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MOA115 Medical Records and InsuranceLesson Plans

Course DescriptionStudents explore the fundamentals of paper and electronic medical record management, fee determination, billing methodology, and collection processes. Students perform basic bookkeeping, coding, and third-party billing procedures. Financial management of the medical office and various medical insurance plans are discussed along with related terminology and legal regulations.

Prerequisite: NoneTotal Contact Hours: 60 (20 for Lecture & 40 for Laboratory); Out-of-Class Work: 40 hoursQuarter Credit Hours: 4.0

Course ObjectivesIn this course, students will:1. Demonstrate medical record management through filing, creating, and maintaining

medical records. Explain the different types of medical records, including traditional, problem-

oriented, paper, and electronic. Explain how to establish and organize a patient medical record. Discuss medical record organizing systems, indexing rules, and filing

methods. File records using various filing systems. Explain how to document appropriately and accurately, including making

additions and corrections. Discuss the importance of healthcare standards in medical facilities related to

the paper and electronic medical record.

2. Perform basic medical practice financial procedures including fee determination, billing, bookkeeping, collections, and banking.

List three values that are considered in determining professional fees. Explain basic bookkeeping computations. Explain both billing and payment options. Identify procedures for preparing patient accounts and collecting outstanding

accounts. Discuss the types of adjustments that may be made to a patient's account. Describe banking procedures performed in a medical office.

3. Apply managed care policies and procedures. Identify types of insurance plans and models of managed care plans. Discuss the different types of physician fee schedules. Define Diagnosis-Related Groups (DRGs). Discuss the managed care referral process as it applies to the medical office. Describe utilization review principles. Demonstrate verifying eligibility, obtaining precertification and

preauthorization, and using appropriate documentation.

4. Apply third-party billing guidelines.

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List major third-party payers. Describe guidelines for third-party claims. Complete the universal claim form. Describe RBRVS. Discuss worker’s compensation as it applies to patients. Demonstrate assertive communication with managed care providers and

sensitivity when providers and patients.

5. Demonstrate basic procedural and diagnostic coding. Explain ICD, CPT and HCPCS codes. Describe the difference between ICD-9 and ICD-10. Describe how to use the most current diagnostic coding system. Describe how to use the most current procedural coding system. Demonstrate diagnostic coding. Demonstrate procedural coding.

6. Examine state and federal regulations related to billing and collection procedures. Discuss the HIPAA Privacy Rule and meaningful use as it pertains to the

medical office. Describe the impact of the Fair Debt Collection Practices Act on the medical

office. Discuss the Federal Truth in Lending Act as it applies to debt collection

practices. Describe when a release of Information form needs to be completed. Complete a release of Information form. Discuss the importance of the Notice of Privacy Practices to patients and to

the medical office.

Required Instructor Resources Proctor, Debra and Adams, Alexandra. (2014) Kinn’s The Medical Assistant: An

Applied Learning Approach. (12th ed). Elsevier. Proctor, Debra and Adams, Alexandra. (2014) Kinn’s The Medical Assistant: An

Applied Learning Approach – Study Guide and Procedure Checklist Manual Package. (12th ed). Elsevier.

Proctor, Debra and Adams, Alexandra. (2014) Kinn’s The Medical Assistant: An Applied Learning Approach – Virtual Medical Office Study Guide with Online Simulation (12th ed). Elsevier.

Kinn’s The Medical Assistant: ICD-10 Diagnostic Coding (Supplement) Beik, Janet. (2013) Health Insurance Today– Text, Virtual Medical Office Study

Guide with Workbook. (4th ed). Elsevier. CMAA Online Study Guide. Evolve MOA Step-by-Step Instructions for Instructors.docx. Learning Resource Center materials are available

Certification Exams

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Taking and passing a certification exam is very important for our Allied Health students, will add value to their education, and give our graduates a competitive edge in the employment market. The National Health Career Association (NHA) is the provider of this critical service. The curriculum in each course is mapped to program competencies that will be typically expected by the certifying agencies.

The NHA Study Guide is a Student Resource for this course. Please utilize this guide with the students to review content appropriate to this particular course. This will allow students to become familiar with the certification testing content throughout the entire program.

Instructors have access to online study guides so they can present virtual lectures and media to their classes. The online media and assignments from the students printed study guides are not identified in the lesson activities. The materials may be used at each instructors discretion throughout the course based on the needs of each class.

References to prepare for the certifications exams can be found in the first week’s lesson folder:

Guidelines for Managing Certification Exam for Allied Health 11-2014.rtfHow to Access NHA's Online Study Guide.docx

Grading ResourceRefer to the “MOA115 Point Breakdown” document, which resides outside of the course lesson folders on SharePoint, to identify points for assignments and exams. The document also lists the items included in each method of evaluation.

Equipment Computer Projector and Screen Internet Connection – Internet Explorer, Version 9

60 Hour Class – 6 weeksWeeks 1-6: 10 hours per week = 2 lessons at 5 hours per lesson(20 hours of lecture, 40 hours of lab, 40 hours out-of-class work equal 4 credits)

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Week One Lesson One

I. Learning Objectives: CO1 Demonstrate medical record management through filing, creating, and maintaining medical records.

Explain the different types of medical records, including traditional, problem-oriented, paper, and electronic.

Explain how to establish and organize a patient medical record. Discuss medical record organizing systems, indexing rules, and filing

methods. File records using various filing systems. Explain how to document appropriately and accurately, including making

additions and corrections.

II. In-Class Learning Activities: (Assets can be found in Week 1, Lesson 1 folder)a. Course Overview/Orientation:

Description: During this course, we will discuss the paper and electronic medical record. We will also address the financial procedures that are performed in the medical office, including billing, coding charges, collections, and banking. State and federal regulations that relate to billing and collection procedures, managed care plans and third party payors will be also be examined.

Directions: Give each student a copy of the course syllabus. Review the syllabus with the students, including the course

policies, grading, expectations, and schedule. Document: MOA115 Medical Reocrds and Insurance Syllabus Estimated Time: 30 minutes

b. Lesson Overview: Paper Medical Record Description: We will discuss the basic methods used in the filing and maintenance of medical records. Students will learn the sections of a medical record and the difference between subjective and objective information. Students will use the medical record vocabulary, learn about the legality of the medical record, and recognize its ownership.

Estimated Time: 5 minutes

c. Test Preparation: Paper Medical Record Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.

Directions: o Give each student 2-3 index cards.o Instruct students to create a multiple choice question on each

index card with the answer on the opposite side. Students will create these questions throughout the day as the lesson is presented.

o Discuss with students how to write test questions. They may want to use terminology and definitions or concepts that are discussed. They should practice using their own words for the questions and answers, instead of using quotes directly from the textbook. The

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answers should sound realistic and they should list 4-5 answers for the question.

o Instructor note: Periodically, remind the students to create the questions throughout the day. Collect the cards at the end of the day. Sort through and use the questions during the test review session. Keep the cards and use again during the midterm and final test review sessions.

