SYLLABUS MODULE FOR OUTCOME BASED ASSESSMENTS
Course Information
Course:
Semester:
Instructor:
MED 130 Administrative Office Procedures I
Spring
2007
Laura Durham, CMA
Course Description
This course introduces medical office administrative procedures. Topics include
appointment processing, written and oral communications, medical records, patient
orientation and safety. Upon completion, students will perform basic administrative
skills within the medical environment.
Course Objectives
Upon Completion of this course students will be able to:

Schedule and manage appointments

Utilize medical administrative software to maintain office systems

Schedule inpatient and outpatient admissions and procedures

Respond to and initiate written communications

Recognize and respond to verbal and nonverbal communications

Demonstrate telephone techniques

Organize a patient’s medical record

File medical records

Establish and maintain the medical record

Explain general office policies

Complete an incident report

Recognize elements of patient safety in the reception area.
Learning Activities and Measurable Outcomes
This course will combine lecture and lab to give students an opportunity to perform the
tasks they are learning about. Students are required to successfully perform each task
within the specifications of the individual performance steps and/or check-off sheets.
Students will be given three attempts to satisfactorily complete each competency.
Learning Unit
Assessment
Expected Outcome
Manage and schedule
appointments
Schedule Office
Appointment
1. Provided with workbook
exercise giving doctor’s
names, times the doctors
are available to see patients
and a list of patients and
their chief complaints, and
triage guidelines; students
will place names, phone
numbers, and reasons in
spaces provided.
See Steps
Utilize Medical Manager
software to maintain office
systems
2. With manual
appointment sheet,
students will assign the
same appointments in
Medical Manager computer
software.
Satisfactory: Student will
create a matrix by crossing
off unavailable times for
scheduling. Student will
then schedule patients in a
manner that utilizes times
available and gives the
sickest patients the first
available slots. Names,
phone numbers and
reasons will be legible.
Successful completion of
each crucial step in the list
of steps. Each procedure
has a total amount of
points that can be earned.
To get this number, add
the number of steps and
multiply that number by 4.
To calculate score, add the
total number of points
earned and divide by 100.
Divide this number by the
total possible points to get
the final percentage score.
Instructor will mark NA by
any steps to be deleted.
Unsatisfactory: Student
leaves out any crucial step
in the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Schedule inpatient
admissions
Provided with a physician’s
order with the reason for
admission and the patient’s
record, students will role
play calling an admissions
department of a hospital
providing them with patient
requirements, referral and
insurance information and
See Steps
Satisfactory: Student will
accurately give the patient’s
demographic and insurance
information to the hospital
admissions office,
document the admission
information legibly and with
no spelling errors, and
communicate to the patient
after which the patient
repeats the information
back to the MA correctly.
Successful completion of
each crucial step in the list
of steps. Each procedure
has a total amount of
points that can be earned.
To get this number, add
the number of steps and
multiply that number by 4.
To calculate score, add the
total number of points
earned and divide by 100.
Divide this number by the
total possible points to get
the final percentage score.
Instructor will mark NA by
any steps to be deleted.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Schedule outpatient
procedures
Provided with a physician’s
order, referral form, patient
record, patient’s insurance
information, name,
address, and phone
number of referral facility,
students will arrange an
appointment and document
the information through
role playing.
See Steps
Satisfactory: Student will
accurately give the patient’s
demographic and insurance
information to the referring
physician’s MA, document
the appointment legibly and
with no spelling errors, and
communicate to the patient
after which the patient
repeats the information
back to the MA correctly.
Successful completion of
each crucial step in the list
of steps. Each procedure
has a total amount of
points that can be earned.
To get this number, add
the number of steps and
multiply that number by 4.
To calculate score, add the
total number of points
earned and divide by 100.
Divide this number by the
total possible points to get
the final percentage score.
Instructor will mark NA by
