Electronic Medical Records and Medical Billing Procedures

Curriculum guideline

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Course
OADM 1265
Discontinued
No
Course code
OADM 1265
Descriptive
Electronic Medical Records and Medical Billing Procedures
Department
Office Administration
Faculty
Commerce & Business Administration
Credits
3.00
Start date
End term
201620
PLAR
Yes
Semester length
15 Weeks X 4 Hours per Week = 60 Hours
Max class size
30
Contact hours
Lecture: 3 Hours Seminar: 1 Hour
Method(s) of instruction
Lecture
Seminar
Learning activities

A combination of lecture, demonstration, guided practice, and self-paced laboratory assignments and projects will be used.  Guest speakers may be invited.  Active learning is an integral part of this course and major emphasis will be placed on a “hands-on” environment to allow students to work both independently and collaboratively to learn and apply EMR and medical billing concepts and procedures.  

Course description
This course is designed to introduce the student to hands-on electronic medical records and electronic medical billing procedures. The student will be given an overview of electronic medical records with an emphasis on privacy, confidentiality and security. The student will learn how to manage a variety of administrative components of electronic medical records. The student will be introduced to all facets of medical billing using at least one medical billing software program.
Course content
  1. Overview of Electronic Medical Records (EMR)
    • role of the health care professional using EMR
    • advantages and disadvantages of EMR
    • differences between paper files and EMR
    • selecting an EMR vendor
    • PITO (Physician Information Technology Office)
  2. Privacy, Confidentiality and Security
    • role of the health care worker in regard to EMR security
    • review of medical law and ethics and patient rights
    • importance of passwords
    • breach of confidentiality consequences
  3. Transitioning from Paper Charts to EMR
    • planning for a successful transition
    • office procedures requiring workflow re-design
    • conversion of the paper chart to digital
    • what happens to the paper chart
  4. Establishing and Maintaining a Patient Registry
    • patient registration
    • entering demographic information
    • past medical history, allergies, immunizations and clinical data such as height and weight
  5. Entering Prescription Details into EMR
    • understanding prescription parts in relation to EMR
    • how to find brand and generic names
    • enter a complete prescription record on behalf of the physician
    • print a prescription record
  6. Administrative Uses of EMR
    • messaging
    • referral letters
    • diagnostic tests
    • patient education in regards to diagnostic tests
    • laboratory reports
    • overview of chronic disease management and complex care
  7. Appointment Scheduling
    • differences between paper and electronic appointment scheduling
    • introduction to different parts of the appointment scheduling screen
    • making an appointment
    • changing an appointment
    • cancelling an appointment
    • dealing with no-shows
    • printing an appointment card
    • printing a daysheet/schedule for each physician
  8. Alternate billing and required form completion
    • WorkSafe BC
    • Insurance Corporation of B.C.
    • private insurance
    • RCMP billing
    • medical-legal
    • cash, self-responsible patients
    • out-of-province claims
    • non-medically required services
    • hospital visits
  9. Medical Services Plan
    • CareCard information
    • preamble
    • fee schedule - MSP and BCMA
    • location codes
    • diagnostic codes
    • specialty codes
    • practitioner and payment numbers
    • claims processing system
    • remittance statements and explanatory codes
    • claims coverage enquiry
  10. Claims processing information
    • required claims processing information with regard to manual day sheets
    • required claims processing information with regard to electronic medical billing
    • billing from the appointment schedule
    • electronic medical billing to a variety of insurers – MSP, Work Safe, ICBC, Private and Out of Province
    • computer-generated reports and electronic claim s processing
    • understanding the importance of dealing with rejected claims in a timely manner
    • understanding why a claim was rejected – use of explanatory codes
Learning outcomes

The learner has reliably demonstrated the ability to:

  1. understand the advantages and disadvantages of electronic medical records (EMR)
  2. explain the importance of confidentiality in relation to EMR
  3. use an EMR system effectively in regards to patient scheduling, diagnostic tests, laboratory reports, messaging and referral letters
  4. identify types of alternate billing and collection procedures
  5. identify and complete basic medical forms
  6. apply knowledge of the Preamble and Fee Schedule to Medical Services Plan billing procedures
  7. complete manual day sheets and identify information necessary to accurately process claims to the Medical Services Plan of B.C.
  8. use at least one medical billing computer program to produce and print computer generated reports and to process claims to the Medical Services Plan of B.C.
  9. understand the importance of accuracy and attention to detail with regard to billing claims
  10. explain how to deal with rejected claims in relation to maximizing business potential of the health care provider
Means of assessment
Quizzes (2-5) 10% - 25%
Mid-term - EMR and billing theory 25%
Course assignments 10% - 30%
Simulation(s) 0% - 25%
Final Exam 30%
Employability Skills 0% - 10%
 Total 100%
Textbook materials

Textbooks and Materials to be Purchased by Students:

 

Instructor prepared materials

Other materials as approved by department

Prerequisites

OADM 1114 and OADM 1256

Which prerequisite

OADM 1401