Supplies: Index cards (2-3 per student) Estimated time: 10 minutes

d. Pretest: Paper and Electronic Medical Record Description: Students will take pretest. Instructors will use the results of the pretest to guide the lecture.

Directions: o No notes or books. Give the pretest to the students. o When finished, discuss the correct answers. Have students grade

their own papers. o Collect, review the students results, and give back to the students.

Documents: Ch 14 and 15 Pretest.docx, Ch 14 and 15 Pretest Key.docx


e. Lecture/Discussion: Paper Medical Record Description: We will be discussing medical records, including electronic, paper, traditional or source-oriented and problem-oriented records. We will also discuss the difference between objective and subjective information and the importance of documenting accurately.

Directions:o For this discussion, use the PowerPoint presentation, and for

every slide, make sure to address the discussion points to help students learn the concepts.

Document: Ch 14 PowerPoint.pptx, Slides 1-13 Discussion Points: To get a printed copy of the talking points for each

slide of the PowerPoint, print off the PowerPoint as Notes Pages. Estimated Time: 25 minutes

f. Writing Activity: Subjective vs. Objective Information WorksheetDescription: Students will work together to answer the questions.

Directions:o Divide the group into pairs. Review the worksheet directions.

Have students work together to complete the worksheet. o Upon completion, review answers with the class.

Document: Ch 14 Subj and Obj Info.docx, Ch 14 Subj and Obj Info Key.docx

Estimated time: 20 minutes

g. Lecture/Discussion: Paper Medical Record Description: We will be discussing how to establish and organize paper medical records. Documenting and correcting medical records, storage of records, and

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and releasing information and will be discussed. We will discuss filing equipment, supplies, procedures, filing systems, and indexing rules.





h. Lab: Organize Medical Record ProcedureDescription: Students will create a patient medical record that will be used in a later activity.

Note to Instructors: o Procedure 14-2 will be used in MOA135. Please keep procedure

intact in the Procedure Checklist Manual. Directions:

o Using Procedure 14-2 “Organize a Patient’s Medical Record” steps 1–6 and 9, students will create a paper medical record for a mock patient. (Ideas for patient names include cartoons, famous people, etc.)

o Give each student the supplies listed below along with an “Adult Patient Registration Form.”

o For directional purposes, assume the chart main fold is on the left and the tab is at the bottom. Use this position for the next two steps.

o Place name label on the bottom left side of the chart tab. Write patient’s last name followed by a comma, then first name and middle initial/name.

o At the bottom farthest right edge of the folder, place the alpha color code label of the first letter of the last name. Working left, add the label for the second letter of the last name, then the first letter of the first name. Lastly, the year label should be placed and be the closest label to the name label on the tab.

o Place the allergy label on the front of the chart and allow the students to make up allergies for the patient.

o Create the dividers by placing the divider labels on the dividers in a staggered fashion so all labels can be seen at once when the dividers are in the chart. Assign a divider label color for each of the following sections: Progress Notes, Laboratory, Correspondence, and Miscellaneous.

o Using the right-hand side prongs, secure the dividers.o When the folder is completed, have students role-play obtaining

patient registration information from a peer. When completed, the Adult Patient Registration Form should be placed on the left side of the chart and secured by the prongs.

Book: Kinn’s The Medical Assistant Procedure Checklist Manual (PCM), Procedure 14-2 “Organize a Patient’s Medical Record”

Document: Patient Registration Form.docx

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Supplies: Per student: (1) end tab file folders, (4) divider sheets, (1) name file tab labels, alpha color code labels (first 2 letters of last name and first letter of first name – for 1 patient), year label, allergy label, and 4 divider labels (4 different colors), paper punch


i. Lab: File Medical Records Description: Students will file medical records using an alphabetic system.

Preparation:o Collect the medical records created by students. File folders in a

file box, leaving out 5 folders.o As supplies allow, the instructor may want to make two or more

demonstration areas to accommodate more students during the demonstration.

Directions: o Have each student file the remaining folders, following Procedure

14-6 “File Medical Records Using an Alphabetic System.”o Give each student “Ch 14 Filing Systems Worksheet and review

the directions.o While students are waiting to file the folders, they can work on the

worksheet. Document: Ch 14 Filing Systems.docx, Ch 14 Filing Systems

Key.docx, Book: Kinn’s The Medical Assistant PCM, Procedure 14-6 “File Medical

Records Using an Alphabetic System” Supplies: File boxes Estimated Time: 80 minutes

j. Lesson Summary: Paper Medical Records ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the importance of an accurate medical record and the role of the medical assistant with medical records, including organizing, storing and documenting in the medical record.

Directions: o After the summary, discuss the out-of-class assignments the

students need to complete Document: Ch 14 Study Guide Key.docx Estimated Time: 10 minutes

III. Out-of-Class Learning Assignments (Homework):

Read: Kinn’s The Medical Assistant: An Applied Learning Approacho Chapter 14 “The Paper Medical Record”

Estimated Time: 2.5 hours

Assignments:o Complete: Kinn’s the Medical Assistant: An Applied Learning Approach,

Study Guide

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Chapter 14 “The Paper Medical Record,” Vocabulary Review, Parts I–VI, Case Studies

Estimated Time: 2 hours

Instructional materials can be found in the Week 1, Lesson 1 course folder.

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Week One Lesson Two

I. Learning Objectives: CO1, CO6 Demonstrate medical record management through filing, creating, and maintaining medical records.

Explain the different types of medical records, including traditional, problem-oriented, paper, and electronic.

Discuss the importance of healthcare standards in medical facilities related to the paper and electronic medical record.

Examine state and federal regulations related to billing and collection procedures.

Discuss the HIPAA Privacy Rule and meaningful use as it pertains to the medical office.

Describe when a release of Information form needs to be completed. Complete a release of Information form.

II. In-Class Learning Activities: (Assets can be found in Week 1, Lesson 2 folder)

a. Homework Review: Review out-of-class assignments from Week 1, Lesson 1.Description: Review the study guide exercises the students completed for homework.

Directions: o Check each student’s Study Guide to confirm completion of the

assignment for grading purposes. o Review the correct answers for Ch 14 exercises (Vocabulary

Review, Part I–Part VI, Case Studies). o Review the answers and discuss the major concepts of the

chapter that may still be unclear to the students. Document: Ch 14 Study Guide Key.docx Estimated Time: 15 minutes

b. Lesson Overview: Electronic Medical Record Description: Students will discuss the principles of the electronic medical record. Students will address the differences between the electronic health record and the electronic medical record. Advantages and disadvantages of the electronic record and governmental influence will also be covered.


c. Test Preparation: Electronic Medical Record Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.



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o Discuss with students how to write test questions. They may want to use terminology and definitions or concepts that are discussed. They should practice using their own words for the questions and answers, instead of using quotes directly from the textbook. The answers should sound realistic and they should list 4-5 answers for the question.



d. Lecture/Discussion: Electronic Medical Record Description: We will discuss the difference between electronic medical records, electronic health records, and personal health records. Disadvantages and advantages of the electronic medical record will be discussed. Healthcare standards relating to medical records, including HIPAA, HITECH and Meaningful Use will be discussed.