any steps to be deleted.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Organize a patient’s
medical record
Provided with patient
information, a folder,
medical record forms,
labels, and color-coded
terminal digit or
alphabetic tabs, students
will create a new patient
record.
See Steps.
Satisfactory: Student
constructs a sample chart
placing demographic
information on the left side
and clinical information on
the right. Medical record
form is complete and
accurate, spelling is correct
and entries are legible.
Students have three
attempts to achieve a
satisfactory score.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
File medical records
1. Alphabetic filing system:
Provided with a list of
patient names, students will
make an index card for
each and place cards in
alphabetical order.
See Steps
2. Terminal digit filing
system: Provided with
folders with five-digit
number system, students
will place the files in
numerical order.
See Steps
Satisfactory: Student
organizes index cards by
proper alphabetic order,
and organizes files in
proper numerical order.
Successful completion of
each crucial step in the
procedure check-off sheet.
Each procedure has a total
amount of points that can
be earned. To get this
number, add the number of
steps and multiply that
number by 4. To calculate
score, add the total number
of points earned and divide
by 100. Divide this number
by the total possible points
to get the final percentage
score. Instructor will mark
NA by any steps to be
deleted.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Recognize and respond to
verbal and nonverbal
communications
Provided with a scenario,
students will role play
greeting a patient who is
instructed in the scenario to
show fear of physicians
with her words, actions and
body language. Student
will answer list of questions
after the activity
Satisfactory: Student will
List 7 out of 9 possible
responses.
Unsatisfactory: Student
lists less than 7 out of 9
possible responses.
See Activity
Demonstrate telephone
techniques
Provided with a blank
message pad, a scenario, a
partner for role playing,
and a list of triage
guidelines, students will
take a telephone message
and route it appropriately.
See Steps
Satisfactory: Successful
completion of each crucial
step in the procedure. Each
procedure has a total
amount of points that can
be earned. To get this
number, add the number of
assigned steps and multiply
that number by 4. To
calculate score, add the
total number of points
earned and divide by 100.
Divide this number by the
total possible points to get
the final percentage score.
Instructor will mark NA by
any steps to be deleted.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Respond to written
communications
Initiate written
communications
1. Provided with a
simulated stack of incoming
mail, students will process
and stamp mail with today’s
date sort by importance,
pull patient charts and
place with mail if
necessary, and route mail
to its intended recipient.
Students will document
actions on paper.
Satisfactory: Student’s
documentation will prove all
proper actions.
2. Provided with a scenario
requiring the construction
of a letter thanking another
physician for his referral to
your physician-employer’s
practice, students will
produce a letter and
envelope. Names will be
provided by instructor.
Satisfactory: Successful
completion of each crucial
step in the list of steps for
the procedure. Each
procedure has a total
amount of points that can
be earned. To get this
number, add the number of
steps and multiply that
number by 4. To calculate
score, add the total number
See Steps
Unsatisfactory: Student
makes one or more errors.
of points earned and divide
by 100. Divide this number
by the total possible points
to get the final percentage
score. Instructor will mark
NA by any steps to be
deleted.
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Patient Orientation:
Construct a Practice
Brochure
1. Provided with a
computer, Word software,
list of information to be
included, color printer, and
card stock paper, students
will design an attractive,
informative, and accurate
practice brochure to be
sent to all new patients.
See Steps
Satisfactory: Student
constructs a professional
brochure with complete,
accurate, and pertinent
information.
Unsatisfactory: Student
omits any crucial
information or any crucial
step in the procedure.
Crucial steps are those that
change the final outcome of
the exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Explain General Office
Procedures
2. Using the brochure
made, students will role
play to explain general
office procedures to a new
patient. Students will take
steps to be sure patient
understands the
information provided.
Satisfactory: Student
explains the office policies
in a concise, clear and
understandable manner.
Partner is able to repeat
complete and accurate
