Put The Following Steps In The Order Of A Routine Patient Ca
Put The Following Steps In The Order Of A Routine Patient Care Flow F
Put the following steps in the order of a routine patient care flow, from the beginning through to the end of the patient encounter flow:
• New patient paperwork is signed and returned to front desk with insurance information for verification of benefits
• Patient pays standard co-pay if applicable
• Hard copy record is pulled, or made if new patient
• Patient called to back office
• Height, weight, and blood pressure taken by CNA or CMA
• CMS 1500 form is coded and sent to insurance for reimbursement
• Signs in at reception desk
• Patient released from exam room
• Call in to schedule appointment
• Doctor, NP, or Physician’s Assistant examines patient
• Shown to patient care room
• Reason for visit reviewed with patient by CNA, CMA, or NP
• Any refunds due to patient or insurance sent out
• Collections efforts initiated if patient's charges not paid, and any insurance appeals are processed
• Patient checks out and pays any deductible verified
• Explanation of benefits returns with breakdown of payments
• Height, weight, and blood pressure taken by CNA or CMA
• Practice manager applies payments, writes off amounts required by contract with insurance companies, adjusts patient’s account records, and initiates billing to patient that indicates insurance has processed charges
Paper For Above instruction
The process of patient care in a medical setting follows a structured routine that ensures efficient, comprehensive, and patient-centered service. It begins with administrative procedures such as signing and returning new patient paperwork, which includes insurance information necessary for benefits verification. Once the patient's information is secured, the next steps involve financial transactions, including collecting co-pays if applicable and verifying whether the patient has paid deductibles at checkout. For new patients, the medical staff pulls or creates a hard copy of the medical record before the patient is called back to the examination area.
After being called to the back office, vital signs such as height, weight, and blood pressure are taken by a certified nursing assistant (CNA) or a certified medical assistant (CMA). These measurements are essential for assessing the patient’s health status and are documented accurately in the patient’s record. Subsequently, the physician, nurse practitioner (NP), or physician’s assistant conducts a thorough examination, reviews the reason for the visit with the patient, and documents clinical findings. During the encounter, the practice's administrative staff may also explain the visit details and gather additional patient information.
Following the consultation, coding staff prepare and submit the CMS 1500 form to insurance for reimbursement. This step is vital for billing and ensuring the clinic receives appropriate payment for services rendered. Once the insurance processes the claim, an Explanation of Benefits (EOB) is returned, detailing how the charges were processed and what payments were made by the insurance. The billing department then reviews the EOB, applies insurance payments to the patient’s account, and writes off any contractual adjustments. If there are outstanding balances, collection efforts are initiated, and any necessary insurance appeals are pursued.
At the end of the patient encounter, the patient is directed to check out at the reception desk, where remaining balances, such as deductibles, are settled. If refunds are necessary—either to the patient or insurance—they are processed accordingly. The practice manager reviews and adjusts the patient account records, applies payments, and initiates billing to the patient for any remaining charges. This workflow ensures a smooth and organized approach, from the initial patient contact through to final billing and follow-up, maintaining compliance with healthcare regulations and optimizing revenue cycle management.
References
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Miller, R., & Johnson, D. (2022). Managing the Revenue Cycle in Healthcare. Routledge.
Nelson, L., & Carter, S. (2017). The Complete Medical Assistant. Jones & Bartlett Learning.
O’Neill, T. (2020). Coding and Reimbursement for Healthcare Providers. AAPC Publishing.
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