Week 1 review (Stepful) in depth

Scope of practice

Delegated clinical and administrative duties consistent with education , training , and experience .

Standard of care

The degree of care or competence expected in a particular circumstance or role .

Administrative Duties

. Greeting patients

Handling correspondence Scheduling appointments

• Answering phones .

Maintaining medical records Billing , insurance processing

• Performing medical transcription

• Arranging hospital admissions .

Clinical Duties

• Assisting during exams

• Following infection control Performing diagnostic tests

• Giving injections Phlebotomy • Performing first aid

Administering medications Recording vital signs

. Removing sutures , changing dressings

• Sterilizing medical equipment

• Assisting in minor surgery

. Patient education

( OSHA )

Occupational Safety and Health Administration ( OSHA )

- Safety in the workplace

( CLIA '88 )

. Clinical Laboratory Improvement Amendments of 1988 ( CLIA '88 )

- Laboratory compliance

( HIPAA )

Health Insurance Portability and Accountability Act ( HIPAA )

- Privacy

MA programs are accredited by :

- The Commission for Accreditation of Allied Health Education Programs ( CAAHEP )

- Accrediting Bureau of Health Education Schools ( ABHES )

Scope of practice

• Know your scope of practice and work within it .

• Medical assistants must work under a licensed healthcare provider

. You may be delegated duties provided you have had the appropriate training to do the task delegated .

• No national definition of a medical assistant's scope of practice .

• Research the state in which you work to learn about your scope of practice .

Ambulatory

Able to walk

Managed care

A term for medical plans that provide health care in return for preset scheduled payments coordinated through a network of providers and hospitals .

Osteopathic

A type of medical care based on how the musculoskeletal system affects other body parts and using various manipulative methods along with conventional medical , pharmacological and other therapeutic procedures .

Professionalism

The skills , behavior and appropriate judgment that represent the best qualities of a person in a specific profession .

Work ethic

A set of values based on the moral virtues of hard work and diligence .

Medical doctors ( MD )

Diagnosis illness , provides treatments , performs procedures , writes prescriptions . Uses drugs or surgery

Osteopathic providers ( DO )

Uses modern medicine techniques and surgical procedures and osteopathic manipulative therapy .

Nurse practitioners ( NP )

Diagnose prescribe medications Focuses on preventative care and disease prevention .

Physician assistant ( PA )

Practices medicine under the direction and supervision of a licensed MD or DO . Able to make clinical decisions

Medical laboratory technician

Performs testing on blood , body fluids , and other specimens

Pharmacy technician

Assists pharmacists with duties .

Radiology technician

Uses imaging equipment to assist providers in diagnosing and treating diseases .

Accountable care organizations ( ACO )

Groups of physicians , hospitals , and care providers come together voluntarily to provide quality care to Medicare patients .

Patient - centered medical home ( PCMH )

Care delivery model - primary care provider ( PCP ) coordinates treatment to make sure patients receive required care .

Health maintenance organization ( HMO )

- Plan contracts with groups of providers and facilities for preventative and acute care for patients . HMOs require referrals to specialists , precertification , and preauthorization for hospital admissions , outpatient procedures , and treatments .

Preferred provider organization ( PPO )

Plan has more flexibility than an HMO . Patient is not required to have a PCP , can go directly to a specialist without referrals . In - network and out of network providers .

Long - term care : Nursing Homes and Assisted Living

- Residents require healthcare on a regular bases

- Frail , elderly & disabled

Hospice care

Patients with less than six months to live Terminal conditions

Palliative Care

Only relieving pain

Ambulatory ( Walk in )

- Physician offices / Clinics

- Urgent Care centers

- Hospitals / Emergency Department - Surgical Centers

General providers

- Able to assess a wide range of symptoms - Diagnose and builds treatment plans .

Specialist providers

- Assess more specific sets of symptoms , diagnoses , and conditions

General practitioners ( GP )

Medical doctors who treat acute and chronic illnesses and provide preventative care and health education . May take holistic approach to healing .

Internists

Diagnosing and treating chronic conditions . Offer treatment for common illnesses and preventative care .

Cardiologists

Specializes in conditions of the heart and blood vessels .

Dermatologists

Specializes in conditions of the skin .

Endocrinologists

Specializes in hormonal and glandular conditions , Diabetes , thyroid .

Gastroenterologists

Specializes in disease of the gastrointestinal tract stomach , intestines , esophagus , liver , pancreas , colon , rectum

Gynecologists

Specialize in the female reproductive system .

Nephrologists

Specializes in kidney care and disorders of the kidneys .

Obstetricians

Care of women during and after pregnancy .

Oncologists

Specializes in cancer treatments .

Ophthalmologists

Specialize in eye conditions .

