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District

Medical Assisting Services

Medical Assisting Services 51.0801.00

STANDARD 1.0 PREPARE EXAM ROOM FOR PATIENT
1.1   Disinfect and prepare patient care areas prior to and after each patient encounter and at the end of the day
1.2   Check for safety hazards before each patient encounter and at the end of the day
1.3   Stock instruments and replenish all supplies
1.4   Disinfect and ensure functionality of instruments and equipment and report any concerns appropriately
1.5   Prepare instruments and equipment needed for patient care
1.6   Check expiration date of supplies and properly dispose of expired supplies

STANDARD 2.0 MANAGE FINANCIAL AND INSURANCE TRANSACTIONS
2.1   Review insurance claim forms for content (e.g., appropriate terminology, insurance plans, current ICD/CPT codes, and HIPAA regulations)
2.2   Differentiate between payer types and patient responsibilities [i.e., copay, co-insurance, deductible, self-pay, Advance Beneficiary Notice (ABN), etc.]
2.3   Explain Explanation of Benefits (EOB) to the patient
2.4   Identify and enter diagnosis/procedure codes and charges accurately
2.5   Perform bookkeeping procedures (e.g., post charges and reconcile daily receivables)

STANDARD 3.0 UTILIZE MEDICAL TERMINOLOGY
3.1   Identify and define medical terminology (e.g., root word, prefixes, and suffixes)
3.2   Identify and use approved medical abbreviations

STANDARD 4.0 DEMONSTRATE COMMUNICATION SKILLS
4.1   Demonstrate appropriate written, verbal, and nonverbal communication skills
4.2   Describe and explain coping skills (e.g., trauma, dying, and death)
4.3   Apply coping skills (e.g., trauma, dying, and death)
4.4   Utilize screening tools (i.e., depression, abuse, pain, etc.), document, and report patient status
4.5   Describe and explain cultural diversity in the healthcare setting
4.6   Demonstrate telephone communication skills (e.g., answering, screening, and documenting)

STANDARD 5.0 PERFORM SCHEDULING, CHARTING, AND OTHER OFFICE FUNCTIONS
5.1   Prepare, obtain, and verify patient information for scheduling, registration, and check-in using two forms of patient identification (i.e., state-issued driver’s license, insurance card, photo ID, etc.)
5.2   Practice confidentiality of patient data following HIPAA regulations
5.3   Identify and use the correct chart forms (paper and electronic)
5.4   Follow proper charting documentation procedures (e.g., note date, time, and reason for visit)
5.5   Utilize data collection formats for record keeping [e.g., Subjective, Objective, Assessment, and Plan (SOAP); chief complaint, history, examination, details of complaints, drugs and dosage, assessment, and return visit (CHEDDAR); History, Physical, Impression, Plan (HPIP); Health Practitioners’ Intervention Program (HPIP); problem-oriented medical record (POMR); and Situation-Background-Assessment-Recommendation (SBAR)]
5.6   Sort and prioritize mail, email, and FAXES (paper and electronic)
5.7   Explain the use of the patient portal
5.8   Prioritize and process telephone calls
5.9   Obtain prior authorization from insurance companies
5.10   Obtain eligibility benefits and process referrals
5.11   Process patient for checkout and provide any additional instructions, and plan of care
5.12   Perform basic computer applications (i.e., word processing, email, spreadsheet, electronic health records, practice management software, etc.)

STANDARD 6.0 PREPARE PATIENT FOR PHYSICAL EXAMINATION
6.1   Request two identifiers from each patient (i.e., DOB, first and last name, passport, etc.)
6.2   Obtain and record accurate vital signs (including manual blood pressure) and report abnormal findings
6.3   Obtain and record reason for visit, allergies, medication history, pain level, and necessary screening tools
6.4   Collect patient weight, height, and BMI
6.5   Measure chest and head circumference of pediatric patient
6.6   Recognize changes in patient condition and report changes to licensed healthcare provider
6.7   Prepare patient for exam or procedure (gown/drape)
6.8   Place patient in the appropriate position for procedure (e.g., sitting, standing, supine, Sims, Fowler’s, semi-Fowler, prone, Trendelenburg, and lithotomy)
6.9   Provide for patient comfort, safety, and privacy/modesty
6.10   Instruct patients in preparation for examinations and procedures (e.g., routine physical exams and specialty exams)

STANDARD 7.0 ADMINISTER SELECTED TREATMENTS AND MEDICATIONS
7.1   Change dressings or bandages
7.2   Perform wound care (e.g., sterile technique and cultures), and recognize changes in wound to be reported to licensed healthcare provider
7.3   Remove sutures and skin staples
7.4   Assist with physical modalities (e.g., application of heat/cold, splints/slings, ACE bandages, and cast removal)
7.5   Confirm written order, prepare, and administer correct medication according to use, dosage, side effects, contraindications, and patient education
7.6   Re-verify two patient identifiers and patient allergies prior to medication administration
7.7   Perform dosage calculations and units of measurements
7.8   Administer provider-prescribed medication via specified routes applying the “rights of medication administration”
7.9   Observe the patient for adverse reactions prior to discharge and report changes to a licensed healthcare provider
7.10   Process prescription refill order as directed by a licensed healthcare provider
7.11   Provide vaccination information sheet and obtain patient consent
7.12   Administer vaccinations and complete necessary documentation

