Medical assistants work alongside physicians, mainly in outpatient or ambulatory care facilities, such as medical offices and clinics.
In Demand | Medical assisting is one of the nation's careers growing much faster than average for all occupations, according to the United States Bureau of Labor Statistics, attributing job growth to the following:
- Predicted surge in the number of physicians' offices and outpatient care facilities
- Technological advancements
- Growing number of elderly Americans who need medical treatment
Job Responsibilities | Medical assistants are cross-trained to perform administrative and clinical duties, as evidenced by the Occupational Analysis of Medical Assistants.
Here is a quick overview (duties vary from medical practice to medical practice depending on location, size, specialty, and state law):
Clinical Duties (may include, but not limited to):
- Taking medical histories
- Explaining treatment procedures to patients
- Preparing patients for examinations
- Assisting the physician during examinations
- Collecting and preparing laboratory specimens
- Performing basic laboratory tests
- Instructing patients about medication and special diets
- Preparing and administering medications, including by intramuscular, intradermal, and subcutaneous injections—including vaccinations/immunizations, as directed by a physician or other licensed provider (e.g., a nurse practitioner or physician assistant)
- Transmitting prescription refills as directed
- Phlebotomy
- Taking electrocardiograms
- Wound care and changing dressings
Administrative Duties (may include, but not limited to):
- Using computer applications
- Answering telephones
- Welcoming patients
- Updating and filing patient medical records
- Coding and filling out insurance forms
- Scheduling appointments
- Arranging for hospital admissions and laboratory services
- Handling correspondence, billing, and bookkeeping
Patient Liaison | Medical assistants are instrumental in helping patients feel at ease in the physician’s office and often explain the physician's instructions.
PCMH Team Member | Medical assistants are essential members of the patient-centered medical home team. According to a survey by the Healthcare Intelligence Network, medical assistants ranked as one of the top five professionals necessary to the PCMH team.
CMA (AAMA)® Certification | Many employers of allied health personnel prefer, or even insist, that their medical assistants are CMA (AAMA) certified.
The American Association of Medical Assistants (AAMA) offers certification to graduates of medical assisting programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES).
You are here: Home / Articles / Verify Patients’ Insurance Eligibility, Coverage Before Office Visits
It is essential that every physician practice verify the insurance eligibility and benefits of patients before services are provided. There are many missed opportunities to secure income and reduce staff time when patient eligibility is not verified at the time of check in. Training staff to complete this task can help boost revenue at time of service and save time on the back end.
As a general rule, new and returning patients should always bring their insurance identification card to every visit. The front desk staff is responsible for checking in patients and should make it a priority to check the patient’s insurance carrier to ensure the information on the card is up to date and correct for that date of service. This can often be accomplished by checking the insurance carrier website or calling a benefits representative. Some practice management systems and clearinghouses can verify patient eligibility. If staff encounters problems with a patient’s insurance verification, policies should be in place to have the patient pay for the services in full and file the insurance claim themselves. For those with financial need, there should be an option for patients to make payment arrangements.
Office staff should confirm whether the patient’s plan will consider the specialist an in-network or out-of-network provider. This is vital, because it will affect who is responsible for the main part of the bill. The primary advantage of determining that the physician is an in-network provider is to allow the physician to receive a negotiated or discounted rate for the services, and the patient’s insurance generally picks up a larger portion of the bill. If the physician is an out-of-network provider, then the patient will need to pay their portion of the bill at the time of the visit.
Here is an example of how the network affects payment. A visit to an in-network physician may cost $100 for an office visit. The insurance company has contracted with you to discount this visit to $60. If the insurance company covers 80% of the cost, the patient responsibility would be $12. Compare that with an out-of-network physician who also charges $100 for the visit. Without the negotiated rate from the insurance company, the patient’s cost will remain $100. For out-of-network providers and care, the insurance may cover only 50%, making the patient’s responsibility $50.
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There is also co-pay for a specialist visit, which is sometimes different from the co-pay for a primary care encounter, and staff should be aware that this will need to be verified at each visit. Additionally, there should be verification if the services will require a referral or pre-authorization.