Document: Ch 15 PowerPoint.pptx, Slides 1–19 Discussion Points: To get a printed copy of the talking points for each


e. Writing Activity: Electronic Medical Record Description: Students will work together to answer study guide exercises.

Directions:o Divide the class into pairs. o Have students work together to complete the Study Guide

Chapter 15, Vocabulary Review and Part I. o Students can use their textbooks as references (especially the

Vocabulary section in the beginning of the chapter).o Upon completion, review answers with the class.

Books: Kinn’s The Medical Assistant and Kinn’s The Medical Assistant Study Guide (SG) – Vocabulary Review

Document: Ch 15 Study Guide Key.docx Estimated Time: 30 minutes

f. Lecture/Discussion: Electronic Medical RecordDescription: We will be discussing the medical assistant’s role with the EMR and patient interaction while using the EMR.



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Document: Ch 15 PowerPoint.pptx, Slides 20–32 Discussion Points: To get a printed copy of the talking points for each


g. Role Play Lab: Prepare a Record Release FormDescription: Students will role play working with a patient and completing a record release form.

Preparations: o Obtain copies of a release form from a local agency. o Make copies for each student.

Directionso Divide the class into pairs.o Using Procedure 14-5 “Prepare a Record Release Form” steps 1–

3, review the directions with the students. Each student will role play being a medical assistant and help the patient (their partners) complete the form.

o Makes sure the students use their name on the form, but all the other data elements should be made up.

Book: Kinn’s The Medical Assistant Procedure Checklist Manual (PCM), Procedure 14-5 “Prepare a Record Release Form”

Supplies: Record Release Form from a local agency Estimated Time: 60 minutes

h. Virtual Lab: Organizing a Medical Record SimulationDescription: Students will use the VMO learning tools to apply what they have learned regarding organizing medical records. Instructors will use the classroom computer to present this simulation activity to the class, while students complete worksheets individually at their desks, following the presentation.

Directions: o Use the classroom computer to project the VMO activity. o Sign into the Virtual Medical Office Online Study Guide and

navigate to the simulations using the following click path:o Note to instructor: For exercises where the SG indicate the

student is to do something with the software (for example: “add in forms needed”), have the class decide as a group what should be added and then the instructor should add those.

o Evolve Resources for Virtual Medical Office for Kinn’s The Medical Assistant, 12th Edition

o Open Simulations – VMOo Open Online Study Guideo Open Lesson 7: Organizing a Patient’s Medical Recordo Lesson 7:

Review the directions for Lesson 7 “Organizing a Patient’s Medical Record” (Exercise 1 and 2).

Have each student complete Lesson 7 Exercise 1 and 2 in their VMO Study Guide.

o Lesson 8: Review the directions for Lesson 8 “Filing Medical

Records” (Exercise 1).

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Have each student complete Lesson 8 Exercise 1 in their VMO Study Guide.

o After the assignment, collect the documents for grading. Book: Kinn’s Virtual Medical Office – Study Guide with Online Simulation,

Lesson 7 “Organizing a Patient’s Medical Record”, Lesson 8 “Filing Medical Records”

Documents: VMO Lesson 7 Key.pdf, VMO Lesson 8 Key.pdf, Estimated Time: 100 minutes

i. Lesson Summary: Electronic Medical Records ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the importance of Confidentiality in the medical office and the impact of HIPAA, HITECH, and Meaningful Use on healthcare practices.

Directions:o After the summary, discuss the out-of-class assignments the

students need to complete. Document: Ch 15 Study Guide.docx Estimated Time: 15 minutes


Read: Kinn’s The Medical Assistant: An Applied Learning Approacho Chapter 15 “The Electronic Medical Record” o Estimated Time: 1 hour

Assignments:o Complete: Kinn’s The Medical Assistant: An Applied Learning Approach,

Study Guide Chapter 15 “The Electronic Medical Record,” Part II – Part VII


Study: For the Paper and Electronic Medical Record Test (Ch 14 and 15)o Estimated Time: 2 hours


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Week Two Lesson One

I. Learning Objectives: CO1

Demonstrate medical record management through filing, creating, and maintaining medical records.

Explain how to document appropriately and accurately, including making additions and corrections.

Discuss the importance of healthcare standards in medical facilities related to the paper and electronic medical record.

II. In-Class Learning Activities: (Assets can be found in Week 2, Lesson 1 folder)a. Homework Review: Review out-of-class assignments from Week 2, Lesson 1.

Description: Review the study guide exercises the students did for homework. Directions:

o Check each student’s Study Guide to confirm completion of the assignment for grading purposes.

o Review the correct answers for Ch 15 exercises (Part II – Part VII).

o Review the answers and discuss the major concepts of the chapter that may still be unclear to the students.

Document: Ch 15 Study Guide Key.docx Estimated Time: 20 minutes

b. Lesson Overview: Health Information Management Description: We will complete the medical record discussion with a review for the paper and electronic medical record test. After the test, we will discuss the purpose of quality health data and the role of quality assurance with medical records. The importance of HIPAA and the role of the Joint Commission will also be addressed.


c. Test Preparation: Medical Records ReviewDescription: Use the mock test questions the students wrote to review the paper and electronic medical record chapter content.

Directions: o Using the projector (or PowerPoint if you typed the questions into

a presentation), review mock test questions with the class. As you review, help students analyze the answer to identify possible answers and incorrect answers.

Supplies: Mock test question cards from the students Estimated Time: 40 minutes

d. Assessment: Paper and Electronic Medical Record TestDescription: Multiple choice test covering content from “Ch 14 – The Paper Medical Record,” and “Ch 15 – The Electronic Medical Record.”

Directions: o Provide students with test document and blank answer sheeto Students will have 45 minutes to complete the test.

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o Students are not allowed to use any resources to complete the test.

Documents: Test 1 (Ch 14 & 15) Student A.docx, Test 1 (Ch 14 & 15) Key A.docx or Test 1 (Ch 14 & 15) Student B.docx, Test 1 (Ch 14 & 15) Key B.docx


e. Test Preparation: Health Information Management Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.






f. Pretest: Health Information Management Description: Students will take the pretest. Instructors can use the results of the pretest to help guide the lecture.



Documents: Ch 16 Pretest.docx, Ch 16 Pretest Key.docx Estimated Time: 20 minutes

g. Lecture/Discussion: Health Information Management Description: We will discuss the uses of healthcare data, the characteristics of quality data, and quality assurance. We will also discuss how to handle errors in the medical record and the medical assistant’s responsibility related to errors in the record.

Directions:

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o For this discussion, use the PowerPoint presentation, and for every slide, make sure to address the discussion points to help students learn the concepts.



h. Writing Activity: Health Information Management Description: Students will work together to answer study guide exercises.