information back to MA
Unsatisfactory: Student
omits any crucial step in
the procedure. Crucial
steps are those that change
the final outcome of the
exercise and are to be
determined by the
instructor and announced
at the time of the
assignment.
Complete an incident report
and recognize elements of
patient safety in the
reception area.
1. Provided with a
scenario, a blank incident
report, and a partner for
role playing, students will
complete an incident
report.
See Accident Report
2. Using the same
scenario, students will list
unsafe practices and areas
in the reception area.
See Scenario
Satisfactory: Student
completes each line of the
incident report with
accuracy and no spelling
errors.
Unsatisfactory: No more
than two errors in
completion of form.
Satisfactory: Student will
list 4 out of 5 unsafe
practices and areas.
Unsatisfactory: Student
omits more than 1 obvious
unsafe practice.
Grading Policies
Select this text and replace with information regarding your general grading policies.
Personalize explanations and percentages below.
The Forsyth Tech grading scale as explained in the course catalog will be used:
94-100% = A
86-93% = B
78-85% = C
70-77% = D
Attendance
Including interest and participation
Tests
Weighted equally
Labs
Procedure check-offs
Homework
Exercises assigned from workbook
10%
30%
40%
20%
ATTENDANCE: Attendance is crucial to your success in this class. A student may be
dropped from the class after 2 absences. Students entering the room after the last
name of the roll is called will be considered tardy. Three tardies are recorded as one
absence. Also, students who leave early without the express permission of the
instructor will be counted absent. Should you be absent, you will be required to provide
a doctors note or documentation of reason.
If you would like to request accommodations (i.e. note takers, readers, extended test
time, equipment, etc.) for a documented disability, you must register with the Disability
Services Office, Allman Center, Room 113. You will be required to provide current,
official documentation of your disability. Please contact Ms. Gail M. Freeman, Disability
Specialist, at (336) 734-7155. Ms. Freeman will work with you to determine appropriate
accommodations. Registering with her early is important, as she needs adequate time
to arrange the accommodations that you may need. We want to assist you in being
successful.
Procedures require simulated information from the instructor.
Instructor will determine which steps must be performed and which steps may be
deleted, as well as the satisfactory time expected to complete the task.
SUGGESTED STEPS FOR PROCEDURES
Schedule and Manage Appointments
Schedule Office Appointment
1. Using doctor’s names and office hours provided, block out unavailable times
according to doctor’s preferences create the matrix for a week on the
appointment sheet.
2. Identify the patient and the reason for the visit.
3. Based on established triage procedures, offer appropriate choice of days and
times for appointment or instruct patient if emergency.
4. Assign time and date and obtain information from the patient, including:
a. Patient’s name in full
e. Source of referral
b. Date of birth
f. New or established pt.?
c. Daytime phone number
g. Reason for call or appt.
d. Complete address
h. Insurance coverage
5. Place the patient’s name, reason, and phone number in the proper slot in the
appointment book.
6. Give patient an appointment card and/or have patient repeat day and time back
to you.
7. Explain financial policies of office by instructing patient regarding co-pay or
payment required at the time of the visit.
8. Remind patient to bring insurance card and any current medications.
9. Offer caller directions to the office.
10. Using the completed appointment sheet, establish the matrix and enter the same
information into the appointment application of Medical Manager software
program.
Schedule Inpatient And Outpatient Admissions And Procedures
Schedule outpatient procedure
1. Obtain a written order from the physician for the procedure to be done.
2. Obtain referral from the patient’s insurance company and document on the
referral form.
3. Determine patient’s preference of available facilities, days, and/or times. If
none, consult physician as to preference of facility.
4. Gather the following information and role play with a classmate to make an
appointment.:
a. Patient’s name,
e. Designated procedure
b. Phone number
f. Desired date
c. Age
g. Special instructions
d. Date of birth
h. Referral/ insurance info
5. Obtain any information from facility for patient or provide patient with contact for
such information.
6. Convey information to patient orally and in writing. Have patient repeat
information back to you to ensure understanding.
7. Document the place, day, time of the appointment, your actions, and any patient
