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Sep 07, 2024
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AHM 2040 - Medical Assistant II
Clock Hours: 72
Delivery Mode on-ground
Prerequisites: AHM 1070
Industry Certifications Certified Clinical Medical Assistant (CCMA)
Course Description: This course introduces the basic concepts of administrative medical assisting The student develops essential skills required for the typical medical office in the areas of: ICD-10, CPT coding, accounting, insurance billing, banking and payroll, Students will have opportunities to practice manual and computerized information management
Student Learning Outcomes:
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Identify the structure and the format of the ICD-10
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Describe how to use the Alphabetic index to select main terms, essential modifiers and the appropriate code ranges
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Explain how to use the tabular index
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Describe how to use the most current diagnostic codes and perform diagnostic coding
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Summarize coding conventions
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Distinguish between the alphabetic index and the tabular index
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Classify the six different sections of the CPT code set
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Review various conventions in the CPT code set
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Identify the required medical documentation for accurate procedural coding
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Identify common CPT coding guidelines for (E/M) procedures
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Identify procedures and services that require HCPS codes
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Describe how to use the most current HCPS level II coding system
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Identify types of third-party plans
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Explain the importance of verifying eligibility and be able to verify eligibility services, including documentation
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Explain how insurance reimbursements are determined
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Describe privately sponsored health insurance plans
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Differentiate among the different types of managed care models
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Review the process for preauthorization and how to obtain preauthorization including documentation
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List and discuss various government-sponsored insurance plans
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Review employer-established self-funded plans
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Identify steps for filing third-party claims
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Identify the types of information contained in the patient’s billing record
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Demonstrate how to submit health insurance claims, including electronic claims
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Complete a CMS 1500 claim form
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Review and explain Explanation of Benefits
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Define medical necessity guidelines
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Explain a patient’s financial obligation for services rendered
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Perform accounts receivable procedures for patient accounts: Charges
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Perform accounts receivable procedures in patient accounts: Payments and Adjustments
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Describe the patient Truth in Lending Act when offering credit options for payment
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Describe professional courtesy
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Describe collection procedures
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Describe banking procedures as related to the ambulatory care setting
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Explain the importance of depositing checks daily
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Prepare a bank statement
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Understand the purpose of bank account reconciliation for auditing purposes
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