ICBS 120 MEDICAL OFFICE PROCEDURES Health Care Settings and the Healthcare Team

Healthcare is ever-changing Dynamic and stimulating industry Dynamic and stimulating industry Encourage healthcare professionals to constantly develop new skills and stay on top of new technology. Encourage healthcare professionals to constantly develop new skills and stay on top of new technology. Scope of healthcare includes: more than 25 specialties, over 20 kinds of allied health professionals, and increasing non- traditional practitioners. Scope of healthcare includes: more than 25 specialties, over 20 kinds of allied health professionals, and increasing non- traditional practitioners.

Forms of Medical Practice Mgmt Sole Proprietorships: Sole Proprietorships: Entitles the physician to hold executive rights to all aspects of the practice (profits/debts). Entitles the physician to hold executive rights to all aspects of the practice (profits/debts). May employ other physicians May employ other physicians Partnerships: Partnerships: Several physicians who share a facility. Several physicians who share a facility. Corporation: Corporation: Allows income and tax advantages to all employees. Allows income and tax advantages to all employees. Professional employees only liable for “OWN” acts. Professional employees only liable for “OWN” acts. Provides fringe benefits such as health insurance/vacation. Provides fringe benefits such as health insurance/vacation.

Ambulatory Healthcare Settings Individual and Group Practices Individual and Group Practices Individual/Solo Practice: treats all patients in the practice Physician is responsible for all cost of running the practice. Group Practices Group Practices Two or more physicians share the operating costs of the practice. Two or more physicians share the operating costs of the practice. Physicians learn and consult with each other Travel between one or more offices Has a larger patient base and able to offer lower prices Urgent Care Centers Urgent Care Centers Usually private, for-profit Services for primary care, routine injuries, illnesses, and minorsurgery

Managed Care Operations Purpose: To provide comprehensive healthcare at a reasonable cost. Purpose: To provide comprehensive healthcare at a reasonable cost. Health Maintenance Organization (HMO) is a network of participating physicians within a defined geographic area Health Maintenance Organization (HMO) is a network of participating physicians within a defined geographic area Specialists are usually seen by gatekeeper referral. Specialists are usually seen by gatekeeper referral. HMO’s provide a full range of services under one roof HMO’s provide a full range of services under one roof Preferred Provider Organization (PPO) is a Physicians network offers discounted services as agreed Preferred Provider Organization (PPO) is a Physicians network offers discounted services as agreed Individual Practice Association (IPA) treats patients for an agreed-upon fee. Individual Practice Association (IPA) treats patients for an agreed-upon fee.

Ways of Keeping Healthcare Costs Down 1. Lifestyle change 2. Diet and exercise 3. Taking prescriptions as directed 4. Patient education 5. Preventative healthcare 6. Keep on top of billing 7. Make sure billing is accurate

Integrative/Alternative Healthcare Training is highly specialized and specific Training is highly specialized and specific Considered complimentary to traditional health care. Considered complimentary to traditional health care. Broad Disciplines: Chiropractic: drug free, non-surgical, manipulation of the body Chiropractic: drug free, non-surgical, manipulation of the body Naturopathy: remove the underlying causes of disease and to simulate body’s natural healing processes Naturopathy: remove the underlying causes of disease and to simulate body’s natural healing processes Oriental Medicine/Acupuncture: Chinese recognize a vital energy behind all life-forms called “qi” (chee). Oriental Medicine/Acupuncture: Chinese recognize a vital energy behind all life-forms called “qi” (chee).

Integrative/Alternative Healthcare Therapies Cont’d Broad disciplines continued: Oriental medicine is over 3,000 years old. Oriental medicine is over 3,000 years old. Includes acupuncture, Chinese herbology and bodywork, dietary therapy and exercise based on traditional Oriental medicine principles. Includes acupuncture, Chinese herbology and bodywork, dietary therapy and exercise based on traditional Oriental medicine principles.

Integrative/Alternative Healthcare Therapy Cont’d Some Selected Alternative Medicine Modalities: Acupressure: apply pressure to specific acupuncture like points; encourages flow of vital energy along pathways. Acupressure: apply pressure to specific acupuncture like points; encourages flow of vital energy along pathways. Aromatherapy: inhalation and bodily application of essential oils from plants to help relax. It strengthens the self-healing process by indirect stimulation of the immune system. Aromatherapy: inhalation and bodily application of essential oils from plants to help relax. It strengthens the self-healing process by indirect stimulation of the immune system. Homeopathy: healing that claims highly diluted doses of certain substance can leave an energy imprint in the body and bring acout a cure. Homeopathy: healing that claims highly diluted doses of certain substance can leave an energy imprint in the body and bring acout a cure.

Role of the Healthcare TEAM Team concept is critical to the quality of patient care. Team concept is critical to the quality of patient care. A primary care physician is generally, one of the most important members. A primary care physician is generally, one of the most important members. Another critical allied health member is the medical assistant. Another critical allied health member is the medical assistant. Other members: insurance coding and billing specialist, RN, surgeon, Receptionist, etc. Other members: insurance coding and billing specialist, RN, surgeon, Receptionist, etc.

Role of the Healthcare TEAM Cont’d Practice within your scope of training. Practice within your scope of training. For example: no one should ever diagnose a patient except for the physician. For example: no one should ever diagnose a patient except for the physician. Never do anything you feel uncomfortable doing. Never do anything you feel uncomfortable doing. Always ask questions when you don’t know or don’t understand. Always ask questions when you don’t know or don’t understand.

Value of the Administrative Healthcare TEAM Must have qualities: Must have qualities: Great communicators Great communicators Liaison between physician and staff members Liaison between physician and staff members Ability to undertake responsibility for directing, informing, and guiding patients and patient care in a professional and caring tone. Ability to undertake responsibility for directing, informing, and guiding patients and patient care in a professional and caring tone. Must be competent and compassionate. Must be competent and compassionate.