education materials given to the patient in the patient’s chart.
Schedule Inpatient Admission and Any Necessary Precertification
1. Obtain physician’s order for patient’s admission to the hospital with diagnosis and
any special requirements of patient (Ex. Private room, isolation, etc.
2. Instruct and assist patient in obtaining precertification from their third- party
payer (if necessary) using information from the back of the patient’s insurance
card
3. Arrange admission using information gathered for outpatient procedure above.
4. Give patient information and instructions orally and in writing.
5. Document admission, make a copy of doctor’s orders and give to patient to hand
carry, fax, or e-mail orders.
6. Direct patient to hospital.
Respond to and initiate written communications
Compose a Letter
1. Move cursor down to at least 3 lines below letterhead.
2. Enter the date and center under the letterhead.
3. Move to the fifth line below the date and enter the inside address.
4. Move down two lines after the last line of the inside address.
5. Enter an appropriate salutation followed by a colon or comma (informal letters
require a comma, formal letters require a colon.)
6. Move down two lines and center the reference line (Ex. RE: Patient’s Name.)
7. Prepare the body of the letter.
8. Double space between paragraphs
9. If letter goes to second page, move down seven lines and enter a heading at the
including patient’s name, page number, and date. Move down two lines and
continue body of letter.
10. Move down two lines from the last sentence of the body of the letter and enter
the complimentary closing (Ex. Sincerely, Yours Truly, etc.)
11. Move down four lines to allow room for signature, and enter the sender’s name
exactly as it is printed on the letterhead.
12. Move down two lines and enter the reference initials to indicate typist Enter
capital letters the sender’s initials and the lower case for the typist’s initials. (Ex.
JLB/lbd).
13. Return and single space a note for any enclosures (Enc.) and cc or copy if
instructed by the sender to send a copy of the letter to other parties. (Ex. cc:
John Smith, MD).
14. Place the letter with the patient’s chart if applicable in a designated area for the
sender’s review, editing, and signature.
15. Make any changes or corrections indicated by sender and return to sender for
review and signature.
16. Make copy of letter and place in patient’s chart.
17. Address envelope in all capital letters and no punctuation.
18. Fold letter with top half folded down to about ½” above the bottom of the page
and the bottom part folded upward.
19. Place in envelope, affix stamp, and place in designated area for outgoing mail.
Organize a patient’s medical record
Establish and maintain the medical record
1. Assemble supplies
2. Obtain a label and write the patient’s full name for alphabetic filing. ( Ex. Smith,
John P.)
3. Color code the medical record (MR) by using a five-color-coding system with the
first two letters of the last name and the first letter of the first name.
4. Place the patient label along the edge of the folder
5. Place a year label along the tabbed edge of the folder.
6. Organize all the forms in the MR including the problem or source-oriented
record.
7. Legibly write patient’s name on all forms to be included in the medical record
8. Role-play with a classmate and complete the required patient information sheet
and place it in the left front cover of the file. Make up personal and health
information.
9. Obtain “signature on file” and HIPAA consents
File medical records and items alphabetically
1. Using rules for filing items alphabetically, double-check spelling of name for
accuracy
2. Determine appropriate storage file.
3. For new material, scan guides for area nearest to letters of name on items to
file.
4. place folder in correct alphabetical order between two files.
5. Insert new file between to other folders and not within another folder where it
could be lost.
6. In filing material previously on file, scan for the outguide.
7. Remove outguide and check to be sure it was marking the space for the file just
returned and not another.
File medical records using terminal digit system
1. Double check spelling of name for accuracy using cross-reference file.
2. Using rules for numerical filing, match the first two or three numbers with those
already in file.
3. Match remaining numbers with those in file.
4. Scan shelf for like colors
Demonstrate telephone techniques
1. Answer call within the first three rings. Have message book available and ready
to write on.
2. Answer appropriately with greeting, time of day, your name, and name of
practice or physician. Ask how you can assist.
3. Obtain the caller’s name and phone number. Ask if caller is current patient.
4. Determine the purpose of the call (Ex. Prescription refill, obtaining lab results,