Chapter 16, Vocabulary Review, Part I through IV. Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).

o Upon completion, review answers with the class. Books: Kinn’s The Medical Assistant and Kinn’s The Medical Assistant

Study Guide (SG) – Vocabulary Review, Part I through Part IV Document: Ch 16 Study Guide Key.docx Estimated time: 60 minutes

i. Lesson Summary: Health Information Management ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the importance of accurate charting in the medical record and the characteristics of quality healthcare data. The role of the medical assistant with these activities should also be summarized.


students need to complete. Document: Ch 16 Study Guide Key.docx Estimated Time: 15 minutes


Read: Kinn’s The Medical Assistant: An Applied Learning Approacho Chapter 16 “Health Information Management”

Estimated Time: 1 hour


Study Guide Chapter 16 “Health Information Management,” Part V-VI, Case

Studies o Estimated Time: 30 minutes


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Week Two Lesson Two



Discuss the importance of the Notice of Privacy Practices to patients and to the medical office


a. Homework Review: Review out-of-class assignments from Week 2, Lesson 1.Description: Review the study guide exercises students completed for homework.


assignment for grading purposes. o Review the correct answers for Ch 16 exercises (Part V – Part VI,

Case Studies). o Review the answers and discuss the major concepts of the


b. Lesson Overview: Privacy in the Physician’s Office Description: Students will discuss how HIPAA benefits the healthcare industry and patients. The Privacy Rule and incidental disclosures will also be addressed. Estimated Time: 5 minutes

c. Test Preparation: Privacy Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.





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d. Pretest: Privacy Description: Students will take the pretest. Instructors can use the results of this pretest to help guide the lecture.




e. Lecture/Discussion: Privacy Description: We will discuss HIPAA in depth, including the impact to the medical office and the Privacy Rule. The importance of the Notice of Privacy Practices will be explained along with the medical assistant’s role with the NPP.





f. Writing Activity: Privacy Description: Students will work together to answer study guide exercises.


Chapter 17, Vocabulary Review, Part I and II. Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).


Study Guide (SG) – Vocabulary Review, Part I and II Document: Ch 17 Study Guide Key.docx Estimated time: 50 minutes

g. Lecture/Discussion: Privacy in the Physician's OfficeDescription: We will discuss permissions, incidental disclosures, and how to protect a patient’s privacy.



Document: Ch 17 PowerPoint.ppt, Slides 19-35

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Discussion Points: To get a printed copy of the talking points for each slide of the PowerPoint, print off the PowerPoint as Notes Pages.


h. Research: Notice of Privacy Practices LRC ProjectDescription: Students will work in groups to evaluate Notice of Privacy Practice forms from local medical clinics. They will evaluate the NPPs using HIPAA’s requirements and access them for read ability.

Note to instructor:o If the resources in the LRC do not allow for this project, the

instructor can adapt the project by: Obtaining Notice of Privacy Practice documents from 6

or more healthcare agencies. Copying enough NPPs so that each group of 3 or 4

students have 3 different NPPs. Allowing students to handwrite the document.

Directions:o Divide the class into groups of 3 or 4 students. o Give each student a copy of the “Notice of Privacy Practices –

LRC Project” and review the directions.o The students will evaluate 3 different NPPs and then write a report

on their findings.o The students can utilize Ch 17 for information on HIPAA’s

requirements.o When the students have completed the assignment, they can

share their findings with the class.o Collect the documents for grading.

Book: Kinn’s The Medical Assistant Document: NPP LRC Project.docx Estimated time: 120 minutes

i. Lesson Summary: Privacy in the Physician’s Office ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should summarize the importance of having an NPP and it’s use for the medical office staff and the patients. The instructor should also briefly discuss how patients can utilize the NPP.




Read: Kinn’s The Medical Assistant: An Applied Learning Approacho Chapter 17 “Privacy in the Physician’s Office”


Assignments:

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o Complete: Kinn’s The Medical Assistant: An Applied Learning Approach, Study Guide

Chapter 17 “Privacy in the Physician’s Office,” Part III-V, Case Studies



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Week Three Lesson One

I. Learning Objectives: CO5 Demonstrate basic procedural and diagnostic coding.

Explain ICD, CPT and HCPCS codes. Describe the difference between ICD-9 and ICD-10 Explain how to use the most current diagnostic coding system.

I. In-Class Learning Activities: (Assets can be found in Week 3, Lesson 1 folder)

a. Homework Review: Review Out-of-Class Assignments from Week 2, Lesson 2.Description: Review the study guide exercises students completed for homework.


assignment for grading purposes. o Review the correct answers for Ch 17 exercises (Part III – Part V,

Case Studies. o Review the answers and discuss the major concepts of the


b. Lesson Overview: Diagnostic Coding Description: We will conclude our discussion on NPP with a quick discussion on how to handle a situation when patients refuse to sign the notice. Then we will will discuss coding vocabulary, basic coding rules, the history of coding, and the need for uniform application in today’s medical environment. Students will practice basic coding procedures, including the use of the V and E codes.


c. Role Play Lab: Notice of Privacy Practices Description: Students will work in pairs and role-play how to handle the situation if a patient refused to sign the Notice of Privacy Practices Form.

Directions:o Divide the students into pairs and have each student take a turn

role playing the patient and the medical assistant.o They should role play a scenario wherein the medical assistant

asks a patient to sign the NPP and the patient refuses.o After the role plays, discuss the situation as a class.o The instructor can write appropriate actions on the whiteboard

during the activity. Estimated time: 30 minutes

d. Test Preparation: Diagnostic Coding Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.

Directions: o Give each student 2-3 index cards.

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o Instruct students to create a multiple choice question on each index card with the answer on the opposite side. Students will create these questions throughout the day as the lesson is presented.




e. Pretest: Diagnostic Coding Description: Students will take the pretest. Instructors can use the results of this pretest to help guide the lecture.




f. Lecture/Discussion: Diagnostic Coding Description: We will discuss the basics of ICD-9 diagnostic coding, including the vocabulary, purpose, and V and E codes. The contents of the 3 volumes, different medical reports used, and the basics of the coding process will be explained.





a. Writing Activity: Diagnostic Coding Description: Students will work together to answer study guide exercises.


Chapter 18, Vocabulary Review. Students can use their textbooks

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as references (especially the Vocabulary section in the beginning of the chapter).


Study Guide (SG) – Vocabulary Review Document: Ch 18 Study Guide Key.docx Estimated time: 50 minutes

b. Lecture/Discussion: Diagnostic Coding ProcessDescription: We will discuss the coding process in detail, including using the Alphabetic and Tabular Indexes. Coding signs, symptoms, suspected conditions, late effects, past medical history, and specific disease conditions will be explained.





c. Writing Activity: Diagnostic Coding Description: Students will work together to answer study guide exercises.


Chapter 18, Part I. Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).


Study Guide (SG) – Part I Document: Ch 18 Study Guide Key.docx Estimated time: 50 minutes

d. Test Preparation: Midterm Test ReviewDescription: Use the mock test questions the students wrote to review the chapter content.




e. Lesson Summary: Diagnostic Coding ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the purpose

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of ICD coding and the need for the coding to be correct. Key vocabulary terms should be reviewed.


students need to complete. o ICD-9 and ICD-10 Comparison LRC Project:

Provide each student with a copy of the “ICD-9 and ICD-10 Comparison LRC Project” and review the directions.

The students will need to use the LRC resources to research each ICD and the compose a paper using the directions provided.

