HIPAA Privacy Rule
Rationale: The Health Insurance Portability and Accountability Act of 1996, also known as the HIPAA Privacy Rule, gives patients federal protection over their medical records, personal information, and any other details that are given during their stay in a medical facility. However, it does allow disclosure of that same medical information as long as it pertains directly to the patient care of the individual being treated. This is one of the most sensitive areas of any medical professional’s job. You must be constantly aware of how you are talking about your patients, and where you are talking about them. You should always respect the privacy of the patient. For example, the patient confides in you a personal, embarrassing story about the origin of their condition. And, thinking it is funny, you share this story with a co-worker. This is in a direct violation of the privacy act, and is usually punishable by immediate termination from your position.
Rationale: For medical assistants that work for primary care physicians and medical offices, appointment scheduling will be a part of their every day routine. It will pay to familiarize yourself with the scheduling format at the facility. Smaller facilities may use a manual routine by handwriting in a calendar made of specific documents. More modern and up-to-date facilities will more than likely use a digital scheduling system to assist them with setting up appointments. The main advantage of appointment scheduling versus first come first serve, is the ability to not only avoid patient overlap, but to keep the appointments scheduled tightly throughout the day to maximize patient contact. This optimizes the business that your facility can produce every day.
Rationale: At smaller medical facilities, the medical assistant may play a large role with both administrative and clinical duties. A large part of the administrative duties is being able to handle the aspects of health insurance, and help the patients understand what their part is in the transaction. As healthcare and hospital services have become more technical and expensive, it can challenge a medical assistant to remain calm when translating the policies for certain patients. The patient is responsible for paying a copay at the time of service. This copay is a requirement from the health insurance company. In exchange for this copay, the health insurance helps make everything from well checks to surgeries more affordable than they would be otherwise without the insurance. Without the insurance, the expectation would be that the patient would be responsible for repaying 100% of the total cost. This makes health insurance a necessity in today’s modern society.
Patient's Bill of Rights
Rationale: Patients may feel overwhelmed at times with the healthcare system. Patients can feel as if they are being taken advantage of. It is important to inform the patient that they do have rights, and are protected at every step of the way. The patient bill of rights in the United States is a federally protected set of laws that offer people the ability to select the physician of their choice, have confidential treatment that protects their records and information, refuse any medical treatment they do not want, the right to be completely informed about their current condition, the right to informed consent, receive complete disclosure of their insurance in laymen terms that are easily understood, and a number of other rights are included as well. In the event that a patient is having trouble understanding their rights, patient advocates are either available in the facility you work at or in a nearby city, and should be able to help them navigate the more complicated portions of the law.
Rationale: For patient’s that are attempting to find a new primary care physician, their first contact with the new facility is typically the phone call. Answering a telephone may seem like a skill that is easy to disregard, but hearing a polite tone on the line can be a very engaging, calming allure. Every medical facility has its own preferred style to answering the phone, and consistency is the key to imparting maximum professionalism. Generally, you answer the phone by saying, “Hello, Happy Day Medical Facility, my name is John Medicine, how may I help you today?” This lets the potential patient know the facility name, and name of the person helping them, and that you are the one that will be assisting them. This may seem self explanatory, but it is an often overlooked and very necessary skill for all successful businesses. For difficult patients on the phone, always stay calm, and when in doubt, direct the call to the manager on staff to resolve potentially volatile situations.
Rationale: Having a strong interpersonal relationship is extremely important on a healthcare team. When interacting with patients, it is important to know that you can trust those around you no matter what situation may arise. Teamwork is the combined effort by a group for a common goal: utilize this idea as often as you can. Always offer positive reinforcement if you see a member of your team go above and beyond for a patient. If a coworker is having a bad day, give them the opportunity to talk it out with you. Being a good listener can go a long way to building good relationships with those around you. However, don’t share the information that is given to you in confidence. The easiest way to lose the relationships you build is by gossiping and confiding in cliques in the workplace.
Rationale: The medical chart is the source of all patient information. This is a constantly updated resource that communicates to healthcare professionals the ongoing state of care to an individual patient. In smaller facilities, like urgent cares or doctor’s offices, the medical chart is used as a resource to check on the history of the patient, and how it may be involved with or affect their current state of health. These are filed either manually or digitally, and must be retrieved every time a patient visits your facility. Since there can be months between patient visits, accuracy is of the utmost importance to avoid clerical errors. In the event an inaccuracy is left in the chart, it is possible a large amount of time may pass before the physician views it again as well. Always double check your notations and those of the physician as well. A small clerical error can lead to huge medical problems, and because these are used in long-term care, it could devastate the care of a patient.
use their first name.
Rationale: As the medical assistant, you tend to have the first encounter with the patient. Generally, this will be in the waiting room. It is the most proper to use a patient’s first name when calling them, because first names are less specific and give less information out in the open. We always aim to protect the patient’s confidentiality whenever possible. Once the patient begins to follow you, always engage by asking them how they are doing, how their day has been, if they have anything else planned for the day, this makes the visit more personal and not just business. Make sure to tell the patient which exam room they are going to be seen in, and let them enter the room first. This allows them to have control over the environment first, and typically makes patients feel more at ease. If there is going to be a delay before seeing the physician, don’t give specifics, just apologize for the delay in care.
Policy and Procedures Manual
Rationale: In a majority of medical facilities, the actions the staff can perform are dictated in some greater or lesser extent in a policy and procedure handbook. This is one of the primary ways that medical facilities can protect themselves from the actions of their staff. In the event that a staff member makes a grievous error of action, the facility can point to their policy and procedures manual to illustrate where the break down in judgment began. It is typical for a new hire at a facility to sign a document stating that they have read the policy and procedure manual and that they acknowledge all aspects of the handbook. This hand book generally contains information about patient interaction, medication administration, patient assessment, collecting labs, and recording vital signs.
Rationale: Every medical facility will have its own style of cataloging patient information. These are known as filing procedures. Smaller facilities may not have the ability to convert patient related documentation into a digital format, so the process will most likely be alphabetical and possibly by year of last visit. In the event that the facility utilizes digital documentation, it is much easier to find the appropriate documents when required. Patients are either tracked with their name, birth date, or they are given an accession number or special identification number that separates them from other people who may share the same name. This filing system requires that all documents be scanned at the time of the patient’s visit, and digitally stored under the appropriate patient identification.