making appt.)
5. Pull appropriate chart or information needed to expedite return call.
6. Document the call in the message book. Document in the patient chart with:
a. date and time call was received
b. correctly-spelled name of the caller
c. phone number, when the caller can be reached
d. nature and urgency of the call
e. action to be taken
f. message, if any
g. your name or initials
7. Repeat the information back to the caller to verify correct information
8. Instruct the caller when to expect a call or action, and document.
9. Follow through until the caller’s business is complete.
Recognizing and responding to verbal and nonverbal communication
Scenario: Jane Jones is an 18-year-old patient who presents with pain and
intermittent burning in her right breast. She is a new patient to your OB/GYN
practice. On the phone, she explained with a shaky voice that this would be her
first visit to a gynecologist and her first visit without her mother. As she approaches
the front desk to register, Jane walks slowly with her arms crossed in front of her.
She has been crying and is flushed. She rocks in her seat and looks around
nervously while being interviewed by the medical assistant.
1. Did the patient appear fearful? _________
2. How was this shown?
Identify Jane Jones’ nonverbal communication
.
Words:
Actions:
Body Language
Suggested Responses:
Words: shaky voice on phone, shared that this would be a first GYN visit,
stated her mother is usually with her
Actions: crying, slow walk, rocking in her seat, looking around
Body Language: arms crossed, flushed face,
Explain General Office Procedures
Constructing an Office Brochure for New Patients
1. Determine template and/or design to be used.
2. Include the following information:
a. Name and address of practice
b. Providers’ names and credentials
c. Specialties practiced
d. Hours of operation
e. Best times to call for certain needs (Ex. Call by 10 AM for same-day
prescription refills.)
f. Financial information (EX. Payment of co-pays is due at the time of
service.)
g. Directions to the office
Complete an Incident Report
Patient Safety Scenario: Mary Johnson is a 78-year-old patient who is being followed
for severe osteoarthritis and diabetes. As she was leaving your office on Monday, May
7, 2006; she slipped on a wet floor. It was a rainy day. As she was getting up she fell
over a frayed rug at the doorway. Her brittle bones could not withstand the falls, and
she broke three vertebrae in her lower back. She stated that she could not see the rug
sticking up because it was pretty dark in the area. She also felt lightheaded since her
blood glucose level was 52 about 20 minutes ago.
With no intercom in the office, one of the medical assistants ran to get Dr. Snead who
had just examined Mrs. Johnson. It took awhile, but Dr. Snead finally arrived. He
instructed the MA to call 911 and did surgery on Mrs. Johnson at 4:14 p.m. at Forsyth
Medical Center.
Complete an incident report. You may make up any information not given.
Recognize Patient Safety Hazards
Using the scenario, list all safety hazards and/or unsafe practices at the office where
the incident happened.
Suggested List: Dark entrance, frayed rug, no wet floor precaution, no intercom,
patient allowed to leave alone with low blood sugar.
Accident Report
Workplace Requirements Program for Safety and Health
SUPERVISOR’S ACCIDENT REPORT FORM
This form is to be completed by the supervisor and forwarded to the Payroll Coordinator along with a copy of the North Carolina
Industrial Commission Form 19 (Workers Compensation Form) within five days of the accident. All accidents involving serious bodily
injury or death must be reported to the safety and health officer immediately.
ACCIDENT DATA
1. NAME OF EMPLOYEE:
or Patient
2. ADDRESS AND PHONE NO:
3. WORK DEPT. OR DIVISION:
4. SEX:
MAL
5. DATE AND TIME OF INJURY:
FEMALE
E
6. NATURE OF INJURY:
7. PART OF BODY INJURED:
8. CAUSE OF INJURY:
9. LOCATION OF ACCIDENT:
10. OCCUPATION AND ACTIVITY OF PERSON AT TIME OF
ACCIDENT:
11. STATUS OF JOB OR ACTIVITY: (CHOOSE ONE)
Halted
12. NAME AND PHONE NO. OF ACCIDENT WITNESS:
13. LIST UNSAFE ACT, IF ANY:
14. LIST UNSAFE PHYSICAL OR MECHANICAL CONDITION, IF ANY:
15. UNSAFE PERSONAL FACTOR:
16. LIST HAZARD CONTROLS IN EFFECT AT TIME OF INJURY DESIGNED TO PREVENT INJURY:
17. PERSONAL PROTECTIVE EQUIPMENT BEING USED AT TIME OF ACCIDENT:
GLOVES, SAFETY GLASSES, GOGGLES, FACE SHIELD, OTHER
18. BRIEF DESCRIPTION OF ACCIDENT:
19. CORRECTIVE ACTION TAKEN OR RECOMMENDED TO DEPARTMENT SAFETY COMMITTEE:
TREATMENT DATA
20. WAS INJURED TAKEN TO (CHOOSE ONE): Hospital
21. DIAGNOSIS AND TREATMENT, IF KNOWN:
22. ESTIMATED LOST WORKDAYS:
(EXCLUDING DAY OF ACCIDENT)
23. DATE OF REPORT:
Month
24. REPORT PREPARED BY:
25. SIGNATURE OF SUPERVISOR:
26. SIGNATURE OF AGENCY SAFETY AND HEALTH OFFICER:
Day
Year