Orthopedists

Specialize in bones , joints , muscles , tendons , and ligaments .

Otolaryngologists / Otorhinolaryngologi st ( ENT )

Specializes in ear , nose , and throat .

Government plans

- Medicare - patients over 65 and older , Part A ( hospitalization ) , Part B ( medical office visits ) , Part D ( medications )

- Medicaid - medically indigent / low income

- Tricare - active duty service and family members ,

- ( CHAMPVA ) - Veterans Affairs

Private plans

- Group

- Individual

• Examples : Blue Cross , Humana , Aetna , Cigna

• Worker's compensation

Allowed amount

Maximum amount a third - party ( insurance ) will pay for a procedure or service .

Copay

A set amount of money that is paid by the patient at the time of service .

Coinsurance

The policyholder and insurance carrier share costs , 80/20

Deductible

Amount of money paid out of pocket before insurance carrier begins paying .

CMS - 1500 Form

★ Used by most health care payers to invoice insurance government plans .

★ Medical assistant must have all information to complete form

★Sent electronically to insurance companies and government plans .

Direct billing

insurance carrier allows provider to submit directly to insurance company electronically

Clearinghouse

allows provider to submit all insurance claims using software . Clearinghouse audits , sorts claims , and send them to the appropriate insurance company .

o Must be sent timely

■ For Medicare and Medicaid claims - invoice cannot exceed 12 months from service .

Ambulatory

Able to walk

Managed care-

A term for medical plans that provide health care in return for preset scheduled payments coordinated through a network of providers and hospitals .

Osteopathic

A type of medical care based on how the musculoskeletal system affects other body parts and using various manipulative methods along with conventional medical , pharmacological and other therapeutic procedures .

Professionalism

The skills , behavior and appropriate judgement that represent the best qualities of a person in a specific profession .

Work ethic

A set of values based on the moral virtues of hard work and diligence .

Amputation

Surgical removal of all or part of a limb or extremity .

Biopsy

The removal and examination of tissue to diagnose a disease .

Coronary artery bypass graft

Surgery that eliminates a blockage in an artery going to the heart .

Coronary artery disease

A disorder that involves partial or complete blockage of blood vessels that supply the heart .

Chronic obstructive pulmonary disease breathing

A persistent disorder that impairs breathing

Dilation and curettage

Surgery involving the use of an instrument to open the cervix and then cutting away tissue inside the uterus for therapeutic purposes

Electrocardiogram

A record of the heart's electrical impulses

Genitourinary

Referring to the urinary and reproductive organs

Gynecology

The type of medical practice that deals with the female reproductive system

Hematocrit

The percentage of blood sample that is red blood cells .

Hemoglobin

The red oxygen carrying pigment of red blood cells .

Incision

A surgical wound that results from cutting into tissue

Myocardial infarction

An interruption of blood flow to the heart causing heart muscle damage , AKA heart attack .

Nasogastric

from the nose to the stomach .

Obstetrics

The type of medical practice that deals with women giving birth .

Pelvic inflammatory disease

A bacterial infection of the female reproductive organs .

Rheumatoid arthritis

An autoimmune disease that causes pain swelling and deformity especially in the hands and feet due to inflammation in the joints .

Tonsillectomy

Surgical removal of the tonsils

Adenoidectomy

The removal of small masses of lymphatic tissue near the opening into the pharynx .

Tuberculosis

A highly contagious infectious disease of the lungs that causes necrosis , death of lung tissue .

Transient ischemic attack

A temporary interruption of blood flow to the brain .

Urinalysis

A diagnostic examination of urine

Hemi- / Semi- Half ( ½ )

Hemiplegia - Paralysis of half the body

Mono- / Uni- One ( 1 )

Mononuclear

One - lobed nucleus

Bi- / Di Two ( 2 )

Bilaterally

On two sides

Tri Three ( 3 )

Tricuspid valve

Heart valve between . the right atrium & right ventricle

Tetra- / Quad Four ( 4 )

Quadriceps

Muscles of anterior . thigh

Deca (10)

Decaliter

10 liters

Kilo (1,000)

Kilogram

1,000 grams

Deci (10th)

Deciliter

One tenth of a liter

Centi (100th)

Centimeter

One hundredth of a meter

Milli (1,000th)

Microgram

One thousands of a liter

Micro (Millionth)

Microgram

One millionth of a gram

Nano (Billionth)

Nanogram

One billionth of a gram

Albi-

White

Albino

Cirrho-

Tawny yellow

Cirrhosis

Cyan-

Blue

Cyanotic

Erythro-

Red

Erythrocyte

Leuko-

White

Leukocyte

Melano-

Black

Melanoma

Rube-

Red

Rubella

AC , ac

Before meals