What level of education is generally required to obtain a position as a insurance billing specialist quizlet?

Medical assistants work alongside physicians, mainly in outpatient or ambulatory care facilities, such as medical offices and clinics.

In Demand  |  Medical assisting is one of the nation's careers growing much faster than average for all occupations, according to the United States Bureau of Labor Statistics, attributing job growth to the following:

  • Predicted surge in the number of physicians' offices and outpatient care facilities
  • Technological advancements
  • Growing number of elderly Americans who need medical treatment

Job Responsibilities  |  Medical assistants are cross-trained to perform administrative and clinical duties, as evidenced by the Occupational Analysis of Medical Assistants.

Here is a quick overview (duties vary from ​medical practice to medical practice depending on location, size, specialty, and state law):

Clinical Duties (may include, but not limited to):

  • Taking medical histories
  • Explaining treatment procedures to patients
  • Preparing patients for examinations
  • Assisting the physician during examinations
  • Collecting and preparing laboratory specimens
  • Performing basic laboratory tests
  • Instructing patients about medication and special diets
  • Preparing and administering medications, including by intramuscular, intradermal, and subcutaneous injections—including vaccinations/immunizations, as directed by a physician or other licensed provider (e.g., a nurse practitioner or physician assistant)
  • Transmitting prescription refills as directed
  • Phlebotomy
  • Taking electrocardiograms
  • Wound care and changing dressings

Administrative Duties (may include, but not limited to):

  • Using computer applications
  • Answering telephones
  • Welcoming patients
  • Updating and filing patient medical records
  • Coding and filling out insurance forms
  • Scheduling appointments
  • Arranging for hospital admissions and laboratory services
  • Handling correspondence, billing, and bookkeeping

Patient Liaison  |  Medical assistants are instrumental in helping patients feel at ease in the physician’s office and often explain the physician's instructions.

PCMH Team Member  |  Medical assistants are essential members of the ​patient-​centered ​medical ​home team. According to a survey by the Healthcare Intelligence Network, medical assistants ranked as one of the top five professionals necessary to the PCMH team.

CMA (AAMA)® Certification  |  Many employers of allied health personnel prefer, or even insist, that their medical assistants are CMA (AAMA) certified.

The American Association of Medical Assistants (AAMA) offers certification to graduates of medical assisting programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).

The Rights of the Patients

1. Right to Appropriate Medical Care and Humane Treatment. - Every person has a right to health and medical care corresponding to his state of health, without any discrimination and within the limits of the resources, manpowerand competence available for health and medical care at the relevant time. The patient has the right to appropriate health and medical care of good quality. In the course of such, his human dignity, convictions, integrity, individual needs and culture shall be respected. If any person cannot immediately be given treatment that is medically necessary he shall, depending on his state of health, either be directed to wait for care, or be reffered or sent for treatment elsewhere, where the appropriate care can be provided. If the patient has to wait for care, he shall be informed of the reason for the delay. Patients in emergency shall be extended immediate medical care and treatment without any deposit, pledge, mortgage or any form of advance paymentfor treatment.

2. Right to Informed Consent. -  The patient has a right to a clear, truthful and  substantial  explanation,  in  a  manner  and  language  understandable  to  the patient, of all proposed procedures, whether  diagnostic, preventive, curative, rehabilitative or therapeutic, wherein the person who will perform the said procedure shall provide  his  name  and credentials  to  the  patient,  possibilities  of  any  risk  of mortality or serious side effects, problems related to recuperation, and probability of success  and  reasonable  risks  involved:  Provided,   That  the  patient  will not  be subjected  to any procedure without his written informed consent, except in the following cases:

a)  in emergency cases, when the patient is at imminent risk of physical injury, decline Of  death if treatment is withheld or postponed. In such cases, the physician can  perform  any diagnostic  or treatment  procedure  as good practice of medicine dictates without such consent;
b)  when the health of the population is dependent on the adoption of a mass health program to control epidemic;
c)  when the law makes it compulsory for everyone to submit a procedure;
d)  When the patient  is either a minor, or legally incompetent, in which case. a third party consent Is required;
e)  when  disclosure  of  material  information  to  patient  will  jeopardize  the success of treatment,  in which case, third  party disclosure  and consent shall be in order;
f)   When the patient waives his right in writing.

Informed consent shall be obtained from a patient concerned if he is of legal age and of sound mind. In case the patient is incapable of giving consent and a third party   consent  is  required.  the  following  persons,  in  the  order  of  priority  stated hereunder, may give consent:

i.     spouse;
ii.    son or daughter of legal age;
iii.   either parent;
iv.   brother or sister of legal age, or
v.    guardian

If a patient is a minor, consent shall be  ottained  from  his parents or legal guardian. If next of kin, parents or  legal guardians  refuse to give  consent  to  a medical or surgical  proceoure  necessary to save the  life or limb of  a minor or a patient incapable of giving consent, courts, upon the petition of the physician or any person interested in the welfare of the patient, in a summary proceeding, may issue an order giving consent.

