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ALH 0005 - Medical Office Procedures

http://catalog.sierracollege.edu/course-outlines/alh-0005/

Catalog Description Prerequisite: Completion of ALH 1, 2, 3, and 4 with grades of "C" or better Hours: 90 (36 lecture, 54 laboratory) Description: Designed for the Clinical Medical Assistant to learn legal/ethical and accepted procedures for any ambulatory setting. (letter grade only) (not transferable) Course Student Learning Outcomes CSLO #1: Recognize and apply legal and ethical responsibilities related to the role of the Medical Assistant to include HIPPA standards. CSLO #2: Identify and describe various types of insurance plans, specifically HMO, PPO, POS, Medicare, Medicaid, and government sponsored programs to include Workman’s Compensation and Disability. CSLO #3: Demonstrate communication skills that apply to individual client/patient needs. Effective Term Fall 2023 Course Type Credit - Degree-applicable Contact Hours 90 Outside of Class Hours 72 Total Student Learning Hours 162 Course Objectives Lecture Objectives: 1. Recognize and apply legal and ethical responsibilities. 2. Apply HIPAA standards as they relate to the role of Medical Assisting. 3. Compare and contrast types of insurance plans, specifically HMO, PPO, and POS. 4. Distinguish between Medicare, Medicaid and government sponsored programs to include Workman’s Compensation and State Disability. 5. Recognize and apply communication skills that apply to individual client/patient needs. 6. Demonstrate how to triage patient phone calls. 7. Illustrate how to schedule patient appointments Laboratory Objectives: 1. Show the difference between legal responsibilities and ethical responsibilities in the Medical Assisting role. 2. Show what constitutes a violation of HIPAA standards. 3. Explain third-party payers and types of insurance. 4. Demonstrate understanding of Medicare, Medicaid, Workman's Compensation and State Disability. 5. Develop and apply active listening and communication skills. 6. Perform triage and show proficiency while communicating with patients on the phone and in the office. 7. Demonstrate scheduling methods via paper and computer. General Education Information Approved College Associate Degree GE Applicability CSU GE Applicability (Recommended-requires CSU approval) Cal-GETC Applicability (Recommended - Requires External Approval) IGETC Applicability (Recommended-requires CSU/UC approval) Articulation Information Not Transferable Methods of Evaluation Classroom Discussions Example: Instructor gives HIPAA case scenarios and students will discuss and decide whether it violates HIPAA standards. Objective Examinations Example: Students will take a multiple Choice Examination on various types of medical plans. Standard grading. Example as it pertains to HMO/PPO and POS Plans. Which type of insurance plan requires a referral to see a specialist every time? a. HMO b. PPO c. POS d. Indemnity Answer = A (HMO) Problem Solving Examinations Example: Student will answer chapter specific critical thinking exercises. Example: Chapter 16 Health insurance: A. What process will you go through to determine whether a bronchoscopy is a covered benefit? B. What process will you go through to determine if prior approval is necessary? Standard grading applies Skill Demonstrations Example: Students will demonstrate their ability to schedule 3 consecutive days of patients for two doctors. Students will need to pay close attention to availability of the two physicians and new vs. established patients. Standard Grading. Repeatable No Methods of Instruction Laboratory Lecture/Discussion Distance Learning Lab: Students will read the MA Code of Ethics in their book. Instructor will give students a handout with examples to differentiate whether it constitutes a legal or ethical responsibility or both. Instructor will assign Role-play job skill from the workbook on Ethics. Following Whiteboard presentation by instructor, students will work in teams to evaluate HMO/PPO/POS plans on Covered California website using a worksheet provided by the instructor. Lecture: Instructor to use Whiteboard to start discussion on Insurance to include what is an insurance company and what is an insurance plan; specifically HMO/PPO/POS plans. Instructor will explain all requirements. Students will participate in discussion on the various aspects of each plan. Distance Learning Instructor PowerPoint presentation on legal and ethical responsibilities of a Medical Assistant. Students will participate in discussion on the difference between law and ethics. Typical Out of Class Assignments Reading Assignments 1. Students will read section in the textbook on law and ethics, HIPPA standards and be prepared to discuss next class. 2. Students will read section in the textbook on various scheduling techniques and discuss in small groups next class meeting. Writing, Problem Solving or Performance 1. Students will analyze HIPPA case studies and write out possible solutions. 2. Students will complete worksheet on law versus ethics. Students will bring to next class to discuss and compare answers. Other (Term projects, research papers, portfolios, etc.) 1. Research (using textbook, internet and library), California State Disability requirements and how Workman’s Compensation is different than private insurance. Complete one page research paper on both. Required Materials Administrative Medical Assisting Author: Linda L. French Publisher: Delmar Cengage Learning Publication Date: 2017 Text Edition: 8th Classic Textbook?: OER Link: OER: Administrative Medical Assisting Workbook Author: Linda L. French Publisher: Delmar Cengage Learning Publication Date: 2017 Text Edition: 8th Classic Textbook?: OER Link: OER: Other materials and-or supplies required of students that contribute to the cost of the course.