Care Operations Purpose: To provide comprehensive Purpose: To provide comprehensive

healthcare at a reasonable cost.healthcare at a reasonable cost.

Health Maintenance Organization (HMO)Health Maintenance Organization (HMO) is a is a network of participating physicians within a defined network of participating physicians within a defined geographic areageographic area

Specialists are usually seen by gatekeeper referral.Specialists are usually seen by gatekeeper referral.

HMO’s provide a full range of services under one roofHMO’s provide a full range of services under one roof

Preferred Provider Organization (PPO)Preferred Provider Organization (PPO) is a is a Physicians network offers discounted services as agreedPhysicians network offers discounted services as agreed

Individual Practice Association (IPA)Individual Practice Association (IPA) treats patients treats patients for an agreed-upon fee.for an agreed-upon fee.

Ways of Keeping Healthcare Costs Ways of Keeping Healthcare Costs DownDown

1.1. Lifestyle changeLifestyle change

2.2. Diet and exerciseDiet and exercise

3.3. Taking prescriptions as directedTaking prescriptions as directed

4.4. Patient educationPatient education

5.5. Preventative healthcarePreventative healthcare

6.6. Keep on top of billingKeep on top of billing

7.7. Make sure billing is accurateMake sure billing is accurate

Integrative/Alternative Integrative/Alternative HealthcareHealthcare

Training is highly specialized and specificTraining is highly specialized and specific Considered complimentary to traditional health care.Considered complimentary to traditional health care.

Broad Disciplines:Broad Disciplines: Chiropractic: drug free, non-surgical, manipulation of the Chiropractic: drug free, non-surgical, manipulation of the

bodybody Naturopathy: remove the underlying causes of disease Naturopathy: remove the underlying causes of disease

and to simulate body’s natural healing processesand to simulate body’s natural healing processes Oriental Medicine/Acupuncture: Chinese recognize a vital Oriental Medicine/Acupuncture: Chinese recognize a vital

energy behind all life-forms called “qi” (chee). energy behind all life-forms called “qi” (chee).

Integrative/Alternative Healthcare Integrative/Alternative Healthcare Therapies Cont’dTherapies Cont’d

Broad disciplines continued:Broad disciplines continued: Oriental medicine is over 3,000 years Oriental medicine is over 3,000 years

old.old. Includes acupuncture, Chinese Includes acupuncture, Chinese

herbology and bodywork, dietary herbology and bodywork, dietary therapy and exercise based on therapy and exercise based on traditional Oriental medicine traditional Oriental medicine principles.principles.

Integrative/Alternative Healthcare Integrative/Alternative Healthcare Therapy Cont’dTherapy Cont’d

Some Selected Alternative Medicine Some Selected Alternative Medicine Modalities:Modalities:

Acupressure:Acupressure: apply pressure to specific apply pressure to specific acupuncture like points; encourages flow of vital acupuncture like points; encourages flow of vital energy along pathways.energy along pathways.

Aromatherapy:Aromatherapy: inhalation and bodily application inhalation and bodily application of essential oils from plants to help relax. It of essential oils from plants to help relax. It strengthens the self-healing process by indirect strengthens the self-healing process by indirect stimulation of the immune system.stimulation of the immune system.

Homeopathy:Homeopathy: healing that claims highly diluted healing that claims highly diluted doses of certain substance can leave an energy doses of certain substance can leave an energy imprint in the body and bring acout a cure.imprint in the body and bring acout a cure.

Role of the Healthcare TEAMRole of the Healthcare TEAM

Team concept is critical to the quality of Team concept is critical to the quality of patient care.patient care.

A primary care physician is generally, one of A primary care physician is generally, one of the most important members.the most important members.

Another critical allied health member is the Another critical allied health member is the medical assistant.medical assistant.

Other members: insurance coding and billing Other members: insurance coding and billing specialist, RN, surgeon, Receptionist, etc.specialist, RN, surgeon, Receptionist, etc.

Role of the Healthcare TEAM Role of the Healthcare TEAM Cont’dCont’d

Practice within your scope of Practice within your scope of training.training. For example: no one should ever For example: no one should ever

diagnose a patient except for the diagnose a patient except for the physician.physician.

Never do anything you feel Never do anything you feel uncomfortable doing.uncomfortable doing.

Always ask questions when you don’t Always ask questions when you don’t know or don’t understand.know or don’t understand.

Value of the Administrative Value of the Administrative Healthcare TEAMHealthcare TEAM

Must have qualities:Must have qualities: Great communicatorsGreat communicators Liaison between physician and staff Liaison between physician and staff

membersmembers Ability to undertake responsibility for Ability to undertake responsibility for

directing, informing, and guiding directing, informing, and guiding patients and patient care in a patients and patient care in a professional and caring tone.professional and caring tone.

Must be competent and compassionate.Must be competent and compassionate.