MEDICAL RECORDS TECHNOLOGIES 51.0707.00

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DISTINGUISH AMONG VARIOUS HEALTHCARE DELIVERY SYSTEMSMRT 1.0

  • 1.1

    Identify private healthcare facilities (i.e., hospitals, extended care facilities, long-term care services, etc.)MRT 1.1 

  • 1.2

    Identify government healthcare agencies (i.e., public health services, critical access hospitals, etc.)MRT 1.2 

  • 1.3

    Identify voluntary health agencies (i.e., American Heart Association, American Cancer society, National Lung Institute, nonprofit hospitals, visiting nurse associations, local service organizations, etc.)MRT 1.3 

  • 1.4

    Identify ambulatory care services (i.e., private medical practices, hospital-based ambulatory care services, outpatient surgical services, etc.)MRT 1.4 

  • 1.5

    Define subacute and acute careMRT 1.5 

USE MEDICAL TERMINOLOGY AS APPLIED IN HEALTHCARE SYSTEMSMRT 2.0

  • 2.1

    Use medical terminology as it relates to patient medical recordsMRT 2.1 

  • 2.2

    Explain the division of medical word partsMRT 2.2 

  • 2.3

    Identify medical word combining formsMRT 2.3 

  • 2.4

    Explain medical terminology prefixes and suffixesMRT 2.4 

DEMONSTRATE AN UNDERSTANDING OF BODY SYSTEMS AND HUMAN ANATOMYMRT 3.0 

  • 3.1

    Identify body planes and directionsMRT 3.1 

  • 3.2

    Identify body cavities [e.g., dorsal cavities (cranial and spinal) and ventral cavities (thoracic, abdominal, pelvic)]MRT 3.2 

  • 3.3

    Identify body regions and quadrantsMRT 3.3 

  • 3.4

    Identify basic structure and describe the function of the skeletal systemMRT 3.4 

  • 3.5

    Identify basic structure and describe the function of the muscular systemMRT 3.5 

  • 3.6

    Identify basic structure and describe the function of the digestive system MRT 3.6 

  • 3.7

    Identify basic structure and describe the function of the circulatory systemMRT 3.7 

  • 3.8

    Identify basic structure and describe the function of the respiratory systemMRT 3.8 

  • 3.9

    Identify basic structure and describe the function of the central and peripheral nervous system MRT 3.9 

  • 3.10

    Identify basic structure and describe the function of the urinary systemMRT 3.10 

  • 3.11

    Identify basic structure and describe the function of the integumentary systemMRT 3.11 

  • 3.12

    Identify basic structure and describe the function of the endocrine systemMRT 3.12 

  • 3.13

    Identify basic structure and describe the function of the reproductive systemMRT 3.13 

  • 3.14

    Identify basic structure and describe the function of the lymphatic and immune systemMRT 3.14 

  • 3.15

    Describe the medical specialties associated with the body systems (e.g., Cardiologist, OB/GYN, Urologist, Pulmonologist, Dermatologist, Orthopedist, and Otolaryngology)MRT 3.15 

EXAMINE THE PROCESS OF MEDICAL CODINGMRT 4.0 

  • 4.1

    Interpret medical nomenclatures (vocabulary of medical and clinical terms) and classification systems when coding diseases and procedures [e.g., ICD-10-CM (diagnosis), ICD-10-PCS (facility procedure billing codes), CPT (professional procedure codes), and HCPCS (durable medical codes)]MRT 4.1 

  • 4.2

    Discuss the links between CPT codes and ICD-10-CM codes in relation to medical necessity for reimbursement for charges billedMRT 4.2 

  • 4.3

    Use source documents when coding diseases and operationsMRT 4.3 

  • 4.4

    Apply processes and procedures for coding diagnoses with accuracy and completenessMRT 4.4 

  • 4.5

    Describe the integration of paper records with electronic records through indexingMRT 4.5 

APPLY PAYER GUIDELINESMRT 5.0 

  • 5.1

    Explain the Medicare National Correct Coding InitiativeMRT 5.1 

  • 5.2

    Explain third-party payers [e.g., Medicare, Medicaid (AHCCCS), and commercial and private insurers]MRT 5.2 

  • 5.3

    Explain the difference among HMOs, PPOs EPOs IOSs, IPAs, and consumer directed plansMRT 5.3 

  • 5.4

    Explain the use of the master patient index to improve quality care, reduce costs, and increase efficiencyMRT 5.4 

  • 5.5

    Verify accurate collection of proper patient demographic and insurance informationMRT 5.5 

  • 5.6

    Verify patient insurance eligibility and benefits, authorization, and referral (e.g., pre-authorization, pre-certification, and predetermination)MRT 5.6 