3. Right to Privacy and Confidentiality.  -  The privacy of the patients must be assured at all stages of his treatment. The patient has the right  to be free from unwarranted public exposure, except in the  foHowing cases: a) when his mental or physical condition is in controversy and the appropriate court, in its discretion, order him to submit to a physical or mental examination by a physician; b) when the public health and safety so demand; and c) when the patient waives this right in writing.

The patient has the right to demand that all information, communication  and records pertaining to his care be treated as confidential. Any health care provider or practitioner involved in the treatment  of a patient and all those who have legitimate access to the patient's record is not authorized to divulge any information to a third party  who  has  no concern  with  the  care  and  welfare  of  the  patient  without  his consent, except:  a) when  such disclosure  will benefit public  health and  safety; b) when it is in the interest of justice and  upon the order of a competent court; and c) when the patients  waives  in writing the confidential  nature of such  information; d) when  it is  needed  for  continued  medical  treatment  or  advancement  of  medical science subject to de-identification  of patient and shared medical confidentiality  for those who have access to the information.

Informing the spouse or the family to the first degree of the patient's medical condition may be allowed; Provided That the patient of legal age shall have the right to choose on whom to inform. In case the patient is not of legal age or is mentally incapacitated, such information shall be given to the  parents, legal guardian  or his next of kin.

 4. Right to  Information. -  In the course  of his/her  treatment  and  hospital care, the patient or his/her legal guardian has a right to be informed of the result of the evaluation  of the nature and extent of his/her disease,  any other additional  or further  contemplated   medical  treatment on surgical procedure or procedures, including any other additional medicines to be administered and their generic counterpart including the possible complications  and other pertinent facts, statistics or studies,  regarding  his/her  illness,  any  change  in the  plan  of  care  before  the change  is  made,  the  person's  participation  in the  plan  of  care  and  necessary changes  before its implementation, the  extent to  which payment  maybe  expected from Philhealth or any payor and any charges for which the patient maybe liable, the disciplines of health care practitioners who will fumish the care and the frequency of services that are proposed to be furnished.

The patient or his legal guardian has the  right to examine and  be given an itemized bill of the hospital and medical services rendered in the facility or by his/her physician and other health care providers, regardless  of the manner and source of payment.He is entitled to a thorough explanation of such bill.

The  patient  or  hislher  legal guardian  has the  right to  be informed  by the physician or his/her delegate of hisJher continuing health care requirements following discharge, including instructions about home medications, diet, physical activity and all other pertinent information to promote health and well-being.

At the  end of  his/her confinement, the patient is entitled  to a brief, written summary  of the  course  of  his/her  illness which  shall  include  at least the  history, physical examination, diagnosis, medications, surgical procedure, ancillary and laboratory procedures, and the plan of further treatment, and which shall be provided by the attending physician. He/she is likewise entitled  to the explanation  of, and to view, the contents of medical record of his/her confinement but with the presence of his/her  attending   physician  or  in  the  absence  of  the  attending  physician,  the hospital's representative.  Notwithstanding that  he/she   may  not be able  to  settle  his accounts   by reason of  financial   incapacity, he/she is entitled  to reproduction, at  his/her   expense,   the pertinent   part  or  parts  of the  medical   record  the  purpose   or  purposes   of  which   he shall  indicate  in his/her  written  request  for  reproduction.   The  patient  shall likewise  be entitled  to  medical  certifICate, free  of  charge,  with  respect  to  his/her  previous confinement.

5. The Right to Choose  Health  Care Provider  and Facility. -  The patient is free to choose the health care provider to serve  him as well as the facility except when he is under the care of a service facility or when public health and safety so demands or when the patient expressly waives this right in writing.

The patient has the right to discuss his condition with a consultant specialist, at the patient's  request and expense.  He also has the  right to seek  for a second opinion and subsequent opinions, if appropriate, from another health care  provider/practitioner.

 6. Right to Self-Determination. - The  patient has the right to avail himself/herself of any recommended diagnostic and  treatment  procedures.Any person of legal age and of sound mind may make an advance written directive for physicians to administer terminal care when he/she suffers from the terminal phase of a terminal illness:  Provided That a) he is informed of the medical consequences of his choice; b) he releases those involved in his care from any obligation relative to the consequences of his decision; c) his decision will not prejudice public health and safety.

