Electronic Medical Records and Medical Billing Procedures
Curriculum guideline
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.
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
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
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
Establishing and Maintaining a Patient Registry
- patient registration
- entering demographic information
- past medical history, allergies, immunizations and clinical data such as height and weight
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
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
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
Alternate billing and required form completion
- WorkSafe BC
- Insurance Corporation of B.C.
- private insurance
- medical-legal
- cash, self-responsible patients
- out-of-province claims
- non-medically required services
- hospital visits
Medical Services Plan
- CareCard information
- preamble
- fee schedule - MSP and Doctors of BC
- location codes
- diagnostic codes
- specialty codes
- practitioner and payment numbers
- claims processing system
- remittance statements and explanatory codes
- claims coverage enquiry
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 claims processing
- understanding the importance of dealing with rejected claims in a timely manner
- understanding why a claim was rejected – use of explanatory codes
The learner has reliably demonstrated the ability to:
- understand the advantages and disadvantages of electronic medical records (EMR)
- explain the importance of confidentiality in relation to EMR
- use an EMR system effectively in regards to patient scheduling, diagnostic tests, laboratory reports, messaging and referral letters
- identify types of alternate billing and collection procedures
- identify and complete basic medical forms
- apply knowledge of the Preamble and Fee Schedule to Medical Services Plan billing procedures
- complete manual day sheets and identify information necessary to accurately process claims to the Medical Services Plan of B.C.
- 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.
- understand the importance of accuracy and attention to detail with regard to billing claims
- explain how to deal with rejected claims in relation to maximizing business potential of the health care provider
| 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% |
THERE ARE NO ORAL PRESENTATIONS IN THIS COURSE.
Students may conduct research as part of their coursework in this class. Instructors for the course are responsible for ensuring that student research projects comply with College policies on ethical conduct for research involving humans, which can require obtaining Informed Consent from participants and getting the approval of the Douglas College Research Ethics Board prior to conducting the research.
Textbooks and Materials to be Purchased by Students:
Instructor prepared materials
Other materials as approved by department