  • 5.7

    Interpret remittance advice to determine the financial responsibility of the patient and the insurance company and post payments MRT 5.7 

  • 5.8

    Identify accounts that are ready for final billing and how to obtain information for accounts that are not ready for billingMRT 5.8 

  • 5.9

    Interpret collection policies and laws for accounts that govern collection [e.g., Federal Trade Commission Act (FTCA) and Fair Debt Collection Practices Act (FDCPA)]MRT 5.9 

EXECUTE HEALTHCARE PRIVACY, CONFIDENTIALITY, AND LEGAL AND ETHICAL METHODS RELATED TO MEDICAL RECORDSMRT 6.0 

  • 6.1

    Explain HIPAA Privacy Rule standards to maintain compliance with the privacy and security of Protected Health Information (PHI) MRT 6.1 

  • 6.2

    Define the safeguards of the HIPAA Security RuleMRT 6.2 

  • 6.3

    Apply policies and procedures for use and disclosure of Protected Health Information (PHI) in compliance with HIPAA standardsMRT 6.3 

  • 6.4

    Identify appropriate release of patient-specific data to authorized users per HIPAA guidelinesMRT 6.4 

  • 6.5

    Describe how and when to de-identify Protected Health Information (PHI) as directed by HIPAA regulationsMRT 6.5 

  • 6.6

    Analyze the process for investigating audit complianceMRT 6.6 

  • 6.7

    Identify components used in internal audits of medical records (e.g., consent forms, Release of Information forms (ROI), and signature on file)MRT 6.7 

  • 6.8

    Evaluate methods to protect patients’ rights through legal, moral, and ethical measures (e.g., HIPAA, legal liability, and malpractice)MRT 6.8 

PERFORM SCHEDULING AND OTHER MEDICAL OFFICE FUNCTIONSMRT 7.0 

  • 7.1

    Obtain and verify patient information for scheduling registration and check-inMRT 7.1 

  • 7.2

    Schedule patient appointments (paper and electronic) and provide patients with complete appointment informationMRT 7.2 

  • 7.3

    Process and maintain security of mail, email, and faxesMRT 7.3 

  • 7.4

    Apply telephone etiquette to telephone callsMRT 7.4 

  • 7.5

    Obtain prior authorization and benefit information from insurance companiesMRT 7.5 

  • 7.6

    Process patient for checkout including any additional instructionsMRT 7.6 

  • 7.7

    Purge and back up patient paper and electronic recordsMRT 7.7 

MAINTAIN THE MEDICAL RECORDS SYSTEMMRT 8.0 

  • 8.1

    Collect and input patient demographics (i.e., name, address, contact information, etc.)MRT 8.1 

  • 8.2

    Collect and input patient insurance, payment guarantor information, and necessary signed consent formsMRT 8.2 

  • 8.3

    Collect and input medical history (i.e., allergies, social history, family history, current medications, etc.)MRT 8.3 

  • 8.4

    Record provider services notes and instructions including patient communications regarding the instructionsMRT 8.4 

  • 8.5

    Record ordered tests and procedures and the resultsMRT 8.5 

  • 8.6

    Explain the purpose of superbills, charge tickets, and encounter formsMRT 8.6 

  • 8.7

    Explain the legalities of recording changes, additions, and deletions in the medical record MRT 8.7 

APPLY REVENUE MANAGEMENT TASKSMRT 9.0 

  • 9.1

    Explain key components in the healthcare revenue cycle (i.e., scheduling, patient registration and eligibility of insurance, upfront patient collections, medical billing and patient collections, etc.)MRT 9.1 

  • 9.2

    Explain the financial accounting processes (i.e., primary or secondary insurance to be billed, fees for returned checks, statements, cash-pay fee schedule, doctor’s fee schedule, interest or finance charges, etc.)MRT 9.2 

  • 9.3

    Explain resource allocation and data analytics when managing budgetsMRT 9.3 

  • 9.4

    Identify the benefits of revenue managementMRT 9.4 

UTILIZE MEDICAL RECORDS TECHNOLOGIES REPORTINGMRT 

  • 10.1

    Describe the basic need for statistical reports for clinical Quality Improvement (QI) measures including the clinical process and financial measuresMRT 10.1 

  • 10.2

    Compile medical care and census data for continuity of care records (e.g., statistical reports on diseases treated, surgery performed, and use of hospital beds for clinical audits)MRT 10.2 

  • 10.3

    Define Diagnosis-Related Groups (DRGs) and outliers when classifying patients for purposes of paymentMRT 10.3 

Frequently asked questions

What grade levels do these standards cover?
Grade 11, Grade 12, and VOCATIONALTRAINING
Where can I read the official document?
ARIZONA DEPARTMENT OF EDUCATION

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