Ethical Profiling By Medical Assistants

A nurse is given an opportunity to help patients, either if its by helping them through a very serious sickness or just helping a patient get to the bathroom on time, or a time when happiness is overfilling the room and a child is being born. Registered nurses provide a wide variety of patient care services (Mitchell, p.12). A Nurse must always know where to begin and where to stop, as any other career in the health field there is always something that cannot be done by everyone but only the certified person, a nurse must always remain inside her scope of practice to prevent any misunderstandings. A nurse must also follow a code of ethics , the code of ethics of the American Association of Medical Assistants states that a nurse should at all times render service with full respect and dignity of humanity, respect confidential information obtained by a patients file, uphold the honor and high principles the profession and accept its discipline, and last but not least always want to improve her services to better serve the health and well being of the community. (Mitchell, p.65).

Physician Assistant’s who may also go by the name PA, practice medicine under the supervision of a physician or a surgeon. PA’s must be formally trained and can examine patients, review medical histories, diagnose illnesses and injuries, order and interpret diagnostic tests such as x-rays and blood tests, prescribe medication, document patient progress, and treat a range of ailments (Bureau of Labor Statistics, U.S. Department of Labor, 2014). The physician assistants code of ethics is divided into four categories; Patient independence, goodwill, fair treatment and nonmaleficence (Anderson, J. (2015)). The code of ethics promotes dignity, integrity, honesty and accountability.

Responsible coder collects post and manages account payments, submitting claims and keeping in touch with insurance companies. If patient information is coded incorrectly or incomplete it could leave an impact that can be brought to a claim. Inaccuracy in patient information can leads to denials, none payment and investigation. It is important to get all the details right by verifying insurance coverage properly. Make sure that the patient’s name is spelled correctly, date of birth and sex of patient are correct; and most important be sure that the policy number is valid.0verall before claims are sent, documentation should be in order and the claim should be checked for completeness and accuracy.

There’s also non-maleficence, which basically means, ‘Do no harm’. The physician assistant must aim at producing a net benefit over harm. 6 If Sally decides not to treat the abusive patient, which is simply abandoning the patient, then she is doing harm. Ignoring the patient’s needs is an act of negligence, which will probably cause the patient’s condition to worsen. Sally must act accordingly with the Deontological view 7, which requires her to do her duty as a medical provider to treat the patient no matter what he does. This requires Sally to show the virtue of compassion as she is trying to provide care even to the most abusive, noncompliant, dishonest patients. This act will also satisfy some of the competencies a physician assistant must uphold: Commitment, dedication and self-regulation.

"Medical coding professionals provide a key step in the medical billing process. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS." (Aapccom, 2015) It is very important that billing coders have a full understanding of how to properly use medical codes to prevent denial of claims submitted.

As the CFO of Health Care Systems, Inc., I feel like, in order to have proper reimbursement, correct coding is very important. If the codes are wrong, the charges will be wrong, as well. When you submit codes, the federal government uses them to reduce health care fraud. It is always good practice to double check your numbers before you submit them. “So, knowing the difference a diagnosis code of 280 (iron deficiency anemia) and 820 (a fracture of the neck of the femur) will help protect your practice from fraud and

The E/M code's is a big important part in this process. Being a health care professional, using the medical code's. like medicare, medicaid, other private insurance to be reimbursement. If not using the right code, the doctor office, hospital, and urgent care. Will lose a lot of money. So using the right cpt code's insurance companies, office, hospital, and urgent care can be reimbursement correct. Cause CPT code's are formed with 5 digits.

properly documented and can be billed to you in the correct manner. Also, another use for medical codes is to protect yourself from false

As a medical assistant I can make a patient with a skin disorder feel more comfortable by allowing the patient to tell me what they are willing to do. I would not overstep my boundaries by pushing a patient to do something that they are not comfortable with. Although if the doctor is recommending that a patient needs to show more skin than they are used to, I as the medical assistant will tell the patient why it is advised and why they should corporate. If the patient still does not want to do it, I will simply note it in their chart and let the doctor handle the situation from then on.

Medical coding, on the other hand, deals more closely with patient medical records. Medical coders work in the billing office, or “back office” of medical practices or hospitals. Alphanumeric codes are assigned to all illnesses, injuries and treatments. Medical procedures are coded for the purpose of classifying diseases in numerical sequences for identification and data collection purposes, similar to the Dewey Decimal System in libraries. Coding specialists review medical records and assign numeric codes for the diagnoses identified and procedures performed. Each medical procedure and patient encounter has a number (CPT code) associated with it which corresponds to an ICD code. These

An accurate and specific documentation of universally accepted set of codes are important for the protection of healthcare providers as well as increased reimbursement for services received. These codes are for the validation of which services the patient received from their health care provider ( (Page, 2009). Having the correct codes in place insures the provider with the information needed by the health insurance carrier. Maintained by the AMA (American Medical Association), this universal numeric assignment is also used for developing guidelines for medical care review as well as data collection for medical education and research (Scott, 2013).

The definition for Medical Billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a health provider. The definition for Medical coding, is the process of converting diagnosis codes to ICD-9/10 codes and procedure codes into CPT codes. A Medical Biller and Coder may specialize in different areas. One area is in-patient facilities, and another area is in and out-patient facilities. An In-patient Coder works in an in-patient facility such as a nursing home, a rehabilitation centers or a hospital. Coders who work in hospital facility may utilize a different skill set, than those who work in a different kind of a health facility. A Coder needs to be

Responsible coder collects post and manages account payments, submitting claims and keeping in touch with insurance companies. If patient information is coded incorrectly, or incomplete it could leave an impact that can be brought to a claim. Inaccuracy in patient information can lead to denials, none payment and investigation. It is important to get all the details right by verifying insurance coverage properly. Make sure that the patient’s name is spelled correctly, date of birth and sex of the patient are correct; and most important be sure that the policy number is valid.0verall before claims are sent, documentation should be in order and the claim should be checked for completeness and accuracy.

Healthcare professionals will be faced with ethical dilemmas throughout their career, particularly in the hospital environment. Having an education regarding professional healthcare ethics will provide some direction in how to best address these dilemmas at a time when either the patient or their family is in need of making decisions for themselves or their family member. It can be difficult for healthcare professionals to weigh professional protocol against their own personal beliefs and ethical understandings when determining critical care for their patient.

specialist determine the ICD, CPT or HPCS coding. The coder or biller may have to communicate with the healthcare provider if there are any questions on any of the diagnoses, treatments or duration of the office visit (Dietsch, 2011). Because insurance companies are very strict on correct medical billing and coding, a small mistake can cause the insurance company to deny the claim and will then require the doctor to fix the error and the claim will need to be resubmitted (Cocchi & White, n.d.).