This assignment will be due at the start of Week 4, Lesson 1.

Document: ICD LRC project.docx Estimated Time: 10 minutes

I. Out-of-Class Learning Assignments (Homework):

Read: Kinn’s The Medical Assistant: An Applied Learning Approacho Chapter 18 “Basics of Diagnostic Coding”


Assignments:o Start: ICD-9 and ICD-10 Comparison LRC Project

Document: ICD LRC project.docx Estimated Time: 3 hours


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Week Three Lesson Two


Explain ICD, CPT and HCPCS codes. Describe the difference between ICD-9 and ICD-10. Describe how to use the most current diagnostic coding system. Demonstrate diagnostic coding


a. Homework Review: Review out-of-class assignments from Week 3, Lesson 1.Description: Review and discuss the assigned homework.

Directions:o Review and discuss the assigned homework. o Answer any questions the students may have on the readings or

the ICD LRC project. Document: ICD LRC project.docx Estimated Time: 15 minutes

b. Assessment: Medical Records and Insurance Midterm Test

Description: Multiple choice test covering chapter content from “Ch 14 – The Paper Medical Record,” “Ch 15 – The Electronic Medical Record,” “Ch 16 – Health Information Management,” and “Ch 17 – Privacy in the Physician’s Office."

Directions: o Provide students with test document and blank answer sheeto Students will have 35 minutes to complete the test. o Students are not allowed to use any resources to complete the

test. Documents: Test 2 Midterm (Ch 14-17) Student A.docx, Test 2

Midterm (Ch 14-17) Key A.docx or Test 2 Midterm (Ch 14-17) Student B.docx, Test 2 Midterm (Ch 14-17) Key B.docx


c. Lesson Overview: Basics of Diagnostic Coding Description: Students will complete the discussion on ICD-9. Students will also practice basic coding procedures, including the use of the V and E codes.


d. Lecture/Discussion: Diagnostic Coding Description: We will discuss coding the etiology and manifestation, neoplasms, and specific conditions, including cardiovascular, obstetrics, burns and accidents.




slide of the PowerPoint, print off the PowerPoint as Notes Pages.

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Estimated Time: 85 minutese. Demonstration: Diagnostic Coding Introduction

Description: Instructor will provide orientation to the ICD-9-CM manual. Directions:

o Student use classroom copies of the ICD-9-CM manual.o Provide an orientation to the ICM manual book. Show students

how to find different codes. Then select a random code and have the students find it. Repeat this process several times to familiarize students with the book.

NOTE: Students should also use LRC resources for ICD-9 manual Estimated time: 20 minutes

f. Lab: Diagnostic Coding Description: Students will work on finding the diagnostic codes for scenarios.

Directions:o Using the ICD-9-CM manual, work with the class to find the

answers for Study Guide Chapter 18, Part III (#1-5).o When the instructor feels the class is confident with looking up the

codes, have them complete Part III (#6-30)o When the class has completed the questions, review the answers

with the class.o Collect the documents for grading purposes.o Please note that the remaining section in Part III will be used for

other courses. Please keep these documents intact in the SG. Books: Kinn’s The Medical Assistant Study Guide (SG) – “Part III,” NOTE: Students should also use LRC resources for ICD-9 manual Document: Ch 18 Study Guide Key.docx Estimated time: 140 minutes

g. Lesson Summary: Diagnostic Coding ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the correct procedure to use when performing ICD-9 coding. A quick summary of ICD-9 vocabulary should be given.


students need to complete. o ICD-9 and ICD-10 Comparison LRC Project:

Answer any questions the students may have on the project.

This assignment will be due at the start of Week 4, Lesson 1.

Document: ICD LRC project.docx Estimated Time: 10 minutes

III. Out-of-Class Learning Assignments (Homework): Assignments:

o Complete: Kinn’s The Medical Assistant: An Applied Learning Approach, Study Guide

Chapter 18 “Diagnostic Coding,” Part II

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Estimated Time: 0.5 houro Complete: ICD-9 and ICD-10 Comparison LRC Project

Document: ICD LRC project.docx Estimated Time: 3 hours


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Week Four Lesson One


Demonstrate basic procedural and diagnostic coding. Explain ICD, CPT and HCPCS codes. Describe the difference between ICD-9 and ICD-10. Describe how to use the most current diagnostic coding system. Demonstrate diagnostic coding.


a. Homework Review: Review out-of-class assignments from Week 3, Lesson 2.Description: Review the study guide exercises the students did for homework.


assignment for grading purposes. o Review the correct answers for Ch 18 exercises (Part II). o Review the answers and discuss the major concepts of the

chapter that may still be unclear to the students.o Collect the ICD-9 and ICD-10 Comparision LRC Project for

grading. Document: ICD LRC project.docx, Ch 18 Study Guide Key.docx Estimated Time: 15 minutes

b. Lesson Overview: ICD-10 Coding Description: We will discuss ICD-10 Coding. Students will discuss coding vocabulary, basic coding rules, and the need for uniform application in today’s medical environment. Students will also have the opportunity to code using the ICD-10-CM manuals.


c. Test Preparation: ICD-10 Coding Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.




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d. Pretest: Coding Description: Students will take the pretest on ICD-10 and procedure coding. Procedure coding will be addressed in the next lesson. Instructors can use the results of the pretest to help guide the lecture.



Documents: Coding Pretest.docx, Coding Pretest Key.docx Estimated Time: 15 minutes

e. Lecture/Discussion: ICD-10 Coding Description: We will be discussing ICD-10 diagnostic coding, including the important vocabulary terms, code structure, format of the ICD-10-CM manual, abbreviations and punctuation used, and the process of coding.



Document: ICD10 PowerPoint.pptx, Slides 1-34 Discussion Points: To get a printed copy of the talking points for each


f. Demonstration: ICD-10-CM IntroductionDescription: Instructor will provide orientation to the ICD-10-CM manual.

Directions:o Student use classroom copies of the ICD-10-CM manual.o Provide an orientation to the ICM manual book. Show students

how to find different codes. Then select a random code and have the students find it. Repeat this process several times to familiarize students with the book.

Book: 2015 ICD-10-CM Draft Edition Estimated time: 25 minutes

g. Lab: ICD-10-CM Coding Description: Students will work on finding the diagnostic codes for scenarios.

Directions:o Provide each student with a copy of the “ICD-10-CM Coding

Exericise” document.

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o Using the ICD-10-CM manual, help the class find the answers for Practice Coding Exercises.

o Have the students complete the rest of the worksheet, looking up the codes for the listed issues.

o When the class has completed assignment, collect the document for grading.

Book: 2015 ICD-10-CM Draft Edition (classroom copies) Documents: ICD10CM Exercises.docx, ICD10CM Key.docx Estimated time: 150 minutes

h. Lesson Summary: ICD-10 Coding ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the benefits of ICD-10 and the need to be accurate when coding charges.

