role as medical administrator at a podiatrist medical office

Medical Administration Mod 3

Read the scenario below and complete the tasks that follow.


You just accepted a role as medical administrator at a podiatrist medical office. There are many responsibilities associated with this position including managing the office, patient registration, insurance verification/referrals, and scheduling following up appointments. As you navigate through your first day at work, the waiting room is full and a patient with a severe foot infection is seeking treatment without an appointment. As part of your new position and responsibilities, you will be required to review, assess, and participate in all medical administrative duties that will support this patient.

As the new medical administrator, you have will complete an encounter form of the new patient with a severe foot infection.

Identify and summarize the steps for registering this patient by completing the encounter form as the patient and the registration form as the medical administrator, which includes verification of the patient insurance. HIPAA privacy rule should be adhered when registering the patient.

In order to successfully complete the Outpatient Encounter Form and the Patient Registration Form below, please use the information contained in the following document:

Patient and Outpatient Information

  • Patient Welcome/Managing Wait Time
    • In one page summarize how to greet the patient and manage the waiting room
    • Include a brief outline describing how to verify the patient’s insurance
  • Outpatient Encounter Form
  • Patient Registration Form
  • Apply HIPAA rules when documenting patient information
    • Outline the five steps under the HIPAA privacy rule to ensure patient information is protected while registering the patient. The summary should follow the “Guidelines for Ensuring” patient privacy isn’t breached in the reception area

Outpatient Encounter Form

Patient Information Billing Information Visit Information
Patient ID number Primary Visit date
Patient name Primary ID number Visit number
Address Primary group number Rendering physician
City/State Secondary Referring physician
Social Security number Secondary ID number Reason for visit
Phone number Secondary group no.
Date of birth Cash/credit card
Age Other billing
E/M Modifiers Procedure Modifiers Other Modifiers
24 — Unrelated E/M service during postop. 22 — Unusual, excessive procedure
25 — Significant, separately identifiable E/M 50 — Bilateral procedure
57 — Decision for surgery 51 — Multiple surgical procedures in same day
52 — Reduced/incomplete procedure
55 — Postop. management only
59 — Distinct multiple procedures
Office Visit — New Patient Wound Care
Minimal office visit 99201 Debride partial thick burn 11040
20 minutes 99202 Debride full thickness burn 11041
30 minutes 99203 Debride wound, not a burn 11000
45 minutes 99204 Unna boot application 29580
60 minutes 99205 Unna boot removal 29700
Other Other
Office Visit — Established Supplies
Minimal office visit 99211 Ace bandage, 2” A6448
10 minutes 99212 Ace bandage, 3″-4” A6449
15 minutes 99213 Ace bandage, 6” A6450
25 minutes 99214 Cast, fiberglass A4590
40 minutes 99215 Coban wrap A6454
Other Foley catheter A4338
General Procedures Immobilizer L3670
Anascopy 46600 Kerlix roll A6220
Audiometry 92551 Oxygen mask/cannula A4620
Breast aspiration 19000 Sleeve, elbow E0191
Cerumen removal 69210 Sling A4565
Circumcision 54150 Splint, ready-made A4570
DDST 96110 Splint, wrist S8451
Flex sigmoidoscopy 45330 Sterile packing A6407
Flex sig. w/ biopsy 45331 Surgical tray A4550
Foreign body removal—foot 28190 Other
Nail removal 11730 OB Care
Nail removal/phenol 11750 Routine OB care 59400
Trigger point injection 20552 OB call 59422
Tympanometry 92567 Ante partum 4–6 visits 59425
Visual acuity 99173 Ante partum 7 or more visits 59426
Other Other

Other Visit Information: Fees:

Lab Work to Order: Total Charges: $

Referral to: Copay Received: $

Provider Signature: Other Payment: $

Next Appointment: Total Due: $

� MACROBUTTON DoFieldClick [Company Name]�

Company Name, Street Address, City, State ZIP Code, phone number


(Please Print)

Today’s date: PCP:

PATIENT INFORMATION Patient’s last name: First: Middle:  Mr.

 Mrs.  Miss  Ms.

Marital status (circle one)

Single / Mar / Div / Sep / Wid

Is this your legal name? If not, what is your legal name? (Former name): Birth date: Age: Sex:

 Yes  No / /  M  F

Street address: Social Security no.: Home phone no.:

( )

P.O. box: City: State: ZIP Code:

Occupation: Employer: Employer phone no.:

( )

Chose clinic because/Referred to clinic by (please check one box):  Dr.  Insurance Plan  Hospital

 Family  Friend  Close to home/work  Yellow Pages  Other

Other family members seen here:

INSURANCE INFORMATION (Please give your insurance card to the receptionist.)

