Put The Following Steps In The Order Of A Routine Pat 156551

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

•Signs in at reception desk

•Call in to schedule appointment

•Shown to patient care room

•Reason for visit reviewed with patient by CNA, CMA, or NP

•Height, weight, and blood pressure taken by CNA or CMA

•Doctor, NP, or Physician’s Assistant examines patient

•CMS 1500 form is coded and sent to insurance for reimbursement

•Explanation of benefits returns with breakdown of payments

•Patient checks out and pays any deductible verified

•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

•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 released from exam room

Paper For Above instruction

In a standard outpatient medical practice, the patient care process follows a systematic flow to ensure efficient and effective delivery of healthcare services. The process begins with administrative procedures such as the patient arriving and signing in at the reception desk. For new patients, their paperwork is completed and insurance information is verified, which may involve pulling or creating a medical record. Patients then proceed to schedule their appointments, either by calling in or through online systems, and are subsequently shown to the examination room.

Once in the examination room, the healthcare team reviews the reason for the visit with the patient, providing an opportunity for the patient to express concerns or symptoms. The medical assistants, such as CNAs or CMAs, take vital signs including height, weight, and blood pressure. These initial assessments support the healthcare provider—doctor, nurse practitioner, or physician’s assistant—in conducting a thorough examination.

After the clinical assessment, documentation such as the CMS 1500 form is prepared and submitted to insurance companies for reimbursement. During the review process, explanations of benefits are received, detailing coverage and payments made. This information informs billing and collections efforts, which include applying payments, adjusting amounts per insurance contracts, and issuing refunds if necessary. Patients are responsible for any deductibles, which they pay at checkout, where the practice staff also verify the payment and update the patient's financial records.

Throughout this process, administrative tasks such as coding insurance claims, processing payments, and initiating appeals or collections are integral. Once all billing and payments are settled, patients are formally released from the exam room, marking the completion of the clinical encounter. This structured flow ensures that patient care is not only comprehensive but also aligned with insurance and billing requirements, facilitating smooth operation within outpatient healthcare settings.

References

  • American Medical Association. (2020). CPT Coding Manual. AMA Press.
  • Centers for Medicare & Medicaid Services. (2022). CMS 1500 Claim Form Instructions. CMS.gov.
  • Gordon, G. (2021). Medical Office Procedures and Billing. Medical Practice Management.
  • Haines, T. (2019). Efficient Patient Flow in Clinical Practice. Health Administration Press.
  • Jones, L., & Smith, R. (2018). Billing and Reimbursement in Healthcare. Springer Publishing.
  • Reid, R. E. (2020). Medical Office Management. Assessment Technologies Institute.
  • Smith, A. (2021). Outpatient Procedures and Documentation. Elsevier.
  • Thomas, K., & Williams, D. (2019). Medical Billing and Coding for Healthcare Professionals. Cengage Learning.
  • U.S. Department of Health & Human Services. (2023). Patient Intake and Documentation Best Practices. HHS.gov.
  • Williams, P. (2022). Healthcare Revenue Cycle Management. Routledge.

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