Directions:o After the summary, discuss the out-of-class assignments students

need to complete. Estimated Time: 10 minutes


Read: Health Insurance Todayo Kinn’s Supplement – “ICD-10 Diagnostic Coding”

Estimated Time: 2 hours


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Week Four Lesson Two


Explain ICD, CPT and HCPCS codes. Describe how to use the most current procedural coding system.


a. Homework Review: Review out-of-class assignments from Week 4, Lesson 1. Description: Answer any questions the students may have on the diagnostic

coding reading they completed as homework. Directions:

o Respond to any questions students may have on ICD-10 coding. Estimated Time: 10 minutes

b. Lesson Overview: Basics of Procedural Coding Description: We will discuss procedure coding, the important vocabulary, resources, and the procedure coding process. Students will also practice basic procedural coding techniques.


c. Lecture/Discussion: Procedural Coding Discussion: We will discuss procedure coding, including the purpose, code

structure, categories, and bundled and unbundled codes. We will exam the CPT manual, including the sections to the manual.





d. Writing Activity: Procedural Coding Description: Students will work together to answer study guide exercises.


Chapter 19, Vocabulary Review. Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).



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e. Lecture/Discussion: Procedural Coding ProcedureDescription: We will discuss procedural coding in detail, including the steps to take as you code charges. Using the alphabetic and tabular indexes and coding specific charges will be described.





f. Demonstration: Procedural Coding IntroductionDescription: Instructor will provide orientation to the CPT book.

Directions:o Student use classroom copies of the CPT book.o Provide an orientation to the CPT book. Show students how to

find different codes. Then select a random code and have the students find it. Repeat this process several times to familiarize students with the book.

Book: 2015 Professional Edition CPT 2015 Estimated time: 20 minutes

g. Lecture/Discussion: Procedural Coding Description: We will be discussing evaluation and management, level of service, history and examination, and complexity levels. Specialty coding will be discussed along with HCPCS Codes.





h. Lesson Summary: Procedural Coding ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the key procedure steps involved with procedural coding and the need for accuracy when coding charges.


students need to complete. o Instructor will identify which version of ICD the students should

address in the Worksheet. Documents: Ch 19 Coding Worksheet.docx, Ch 19 Coding Worksheet

Key.docx Estimated Time: 10 minutes

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III. Out-of-Class Learning Assignments (Homework): Read: Kinn’s The Medical Assistant: An Applied Learning Approach

o Chapter 19 “Basics of Procedural Coding” Estimated Time: 2.5 hours

Assignments:o Complete: Coding Worksheet

Document: Ch 19 Coding Worksheet.docx Estimated Time: 1 hours


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Week Five Lesson One

I. Learning Objectives: CO3, CO4, CO5

Apply managed care policies and procedures. Identify types of insurance plans and models of managed care plans. Discuss the different types of physician fee schedules. Define Diagnosis-Related Groups (DRGs). Discuss the managed care referral process as it applies to the medical office. Describe utilization review principles. Demonstrate verifying eligibility, obtaining precertification and

preauthorization, and using appropriate documentation.

Apply third-party billing guidelines. List major third-party payers. Describe guidelines for third-party claims. Describe RBRVS. Discuss worker’s compensation as it applies to patients.

Demonstrate basic procedural and diagnostic coding. Demonstrate procedural coding.


a. Homework Review: Review out-of-class assignments from Week 4, Lesson 2.Description: Review and answer questions on procedural coding

Directions: o Review any areas in which students are unclear on procedural

coding. Answer any questions they have on the topic.o Collect the Ch 19 Coding Worksheets for grading.

Documents: Ch 19 Coding Worksheet.docx, Ch 19 Coding Worksheet Key.docx

Time: 10 minutes

b. Lesson Overview: Basics of Health Insurance Description: Students will have an opportunity to perform procedural coding. Students will discuss types of health insurance, insurance benefits, models of managed care and third-party payers. Students will also discuss procedures for implementing managed care and insurance plans, procedures for verifying insurance benefits, fee schedules, and workers’ compensation. Referrals and precertification, procedures for performing eligibility and verification of benefits, and preauthorization procedures will also be covered.


c. Lab: Procedural Coding Description: Students will find procedural codes for scenarios.

Directions:o Student use classroom copies of the CPT book.

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o Assist the class to find the answers for Study Guide Chapter 19, Coding Exercises (#1-3).

o When you feel the class is confident with looking up the codes, have them complete Coding Exercises (#4-18)

o When students have completed the questions, collect the assignment for grading.

o Please note that the remaining section will be used for other courses. Please keep these documents intact in the SG.

Books: Kinn’s The Medical Assistant Study Guide (SG) – Ch 19 “Coding Exercises,” 2015 Professional Edition CPT 2015

Document: Ch 19 Study Guide Key.docx Estimated time: 75 minutes

d. Test Preparation: Insurance Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.






e. Lecture/Discussion: Insurance OverviewDescription: We will discuss the basics of insurance, including primary and secondary coverage, deductible, co-insurance, co-payment, types of policies, and type of benefits. We will also discuss how benefits are determined, including indemnity schedules, resource-based relative value scale (RBRVS), relative value scale (RVS), diagnosis related groups (DRGs) and usual, customary, and reasonable fees. Managed care plans, HMO models, Blue Cross/Blue Shield, Medicaid, Medicare, TRICARE, CHAMPVA, Workers’ Compensation, and disability programs will be discussed.



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f. Writing Activity: Insurance Description: Students will work together to answer study guide exercises.


Chapter 20, Vocabulary Review (#1-16). Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).



g. Lecture/Discussion: Insurance BasicsDescription: We will discuss utilization review. Insurance benefit verification, precertification, preauthorization, referrals and their impact on claims will be explained.. We will discuss third-party payers and fee schedules.





h. Lab: Completing Progress Notes Description: Students will complete physician’s progress notes for continued disability using a mock patient record.

Directions:o Review the directions with the students. Have them complete

Workbook, Chapter 11 “Performance Objective 11-7: Progress Notes: Continued Disability Form”.

o Upon completion, collect documents for grading. Book: Health Insurance Today Workbook – “Performance Objective 11-

7.” Document: Ch 11 Workbook Key.docx Estimated time: 25 minutes

i. Lab: Completing a Release to Return to Work Description: Students will complete a Release to Return to Work form using a mock patient record.

Directions:

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o Review the directions with the students. Have them complete Workbook, Chapter 11 “Performance Objective 11-8: Release to Return to Work”.

o Upon completion, collect documents for grading. Book: Health Insurance Today Workbook – “Performance Objective 11-

8.” Document: Ch 11 Workbook Key.docx Estimated time: 25 minutes

j. Lesson Summary: Insurance ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the medical assistant’s role with insurance. Discuss how the verification activities at the check-in desk impact the claims and payment process.




Read: o Kinn’s The Medical Assistant: An Applied Learning Approach

Chapter 20 “Basics of Health Insurance” Estimated Time: 2 hours

o Health Insurance Today: A Practical Approach Chapter 17 “Reimbursement Procedures: Getting Paid”, (read: “Other

Systems for Determining Reimbursement” section) Estimated Time: 30 minutes

o Health Insurance Today: A Practical Approach Chapter 11 “Miscellaneous Carriers: Workers’ Compensation and

Disability Insurance” Estimated Time: 2 hours – optional reading


Study Guide Chapter 20 “Basics of Health Insurance,” Vocabulary Review (#17-33)

and “Skills and Concepts” Estimated Time: 2 hours


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Week Five Lesson Two

I. Learning Objectives: CO3, CO4 Apply managed care policies and procedures. Demonstrate verifying eligibility, obtaining precertification and preauthorization,

and using appropriate documentation.