STANDARD 8.0 ASSIST PROVIDER WITH PATIENT PROCEDURES
8.1   Identify common instruments needed for procedures
8.2   Prepare and maintain a sterile field and assist the provider as instructed
8.3   Assist provider in minor surgery or procedure
8.4   Collect, label, and process specimens
8.5   Recognize a medical emergency and assist in providing aid
8.6   Perform and document Clinical Laboratory Improvement Amendments (CLIA)-waived point-of-care testing
8.7   Employ principles of asepsis (e.g., sanitization, disinfection, and sterilization)
8.8   Reinforce provider instructions with patient prior to discharge

STANDARD 9.0 MANAGE MEDICAL RECORDS
9.1   Identify components of the medical record
9.2   Ensure accuracy and completeness of the medical record
9.3   Maintain integrity and security of the medical record
9.4   Identify medical filing systems (e.g., numeric and alphabetical)
9.5   Explain record retention practices
9.6   Explain release of medical records and HIPAA requirements

STANDARD 10.0 APPLY STANDARD PRECAUTIONS AND SAFETY MEASURES
10.1   Use hand hygiene according to the Center for Disease Control (CDC)
10.2   Use Universal Precautions according to Occupational Safety and Health Administration (OSHA) and use transmission-based precautions according to CDC
10.3   Identify the procedure for the reporting of communicable diseases and bloodborne pathogens
10.4   Don, remove, and discard personal protective equipment (PPE) according to standard procedure including gloves, gowns, masks, lab coats, goggles, and face shields
10.5   Demonstrate isolation techniques and the use of isolation procedures
10.6   Comply with hazardous labeling requirements according to OSHA (e.g., safety signs, symbols, and special instructions)
10.7   Describe procedures for cleaning laboratory spills
10.8   Handle and dispose of contaminated and hazardous items according to OSHA guidelines
10.9   Use fire and chemical safety protocols [e.g., Safety Data Sheets (SDSs) and the use of fire extinguishers]
10.10   Describe disaster and fire evacuation plans used by various facilities and statewide alert codes
10.11   Maintain a clean work area (e.g., cleaning agents, Clorox, and other disinfectants)
10.12   Maintain a safe work environment (e.g., proper storage of equipment, materials, and chemicals; proper containment of food and personal items; hair tied back and minimal jewelry)
10.13   Maintain environmental control for medications and supplies according to manufacturer specifications
10.14   Use and maintain equipment, materials, and chemicals according to manufacturer specifications
10.15   Report and isolate unsafe conditions for self and others (e.g., frayed cords, spillages, puddles on floor, and bed rails down)
10.16   Demonstrate proper body mechanics and lifting techniques
10.17   Demonstrate imaging safety
10.18   Practice National Patient Safety Goals (NPSG) (i.e., falls, patient medication, clinical alarm systems, etc.)
10.19   Define and utilize Safety Data Sheets (SDSs)
10.20   Perform autoclaving following American National Standards Institute/Association for the Advancement of Medical Instrumentation (ANSI/AAMI) guidelines

STANDARD 11.0 APPLY LEGAL AND ETHICAL PRACTICES
11.1   Follow local, state, and federal laws, rules, and regulations for Medical Assistants
11.2   Explain HIPAA regulations and requirements (i.e., disclosure of information to a spouse, employer request for records, creation of NPI number, etc.)
11.3   Adhere to organizational policy and procedures for Medical Assistants
11.4   Maintain positive professional relationships in the workplace
11.5   Perform professional responsibilities with honesty, reliability, and integrity
11.6   Perform only those tasks within the Medical Assisting scope of practice

STANDARD 12.0 PERFORM CLINICAL SKILLS
12.1   Perform venipuncture
12.2   Perform electrocardiograms
12.3   Perform visual acuity and color vision testing
12.4   Perform audiometry
12.5   Perform basic spirometry and peak flow testing
12.6   Administer small volume nebulizer (SVN) treatment
12.7   Perform pulse oximetry
12.8   Perform ear lavage
12.9   Perform capillary puncture

STANDARD 13.0 REVIEW BODY SYSTEMS
13.1   Identify structure, function, and disorders related to the Integumentary System
13.2   Identify structure, function, and disorders related to the Musculoskeletal System
13.3   Identify structure, function, and disorders related to the Circulatory System
13.4   Identify structure, function, and disorders related to the Respiratory System
13.5   Identify structure, function, and disorders related to the Gastrointestinal System
13.6   Identify structure, function, and disorders related to the Urinary System
13.7   Identify structure, function, and disorders related to the Nervous System
13.8   Identify structure, function, and disorders related to the Endocrine System
13.9   Identify structure, function, and disorders related to the Reproductive System
13.10   Identify structure, function, and disorders related to the Sensory System
13.11   Identify structure, function, and disorders related to the Lymphatic System