1. What competencies are needed for entry level employment in healthcare/HIS?
Healthcare skills: (anatomy and physiology, medical terminology, pathophysiology, clerical and administrative procedures, laws and ethics, communications),
Computer skills :(MS office, EHR, Internet, billing-related/PM, data mining, records management, coding/cac,
And knowledge of healthcare reform: (privacy and security, HIPPA, HITECH, PPACA, ICD-10) for the greatest career opportunities for advancement.
2. Describe various professions (clinical and administrative) and their roles and responsibilities in the medical office.
Physicians, primary clinicians in the practice
Physician Assistants, formally trained to provide diagnostic, therapeutic, and preventative health care services under the supervision of a physician.
Nurses, perform a wide range of clinical and non clinical duties. Caring for patient and developing care plans or contribute to existing ones. Nurses administer Iv medications, blood products and other various duties.
Medical Assistants, trained perform both clinical tasks and administrative duties. MA’s collect specimens, obtain medical history and vital signs, prepare for and assist with medical procedures.
3. What is SOAP format?
Soap (subjective, objective, assessment and plan) is the format used to enter progress notes.
4. Define medical coding and list and describe the different code sets.
Medical coding is the process of applying HIPPA mandated code sets to assigned codes to diagnoses and procedures.
Code sets include:
CPT: (current procedural terminology), used for reporting medical procedures and services.
HCPCS: (healthcare common procedure coding system), procedure code for medicare claims
ICD-9: (international classification of diseases ninth revision, clinical modification), the source of the codes used for reporting diagnoses.
5. Submit Exercise 7.3 on page 329 of the text. (previously completed) (Chapter 7) Answer here
6. Chapter 8 describes different types of health plans. List them.
Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
Health Savings Account (HSA): A Health Savings Account allows individuals to pay for current health expenses and save for future qualified medical expenses on a pretax basis.
7. List and briefly describe the four major government-sponsored insurance programs.
Medicare: is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
Medicaid: is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services.
TRICARE: is the health care program for almost 9.5 million beneficiaries worldwide—including active duty service members, National Guard and Reserve members, retirees, their families, survivors, certain former spouses and others registered in the Defense Enrollment Eligibility Reporting System
CHAMPVA: The Civilian Health and Medical Program of the Department of Veterans Affairs is a health benefits program in which the Department of Veterans Affairs (VA) shares the cost of certain health care services and supplies with eligible beneficiaries.