Apply third-party billing guidelines. Complete the universal claim form. Demonstrate assertive communication with managed care providers and

sensitivity when providers and patients.




assignment for grading purposes. o Review the correct answers for Ch 20 exercises [Vocabulary

Review (#17-33), Skills and Concepts]. o Review the answers and discuss the major concepts of the


b. Lesson Overview: Claim FormsDescription: Students will discuss the differences between paper and electronic claim forms, “clean” and “dirty” claims, and how to prevent rejection of claims. Students will also discuss and complete a CMS-1500 claim form.


c. Test Preparation: Claim Forms Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.




o Instructor note: Periodically, remind the students to create the questions throughout the day. Collect the cards at the end of the

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day. Sort through and use the questions during the test review session. Keep the cards and use again during the midterm and final test review sessions.


d. Lecture/Discussion: Health Insurance Claim Form Description: We will discuss the insurance claim form, including the completion rules, the role of the clearinghouses, electronic submissions, and the steps to complete the form.





e. Virtual Lab: Insurance Forms and Verification SimulationDescription: Students will use the VMO learning tools to apply what they have learned regarding insurance forms and the verification process. Instructors will use the classroom computer to present this simulation activity to the class, while students complete worksheets individually at their desks, following the presentation.

Directions: o Use the classroom computer to project the VMO activity. o Sign into the Virtual Medical Office Online Study Guide and

navigate to the simulations using the following click path:o Evolve Resources for Virtual Medical Office for Kinn’s The Medical

Assistant, 12th Editiono Open Simulations – VMOo Open Online Study Guideo Open Lessson 9: Insurance Forms and Verificationo Review the directions for Lesson 9 “Insurance Forms and

Verification.” o Have students complete Lesson 9 – Exercises 1-2 in their VMO

Study Guide. o After the students have completed the assignment, collect the

documents for grading. Book: Kinn’s Virtual Medical Office – Study Guide with Online Simulation,

Lesson 9 “Insurance Forms and Verification” Document: VMO Lesson 9 Key.pdf Estimated Time: 60 minutes

f. Role Play Lab: Complete CMS-1500 Form Description: Students will gather patient data using scenarios, verify eligibity, obtain preauthorization and other information. Students will complete a CMS-1500 claim form.

Directions: o Have the students find the following documents:

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PCM Procedure 21-1 “Gather Data to Complete CMS-1500 Form”

PCM Work Product 21-1 to 21-2 Study Guide Ch 21 “Part I: Completing Insurance Claim

Forms”, #1 and 2.o Review the procedure with the class. o They should follow Procedure 21-1 “Gather Data to Complete

CMS-1500 Form” as they complete the Work Product 21-1 and 21-2, using the information in Ch 21 Study Guide “Part I: Completing Insurance Claim Forms”, 1-2.

o Divide the class into groups of 2 students and have them complete the Work Products.

o For one of the scenarios, have the students use role play to gather the information necessary for the claim form. Students can verbalize steps if unable to complete.

o Upon completion, collect the documents for grading. Document: Ch 21 Study Guide Key.docx Book: Kinn’s The Medical Assistant PCM, Procedure 21-1 “Gather Data

to Complete CMS-1500 Form” and Work Products 21-1 to 21-2; Kinn’s The Medical Assistant Study Guide (SG) – “Part I”; Professional Edition CPT 2015, ICD-10-CM Draft Edition


g. Role Play Lab: Managed Care Description: Students will role play scenarios dealing with communicating with insurance companies and patients and practicing assertive communication skills. After the role play, students will answer discussion questions.

Directions: o Divide the class into pairs. o Give each student the Managed Care Role Play document and

review the directions.o Students may use their Kinn’s textbook as a resource when

answering the discussion questions.o Upon completion, collect the documents for grading.

Book: Kinn’s the Medical Assistant: An Applied Learning Approach Document: Managed Care Role Play.docx, Managed Care Role Play


h. Writing Activity: Complete Claim Form and Review an Explanation of BenefitsDescription: Students will complete a CMS-1500 claim form and answer questions regarding an Explanation of Benefits (EOB) document.

Directions: o Review Chapter 6 Case Studies A to D with the students. They

may need extra assistance with the ledger card and the EOB.o Allow the students to work in pairs to complete these case studies. o Upon completion, collect the documents for grading.

Document: Ch 6 Workbook Key.docx Book: Health Insurance Today Workbook, Chapter 6 Case Studies Estimated Time: 50 minutes

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i. Test Preparation: Health Insurance Claim Form ReviewDescription: Use the mock test questions the students wrote to review the chapter content.




j. Lesson Summary: Claim Form ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the importance of completing the claim accurately. A brief description of what can occur if the claim is rejected, including the time and money (wage) it takes to reflle the claim.




Read: o Kinn’s The Medical Assistant: An Applied Learning Approach

Chapter 21 “The Health Insurance Claim Form” Estimated Time: 2 hours

o Health Insurance Today: A Practical Approach Chapter 6 “Traditional Fee-for-Service/Private Plans” - (read:

“Commericial Claims Involving Secondary Coverage” section) Estimated Time: 30 minutes

Chapter 15 “The Claim” - (read: “Claim Process” section) Estimated Time: 30 minutes


Study Guide Chapter 21 “The Health Insurance Claim Form,” Vocabulary Review. Estimated Time: 2 hours

Study: For Insurance Test (Ch 20 & 21)o Estimated Time: 2 hours


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Week Six Lesson One

I. Learning Objectives: CO2, CO6 Perform basic medical practice financial procedures including fee determination, billing, bookkeeping, collections, and banking.

List three values that are considered in determining professional fees. Explain basic bookkeeping computations. Explain both billing and payment options. Identify procedures for preparing patient accounts and collecting outstanding

accounts. Discuss the types of adjustments that may be made to a patient's account.


Describe the impact of the Fair Debt Collection Practices Act on the medical office.

Discuss the Federal Truth in Lending Act as it applies to debt collection practices.




assignment for grading purposes. o Review the correct answers for Ch 21 exercises (Vocabulary

Review). o Review the answers and discuss the major concepts of the


b. Assessment: Insurance TestDescription: Multiple choice test covering content from “Ch 20 – Basics of Health Insurance,” and “Ch 21 – The Health Insurance Claim Form.”

Directions: o Provide students with test document and blank answer sheeto Students will have 35 minutes to complete the test. o Students are not allowed to use any resources to complete the

test. Documents: Test 3 (Ch 20 & 21) Student A.docx, Test 3 (Ch 20 & 21)

Key A.docx or Test 3 (Ch 20 & 21) Student B.docx, Test 3 (Ch 20 & 21) Key B.docx


c. Lesson Overview: Billing and Collections Description: Students will discuss billing principles, bookkeeping, accounting, collection procedures and banking procedures. Students will also discuss the related vocabulary and laws involved with these topics.

