Ethical Profiling By Medical Assistants

Coders has to make sure they are putting the decimal in the right place for proper ICD-10 codes in order to get the correct diagnosis. Example Pain in gallbladder K82.9 If it looked like K82 as a coder we would know this not correct and would cause a issue with getting this paid,or the computer kicking it back with error.

In most cases, identification errors lead to ICD and CPT coding that result in dull reimbursement. If the services submitted to the electronic health record system are not written in the patients’ health records, it could also lead to dull reimbursement. Failure to bill records before submission as well as lack of accuracy and wrong use of codes also leads to dull reimbursement (Romano & Stafford 2011). For the claim to demonstrate medical necessity for the exam, the patient’s electronic health records submitted to the system must describe in details the procedure that the patient is to

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.

"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.

The way the on-site dental assistants are asking the dental assistant student to treat the patient presents an ethical dilemma that needs to be dealt with. This circumstance should be seen as a prima facie duty, which means, there is an obvious way to respond to the present situation. The obvious problems to confront are the violation of the patient’s rights as well as transgressing a portion of infection control, standard precautions. Following standard precautions means treating every patient as if they already have an infectious disease. When treating a patient, there should be no extra precautionary measures outside of the standard precautions. This patient trusts us to provide them with optimal care. They trust us to treat them with equality. These on-site assistants are treating this patient like a rabid animal. It is as if the on-site dental assistants fear the patient because of his condition. If standards precautions are being followed, the dental assistant should not need to wear a different gown, wear extra face protection, or follow a different sterilization method. The dental assistant also shouldn’t have to run the instruments through the autoclave twice. If I were the patient, and I realized I was being treated differently than the other patients, I would be

The Top 5 ethical dilemmas for medical assistants are Patient Confidentiality, Patient Relationships, Malpractice and Negligence, Informed Consent, and Issues Related to Physician Assisted Suicide (PAD). For the issue with Patient Confidentiality a patient information is supposed to be kept covertly. If a doctor breach a patient’s confidentiality this can hurt the patient and will result in legal and ethical action for the healthcare specialist. For the issue with Patient Relationships a physician is lawfully banned from falling into an intimate relationship with a patient in the line of providing treatment. For the issue of Malpractice and Negligence if a patient is hurt by poor medical equipment or wounded in the procedure of a medical treatment

Jerry has been trained as a medical assistant and well as LPN or licensed practical nurse. Having an occupation as being a medical assistant is regulated loosely in the U.S. In addition, many states lack medical assistant certification and training requirements. It may be surprising that licensing for medical assistants does not exist. Despite inconsistent regulation, every state mandates by law that whenever a medical assistant provides any type of direct patient care, the supervising physician or licensed health care professional must be physically present in the office or building (medicalassistant.net website, 2012). Another law that is consistent in every state is one that prohibits medical assistants from independently prescribing or refilling medications (medicalassistant.net website, 2012). Licensed Practical Nurses have a broader scope of practice than medical assistants do, but prescribing or refilling medications is not included. In this case study, only Dr. Williams is able to refill the medication. If Jerry decides to call in a refill he will be practicing outside of his professional scope and breaking state law.

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.

A medical office administrative assistance must know the importance of proper medical documentation,the legal aspects of documentation and the various medical laws, regulations, and acts; understand language and other communication barriers, proper billing and reimbursement procedures, workplace conflict and diversity; and know how to properly maintain patient ledger cards. Accurate medical documentation ensures the patient receives the proper treatment and aides in validating medical necessity. This documentation is not only critical to the patient but the facility as well because it ensures proper codes are assigned, clean claims are submitted, and allows the reimbursement process runs smoothly. Medical office administrative assistants must understand the imporatance in protecting patient privacy because they have an ethical and legal

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.

Medical Coding involves the records of the patients. Medical Coders are responsible for getting all the patients information and records from the office staff, that is how the coding process

I complained to no avail. There argument was that the insurance company said they can charge that. Of course, they will. They'll also say you can charge $100. What medical practice charges for calling in a script? None, because

Computer-assisted coding is defined as the “use of computer software that automatically generates a set of medical codes for review, validation, and use based upon clinical documentation provided by healthcare practitioners”

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.

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.