Which of the following actions should a medical assistant who is participating in patient-centered medical home care expect to perform?
Negotiate with insurance companies for increased reimbursement.
Communicate with a nurse coordinator for transportation needs.
Schedule admissions to a facility.
Focus strictly on the course of treatment.
The Correct Answer is B
A. Negotiate with insurance companies for increased reimbursement. Negotiating with insurance companies is typically not a responsibility of a medical assistant within a PCMH.
B. Communicate with a nurse coordinator for transportation needs. This is correct. In a PCMH model, medical assistants may coordinate with other members of the healthcare team, including nurse coordinators, to address various patient needs, including transportation.
C. Schedule admissions to a facility. While scheduling may be part of a medical assistant’s duties, it is not specific to the PCMH model.
D. Focus strictly on the course of treatment. The PCMH model involves a holistic approach to patient care, not just focusing on treatment. It includes coordination of care, addressing social determinants of health, and ensuring continuity of care.
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Correct Answer is A
Explanation
A. A patient who has a breathing disorder: Fowler’s position (sitting with the head of the bed elevated) can help ease breathing difficulties by allowing better lung expansion.
B. A patient who has severe hypotension: Fowler’s position may exacerbate hypotension. A supine or Trendelenburg position might be more appropriate for severe hypotension.
C. A patient who is having a perineal examination: A lithotomy position is generally used for perineal examinations.
D. A patient who is having a rectal examination: The Sims' position is typically used for rectal examinations.
Correct Answer is A
Explanation
A. Obtain precertification: Obtaining precertification from the insurance company is often required before scheduling a surgical procedure to ensure that the procedure will be covered under the patient’s insurance plan.
B. Code the diagnosis and procedure: Coding the diagnosis and procedure is typically done after the procedure has been scheduled and is part of the billing process.
C. Complete the CMS-1500 claim form: The CMS-1500 claim form is used for billing and is completed after the procedure has been performed, not before scheduling.
D. Review the claim information: Reviewing claim information is part of the post-procedure billing process, not the scheduling process.