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d. Test Preparation: Billing and Collections Description: To help students think of potential test questions, think critically about the material presented, and to learn the material, students will be ask to write 2-3 mock test questions that will be used during the chapter review session.






e. Lecture/Discussion: Billing and Collections Description: We will discuss how fees are determined, insurance allowances, computerized and paper billing systems, payment options, and bookkeeping computations and procedures. Bookkeeping entries, including adjustments, credit balances, refunds and insufficient funds checks are also explained.





f. Writing Activity: Billing and Collections Description: Students will work together to answer study guide exercises.


Chapter 22, Vocabulary Review. Students can use their textbooks as references (especially the Vocabulary section in the beginning of the chapter).

o Upon completion, review answers with the class.

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Books: Kinn’s The Medical Assistant and Kinn’s The Medical Assistant Study Guide (SG) – Vocabulary Review

Document: Ch 22 Study Guide Key.docx Estimated time: 30 minutes

g. Lecture/Discussion: Billing and CollectionsDescription: We will discuss acts that impact billing and collection activity, including Truth in Lending Act and Fair Debt Collection Practices Act. Billing cycles, professional courtesy, billing minors, bankruptcy, collection procedures, and litigation circulmstances will be explained.

Directions: o For this discussion, use the PowerPoint presentation, and for




h. Lecture/Discussion: Financial Management Description: We will be discussing banking procedures, accounts payable and recievable, common periodic accounting procedures, and maintaining a petty cash fund.



o Note: This information will not be on the test, but the students will need it when completing the Bookkeeping Worksheet. You may want to give the students a copy of the PowerPoint so they can review the content. This content is pulled from Ch 23 and 24.

Document: Financial Management PowerPoint.pptx, Slides 1-48 Discussion Points: To get a printed copy of the talking points for each


i. Lesson Summary: Coding, Billing, Banking, and Accounting ReviewDescription: Summarize the day’s lesson, including the important points, and review the out-of-class assignments. The instructor should reflect on the role of the medical assistant with bookkeeping, banking and collections. Being honest, accurate, and sensitive to patients regarding their debt should be discussed.


students need to complete. o Bookkeeping and Collections Assignment

Give each student a copy of the Bookkeeping and Collections Assignment document.

Review the directions with the students Documents: Bookkeeping Assignment.docx, Ch 22 Study Guide

Key.docx

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Book: Kinn’s The Medical Assistant PCM, Procedure 22-2 to 22-6, 22-8, and 22-10 and Work Products 22-1 to 22-7; Kinn’s The Medical Assistant Study Guide (SG) – “Part I-II”

Supplies: Calculator Estimated Time: 25 minutes

III. Out-of-Class Learning Assignments (Homework): Read: Kinn’s the Medical Assistant: An Applied Learning Approach

o Chapter 22 “Professional Fees, Billing and Collecting” Estimated Time: 2.5 hours

Assignments:o Complete: Bookkeeping and Collections Assignment

Documents: Bookkeeping Assignment.docx Estimated Time: 2 hours

Study: for Comprehensive Exam (Ch 14-22, ICD-10, and Financial Management)o Estimated Time: 6 hours


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Week Six Lesson Two


Perform basic medical practice financial procedures including fee determination, billing, bookkeeping, collections, and banking.

Describe banking procedures performed in a medical office.


a. Homework Review: Review out-of-class assignments from Week 6, Lesson 1.Description: Review the study guide exercises the students did for homework.

Directions:o Review and respond to any questions from Ch 22 or the study

guide project.o Answer any questions from the assigned reading.o Collect the Bookkeeping and Collection assignment for grading.


b. Lesson Overview: Billing and Collections Description: Students will apply what they have learned about billing, collections, banking, and accounting as they complete a practical bookkeeping and collections project.


c. Writing Activity: Bookkeeping WorksheetDescription: Students will complete questions that have been covered in the PowerPoint.

Directions:o Provide each student the Bookkeeping Worksheet and review the

directions. o Have the students complete the assignment.o Students can use Ch 23 and Ch 24 in their textbooks as

references. o When students have completed the assignment, collect the

documents for grading. Book: Kinn’s The Medical Assistant Document: Bookkeeping Worksheet.docx, Bookkeeping Worksheet


d. Virtual Lab: Bookkeeping SimulationDescription: Students will use the VMO learning tools to apply what they have learned regarding bookkeeping and banking procedures. Instructors will use the classroom computer to present this simulation activity to the class, while students complete worksheets individually at their desks, following the presentation.

Directions: o Use the classroom computer to project the VMO activity.

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o Sign into the Virtual Medical Office Online Study Guide and navigate to the simulations using the following click path:

o Evolve Resources for Virtual Medical Office for Kinn’s The Medical Assistant, 12th Edition

o Open Simulations – VMOo Open Online Study Guideo Open Lesson 10: Bookkeeping o Review the directions for Lesson 10 “Bookkeeping”:

Exercise 2 – Posting Entries to a Day Sheet Exercise 3 – Preparing a Bank Deposit Exercise 7 – Reconciling a Bank Statement

o Have students complete Lesson 10 Exercise 2, 3, and 7 in their VMO Study Guide.

o After the students have completed the assignment, collect the documents for grading.

Book: Kinn’s Virtual Medical Office – Study Guide with Online Simulation, Lesson 10 “Bookkeeping”

Document: VMO Lesson 10 Key.pdf Estimated Time: 105 minutes

e. Test Preparation: Comprehensive ReviewDescription: Use the mock test questions the students wrote to review the chapter content from the entire course.




f. Assessment: Medical Records and Insurance Comprehensive Test Description: Multiple choice test covering chapter content.

Directions: o Provide students with test document and blank answer sheet

Documents: Test 4 Final Student A.docx, Test 4 Final Key A.docx or Test 4 Final Student B.docx, Test 4 Final Key B.docx


g. Lab: Compose a Collection LetterDescription: Students will use a scenario to compose a collection letter.

Directions:o Provide each student with the “Compose a Collection Letter

Project” document. o Review the directions with the students. They will use the PCM

Work Product 22-8 as stationary for the letter. o Upon completion, collect the documents for grading.

Books: Kinn’s The Medical Assistant: An Applied Learning Approach – Procedure Checklist Manual –“Work Product 22-8.”

Estimated time: 20 minutes

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h. Remediation Discussion: Exam Review Description: Students will review the exam results and students will receive remediation as needed.

Directions:o Provide the students with the exam results.o The instructor should provide remediation to the students who

need it. Estimated time: 30 minutes

i. Lesson Summary: Coding, Billing, Banking, and Accounting ReviewDescription: Summarize the day’s lesson, including the important points, and wrap up the course. The instructor should reflect on the important medical record, insurance, coding, billing, and collection activities that a medical assistant does in the medical office.

Directions:o After the summary, wrap up any course issues.



NoneInstructional materials can be found in the Week 6, Lesson 2 course folder.

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