7. Right to Religious  Belief. - The patient  has the  right to refuse medical treatment or procedures which may be contrary to his religious beliefs, subject to the limitations described in the preceding subsection: Provided,  That such a right shall not be imposed by parents upon their children who have not reached the legal age in a life threatening situation as determined by the attending physician or the medical director of the facility.

8. Right to Medical Records. - The patient is entitled to a summary of his medical history and condition.He has the right to view the contents  of his medical records, except psychiatric notes and other incriminatory information obtained about third parties, with the attending physician explaining contents thereof. At his expense and upon discharge of the patient, he may obtain from the health care institution a reproduction of the same record  whether or not he has fully  settled  his financial obligation with the physician or institution concerned.

The health care  institution shall safeguard  the  confidentiality  of the medical records and to likewise ensure the integrity and authenticity of the medical records and  shall  keep the same  within  a  reasonable time  as  may be determined  by the Department of Health.

The health care institution shall issue a medical certificate  to the patient upon request.Any other document that the patient may require for insurance claims shall also be made available to him within forty-fIVe (45) days from request.

9. Right to Leave. - The patient has the right  to leave hospital or any other health care institution regardless of his physical   condition: Provided. That a) he/she is informed  of the  medical consequences  of his/her decisionl  b) helshe  releases those involved in his/her care from any obligation relative to the consequences of his decision; c) hislher decision will not prejudice public health and safety.

No patient shaD be  detained against hi$/her will in any health care institution on the  sole  basis  of  his failure to  fully  settle  his  financial  obligations.  However, he/she shall only be allowed to leave the hospital provided appropriate arrangements have been made to settle the  unpaid  bills: Provided.  further, That  unpaid  bills of patients shall be considered as loss income by the hospital and health care provider/practitioner  and shall be  deducted from gross income as income loss only on that particular year.

10. Right to Refuse Participation In Medical Research. - The patient has the  right to be advised if the  health care provider  plans to  involve him in medical research, including but not limited  to  human  experimentation which may be performed only with the written informed consent of the patient: Provided, That, an institutional review board or ethical review board in accordance with the guidelines set in the Declaration of Helsinki be established for research involving human experimentation:  Provided, further, That the Department of Health shall safeguard the continuing training  and  education  of fUture health care provider/practitioner to ensure the development of the health care delivery in the country: Provided, fUfthermore, That the patient involved in the human experimentation  shall be  made aware of the provisions of the Declaration of Helsinki and its respective guidelines.

11. RIght to Correspondence and to Receive Visitors. - The patient has the  right to  communicate  with  relatives and other  persons  and to receive visitors subject to reasonable limits prescribed by the rules and regulations of the health care institution.

12. Right  to  Express Grievances. - The patient has the  right to  express complaints and grievances about the care and  services received  without fear of discrimination or reprisal and to know about the disposition of such complaints.Such a system shall afford all parties concerned with the opportunity to settle amicably all grievances.

13. RIght to be Informed of His Rights and Obligations as a Patient. - Every person has the right to be  informed of his rights and obligations as a patient.The Department of Health,in coordination with heath  care  providers, professional and civic groups, the media, health insurance corporations, people's organizations,local government  organizations,  shall launch and sustain a nationwide  information and  education  campaign  to  make  known  to  people  their rights  as patients, as declared  in this Act  Such  rights  and obligations  of patients  shall  be posted in a bulletin board conspicuously  placed in a health care institution.

It shall be the duty of health care institutions to inform of their rights as well as of the institution's rules and regulations that apply to the conduct of the patient while in the care of such institution.

What is an insurance billing specialist?

A Billing Specialist is a professional who ensures that insurance companies and healthcare facilities keep accurate records. They work closely with customers, patients, or company personnel to create invoices and check calculations on billing statements so there are no errors in payment procedures.

What skills are important to function as an insurance billing specialist?

Technical skills: Billing specialists generate invoices, print documents and communicate with insurance companies and patients. Basic office skills, such as the ability to use copiers, printers, scanners, fax machines and phones and skills related to word processing, spreadsheet and billing software are needed.

What makes a good billing specialist?

Billing Specialist skills and qualifications Strong communication, including writing, speaking and active listening. Great customer service skills, including interpersonal conversation, patience and empathy. Good problem-solving and critical thinking skills. In-depth knowledge of industry best practices.

What is the name of the modern code of ethics that the American Medical Association AMA adopted in 1980?

The AMA Code of Ethics was adapted from the ethical code of conduct published in 1794 by Thomas Percival. This was the first code to be adopted by a national professional organization. The current AMA code of ethics (2001) has nine articles which is two more than the previous version (1980).