Person responsible for bill: Birth date: Address (if different): Home phone no.:

/ / ( )

Is this person a patient here?  Yes  No

Occupation: Employer: Employer address: Employer phone no.:

( )

Is this patient covered by insurance?  Yes  No

Please indicate primary insurance  [Insurance]  [Insurance]  [Insurance]  [Insurance]  [Insurance]

 [Insurance]  [Insurance]  [Insurance]  Welfare (Please provide coupon)  Other

Subscriber’s name: Subscriber’s S.S. no.: Birth date: Group no.: Policy no.: Co-payment:

/ / $

Patient’s relationship to subscriber:  Self  Spouse  Child  Other

Name of secondary insurance (if applicable): Subscriber’s name: Group no.: Policy no.:

Patient’s relationship to subscriber:  Self  Spouse  Child  Other

IN CASE OF EMERGENCY Name of local friend or relative (not living at same address): Relationship to patient: Home phone no.: Work phone no.:

( ) ( )

The above information is true to the best of my knowledge. I authorize my insurance benefits be paid directly to the physician. I understand that I am financially responsible for any balance. I also authorize [Name of Practice] or insurance company to release any information required to process my claims.

Patient/Guardian signature Date

  • [Name of Practice]
  1. Todays date:
  2. PCP:
  3. Patients last name First Middle:
  4. salutation:
  5. salutation_2:
  6. Yes:
  7. No:
  8. If not what is your legal name:
  9. Former name:
  10. Birth date:
  11. Age:
  12. Sex:
  13. Street address:
  14. Social Security no:
  15. Home phone no:
  16. PO box:
  17. City:
  18. State:
  19. ZIP Code:
  20. Occupation:
  21. Employer:
  22. Employer phone no:
  23. Chose clinic becauseReferred to clinic by please check one box:
  24. Family:
  25. Friend:
  26. Close to homework:
  27. Other:
  28. Yellow Pages:
  29. Dr:
  30. Insurance Plan:
  31. Hospital:
  32. Other family members seen here:
  33. Person responsible for bill:
  34. Birth date_2:
  35. Address if different:
  36. Home phone no_2:
  37. Is this person a patient here Yes No:
  38. undefined:
  39. undefined_2:
  40. Occupation_2:
  41. Employer_2:
  42. Employer address:
  43. Employer phone no_2:
  44. Is this patient covered by insurance Yes No:
  45. undefined_3:
  46. undefined_4:
  47. Insurance:
  48. Insurance_2:
  49. Insurance_3:
  50. Insurance_4:
  51. Insurance_5:
  52. Welfare Please provide:
  53. Insurance_6:
  54. Insurance_7:
  55. Insurance_8:
  56. Other_2:
  57. Subscribers name:
  58. Subscribers SS no:
  59. Birth date_3:
  60. Group no:
  61. Policy no:
  62. Patients relationship to subscriber Self Spouse Child Other:
  63. undefined_5:
  64. undefined_6:
  65. undefined_7:
  66. undefined_8:
  67. Name of secondary insurance if applicable:
  68. Subscribers name_2:
  69. Group no_2:
  70. Policy no_2:
  71. Patients relationship to subscriber Self Spouse Child Other_2:
  72. undefined_9:
  73. undefined_10:
  74. undefined_11:
  75. undefined_12:
  76. Name of local friend or relative not living at same address:
  77. Relationship to patient:
  78. Date:

Module 03 Course Project – Part 1


 Practice – The People’s Clinic

 Address – 1000 Town Square, Anytown Pennsylvania 54321

 Phone – 555-741-8529


 Patient – Mrs. Jane Doe

 Married

 Former name – Jane Smith

 DOB – 01/01/1960

 SSN – 123-45-6789

 Address – 123 Main Street, Anytown Pennsylvania 54321

 Phone – 555-987-6543

 Occupation – Nurse

 Employer – The People’s Hospital

 Employer Phone – 555-456-7890

 Doctor referral to clinic


 Jane Doe is responsible for payment

 Primary insurance is Blue Cross Blue Shield

 Subscriber – Jane Doe

 ID – 123123123

 Grp – 00550055

 No secondary insurance


 Suzie Smith (sister)

 Home – 555-567-8910

 Work – 555-678-9012


Jane Doe (chart #0987) saw Dr. Brown on 1-1-2015.

She is 5’5’’ tall and weighs 130 pounds

Her blood pressure was 120/70

Her pulse was 60

Her temperature was 98.6

This was her second visit with Dr. Brown after she was referred by Dr. White. She is seeing Dr. Brown

for adult onset IDDM (insulin dependent diabetes mellitus).

Jane’s visit was only for an office visit and laboratory tests. Dr. Brown spent 25 minutes with Jane at this

visit and ordered lab testing for Hemoglobin A1C. Jane needs to return to see Dr. Brown in 1 month.

When Jane checked out she gave the receptionist her encounter form which had the office visit at a cost

of $100. She paid the amount of her copayment which was $20.

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