1. C H A P T E R 10 Medical Office Management

2. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 2 Safety, Security, and Emergency Plans in the Medical Office 1 1 U N I T

3. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 3 Safety in the Reception Room Observe the condition of the furniture. Check the state of the electrical cords. Look for burned-out light bulbs. Check the condition of the carpet and make sure the aisles are clear.

4. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 4 Hazards in the Reception and Business Area Magazines and toys can lead to trip and fall injuries. Electrical cords can lead to fires or trip and fall injures. Open file drawers and cupboard doors can cause injury.

5. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 5 Unsafe Items in an Examination Room The exam table must be stable to prevent injury. Stools can cause injury. Containers of medical supplies on the counter can cause injury or poisoning.

6. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 6 Fire Safety Fire is caused by three elements, called the fire triangle. Routine fire drills and training for the office staff on the proper use of fire extinguishers are both necessary.

7. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 7 Preventing Exposure to Pathogens The staff must be trained to use and follow all Standard Precautions. Clean up all spills promptly as directed.

8. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 8 Unit Summary What would you look for when performing a safety check in the reception area? What are the six items named in this unit that provide protective barriers against pathogens?

9. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 9 The Language of Banking 2 2 U N I T

10. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 10 Savings and Checking Accounts Savings accounts  A bank account that earns the depositor interest Checking accounts  A bank account that checks can be written against

11. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 11 ABA and MICR Codes American Bankers Association (ABA) codes  Found on the upper right-hand corner of the check  Identify the bank and the branch where the account was opened originally MICR codes  Characters and numbers printed in magnetic ink along the bottom of the check

12. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 12 Banking Terminology See Unit 2 of your text, which describes more than 40 banking terms and also provides illustrations.

13. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 13 Types of Checks Cashier’s checks  Purchaser pays the bank to write a check from the bank’s account as a form of guaranteed payment Certified checks  Bank stamps the check “certified” and holds the funds until the check clears as a form of guaranteed payment (continued)

14. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 14 Types of Checks Electronic check  A check paid directly from the checking account via the Internet Limited check  A check that the bank will mark void if it is written for over a certain amount (continued)

15. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 15 Types of Checks Stale check  A check presented for payment too long after it was written Traveler’s check  Checks issued by the bank for a specific amount; they are signed at the time of use and guaranteed by the bank to be replaced if they are lost (continued)

16. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 16 Types of Checks Voucher check  A check that has a detachable form that shows the reason the check was written Money orders  Another form of a check that can be bought for a fee as a form of guaranteed payment

17. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 17 Overdraft versus Overdrawn Overdraft accounts  Allow the individual to write checks for over the amount of funds in the account. The amount used that is over the account balance is considered a loan and interest is charged. Overdrawn  There are not enough funds in the account to cover the check.

18. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 18 The Stop Payment Process Call the bank and provide the following information:  Check number  Date issued  Amount of the check  Name of the payee  Reason for stopping payment

19. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 19 Unit Summary How would you decide if a check is a cashier’s check or a certified check? What is the difference between an overdraft account and being overdrawn? When would you use a voucher check?

20. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 20 Currency, Checks, and Petty Cash 3 3 U N I T

21. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 21 Handling Currency in the Medical Office Currency is the name given to cash money in the form of paper dollars. Cash money includes both currency and coins. The office must be sure to provide a secure place for storing cash and it should be deposited into the bank daily.

22. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 22 What Makes a Check Negotiable? To ensure that the check will be honored and cashed by the bank, verify the:  Date  Presence of the words “pay to the order of”  Name of the payee (continued)

23. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 23 What Makes a Check Negotiable? The amount of the check is written numerically The amount of the check is written out in words Financial institution information is present The check must be signed.

24. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 24 Guarding against Check Fraud Examine the check for the following:  Preprinted name and address of the maker  Chronological check number  Presence of an ABA number  Presence of MICR numbers  Presence of one rough or perforated edge

25. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 25 Accepting Checks from Patients Examine the check to make sure it is negotiable. As a rule, do not accept checks from third-party payers.  The exceptions are checks from attorneys or workers compensation payments written directly to the physician. (continued)

26. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 26 Accepting Checks from Patients Do not accept:  Checks written for more than the amount of the service, especially if the patient is requesting cash back  Checks marked as “payment in full” unless you verify that it does pay the account balance in full  A postal money order with more than one endorsement (two endorsements is the limit honored).

27. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 27 Endorsements Endorsement  Signatures and other information that appears on the back of the check that transfers the rights of the check to another party (continued)

28. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 28 Endorsements Blank endorsements  Signatures only: The checks should be endorsed immediately prior to deposit. Restrictive endorsements  Stamps or written information that restricts the transfer of rights, such as “deposit only” or “pay to the order of”

29. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 29 Mail Deposits Avoid sending cash or currency unless it is sent by registered mail. Restrictive endorsements should appear on all checks. Maintain accurate records. Keep a copy of all checks and deposit slips submitted. Request a receipt.

30. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 30 Petty Cash Funds Petty cash is the small amount of cash an office keeps on hand for small expenses such as postage and office supplies. Careful records are maintained with vouchers completed each time funds are withdrawn.

31. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 31 Unit Summary Where would you find the ABA and MICR features on a check? What is the purpose of a restrictive endorsement?

32. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 32 Employee Salary, Benefits, and Tax Records 4 4 U N I T

33. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 33 W-4 and W-2 Forms W-4 form  Employees’ withholding allowance certificate  Identifies the number of exemptions being claimed W-2 form  Annual statement of earnings and deductions  Sent to each employee by January 31 of each year for tax purposes.

34. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 34 I-9 Forms I-9 forms  Employment Eligibility Verification form  Issued by the Department of Justice, Immigration and Naturalization Service  Assures the employer that the individual has legal permission to work in the United States

35. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 35 Items Needed for Payroll Records and Personnel Files Employee information: name, address, phone number Social security number Date of employment Salary Gross earnings Individual deductions Net earnings

36. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 36 Hourly Wages and Salary Hourly wages  Computed by multiplying the number of hours worked by a specified amount of money Salary  Represents either hourly wages or an agreed upon amount that is paid annually for service provided by the employee

37. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 37 Gross and Net Salary Gross salary is the amount earned prior to deductions. Net salary is the amount earned after deductions.

38. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 38 Factors That Affect Federal Tax Withholdings Four factors that affect federal tax withholdings: 1. Amount earned 2. Marital status 3. Number of exemptions claimed 4. Length of the pay period

39. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 39 Salary Benefits Vacation Holidays Sick time Personal time Disability and life insurance Bereavement Jury duty Paid time off Insurance Profit sharing

40. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 40 Unit Summary What are the four factors that affect the amount of federal income tax withheld? How would you describe gross and net salary?

41. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 41 General Management Duties 5 5 U N I T

42. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 42 Refunds to Patients The office manager must verify that there has been an overpayment on the account prior to approving reimbursement to the patient.

43. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 43 The Problem with No Shows Patients who do not show up for their appointments cause a loss of revenue for the office and may even prevent another patient from being seen by the physician.

44. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 44 Ensuring Inventory Supplies The office manager generally creates a card or electronic filing system of suppliers that the office uses. This system lists:  The supplier and contact information  Materials ordered from the supplier  Amounts generally ordered and the cost (continued)

45. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 45 Ensuring Inventory Supplies The office manager generally creates a tracking system for all materials and supplies that includes:  Amount that should be on hand  Amount on hand  Date of last order  Storage requirements  Cost

46. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 46 The Importance of Attention to Office Equipment It is not possible to give quality care to patients with faulty or inadequate office equipment. Contracts for routine maintenance may be in place and equipment should be replaced or purchased according to the needs of the office.

47. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 47 Organizations That Inspect Physicians’ Offices Insurance companies CLIA (Clinical Laboratory Improvement Amendments) COLA (Commission on Office Laboratory Accreditation) (continued)

48. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 48 Organizations That Inspect Physicians’ Offices Occupational Safety and Health Administration (OSHA) for evaluation of office safety compliance Local or state boards of health Drug Enforcement Agency (DEA) for compliance

49. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 49 Manager’s Responsibilities To employees:  Interview, hire, and terminate employees  Supervise and train employees  Conduct staff meetings  Arrange work schedules  Arrange vacation schedules  Conduct performance evaluations (continued)

50. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 50 Manager’s Responsibilities To the physician:  Report employees’ salary increases and benefit changes  Assist in creating or updating office policies  Attend meetings to update management skills  Update the physician on staff and insurance company changes  Order materials and supplies

51. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 51 Facility Responsibilities Purge medical records. Purge x-rays. Arrange for storage of purged materials. Suggest repairs or improvements. Clean and store or discard irrelevant items. Maintain a clean office. Monitor and pay all utilities.

52. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 52 Unit Summary What office equipment requires frequent attention? How would you describe the responsibilities of the office manager to the employees?

53. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 53 Keys to Career Success The successful medical assistant may look forward to becoming an office manager. Taking the additional responsibility for banking or maintaining equipment provides an opportunity for personal and professional growth.

54. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 10 - 54 Hot Links to Career Success www.btcc.com  Bankers Training and Certification Center www.epracticemanagement.org  The American Academy of Medical Management