STANDARD COMPETENCIES

 

 1. Describe banking procedures. (MAERB VI.C. 3)

 2. Explain basic bookkeeping systems. (MAERB VI.C.1,2,7)

 3. Define the bookkeeping terms.

 4. Describe types of adjustments made to patient accounts.

 5. Differentiate between accounts payable and accounts receivable. (MAERB VI.C.6)

 6. Perform accounts receivable procedures. (MAERB VI.P.2)

 7. Discuss precautions for accepting checks and demonstrate sensitivity and professionalism in handling accounts receivable activities with clients. (VI.C.4,VI.A.1)

 8. Inform a patient of financial obligations for services rendered.

 9. Obtain precertification or preauthorization including documentation.

 10. Complete an insurance claim form.

 11. Determine components of financial reports and billing.

 12. Explain how financial reports are used to successfully manage the financial health of the medical practice.(VI.C.8)

 13. Input and process data. (MAERB VI. C. 9,10,13 VI.A.3)

 14. Discuss procedures for collecting outstanding accounts. (VI.C. 11)

 15. Describe the impact of the Fair Debt Collection Act and the Federal Truth in Lending Act of 1968 as they apply to collections. (MAERB VI.C.12)

 16. Demonstrate professionalism.

 17. Utilize computerized office billing systems. (MAERB VI.A.3)

 18. Describe how to use and perform basic procedural coding system.

 19. Describe how to use and perform basic diagnostic coding classification system.

 20. Describe how to use the most current HCPCS level II coding system.

 

 

 

 

 TOPICAL OUTLINE

 

 I. Professionalism

      a. Discussing patient's billing record

      b. Requesting payment

      c. Communication third party

 II. Banking

      a. Checking

      b. Bill paying

 III. Accounting and Bookkeeping

      a. Bookkeeping

              i. Manual

             ii. Computerized

      b. Accounting

 IV. Financial Management

      a. Accounts receivable

              i. Posting entries

             ii. Perform billing and collection services

            iii. Post adjustments

            iv. Process a credit balance

      b. Patient financial obligation

              i. Copay

             ii. Deductible

            iii. Verify eligibility

            iv. Precertification

             v. Prior authorization

 V. Customer Service/Professionalism

      a. Medical Necessity for services

 VI. Data

      a. Retrieve patient accounts

      b. Post procedure codes

      c. Post diagnosis codes

      d. Run the daily report

      e. Posting accounts

      f. Modify or correct an account

      g. Schedule and cancel appointments

      h. Print reports from support files

      i. Back up the daily data files

      j. Software functions

      k. Post patient charges and payments

      l. Produce a patient receipt

     m. Complete insurance claim forms

      n. Prepare the daily deposit slip

      o. Age accounts receivable

      p. Compile a variety of reports

 VII. Payroll

      a. FICA

      b. Deductions

      c. Net vs. Gross

 VIII. Medical Office Management Software

      a. Coding for diagnosis

      b. Coding for procedures