Questions

kitty catt. . .office nurses responsibilities are a tad different than nurses who work in hospitals and nursing homes. office nurses and office assistive personnel must wear many hats. when a nurse is working for a physician, the physician is the boss of the office. he is legally responsible for the people he employs. his employees work under his direction and upon the orders that he gives. as long as the physician has delegated these tasks to them, instructed them and is there on the premises to supervise them, it is permissible. this is an often misunderstood concept by others who work in the healthcare industry, particularly licensed nurses, who cannot understand how a medical assistant who is not a licensed nurse can be allowed to give im injections, for example. the people working with patient's in doctor's offices do all kinds of procedures with patients, including ekgs, giving medications, drawing blood and changing dressings. each doctor runs his office as he wants. as long as the physician has delegated these tasks to them, instructed them and is there on the premises to supervise them, it is permissible. what they cannot do is those things that require a medical decision as that is clearly something that is covered by the doctor's license alone.

as for the billing, most formal ma (medical assistant) programs teach this. however, it is not difficult though it can get very complex and is an extremely important function. the american medical association prints a number of manuals to help physician office staffs in getting the billing correct. most offices have a superbill (also called an encounter form or charge slip) that is made out for each patient that is seen. this superbill is a form that is specifically created for each doctor's practice and includes the most commonly encountered reasons for patient visits. you may have a few of these yourself from visits you've had with doctors. these superbills also have icd-9-cm and cpt codes on them which are required elements in the billing process. maximizing the amount of money that physicians can collect for the services they provide is an important function of the person who does the doctor's billing. most physicians also have access to billing assistance and training for their staff through their medical association.

at this site is a description of what an ma does, in general. as you can see, they wear many hats. and, these are not licensed nurses. however, many vocational schools train mas to do many of these tasks. most mas are hired and work in doctor's offices. because of costs, many doctors employ mas rather than licensed nurses in their offices.

• http://stats.bls.gov/oco/ocos164.htm

nurses do not need to have billing knowledge, it is not taught in school. i don't see why a clinic would want to pay a nurse wage for billing or office management that could be done for way less by someone else who was just specifically trained in those areas.

fyi. . .billing and coding when learned at a college level and with a national certification pays the same, or more, than what any rn earns! i'm not talking about these schools that advertise coding and billing on tv, the inside of matchbook covers or at vocational schools. i'm talking about legitimate health information management programs at very distinguished accredited colleges and universities.

billing and office management is the business side of health care, a side that most clinical practitioners don't know a lot about. nor do many want to take the time to learn. without smart and knowledgeable business minded billing and office management people, healthcare facilities and doctors would go out of business due to bankruptcy or getting saddled with fines or jail time from failure to follow federal laws governing the billing rules.

so,ma does office management/office/deskwork stuff also ma does things nurses do?? yes, but as i said, it has to be under the direction and supervision of a physician in his office while he on the premises. that means nurse can office/desk work stuffs?? yes. although at the wages they are paid, most physicians are going to use a nurse to get their money's worth from them by having them do nursing related things. however, if the office they work in is small, the nurse may very well be answering the phones, making appointments, billing insurance companies as well as doing whatever needs to be done with patients. ma can take x-rays,right?? nurses can do that too?? i'd have to research this, but i don't think so. there are federal safety laws involved with the use of x-rays. radiation is dangerous to be working around. i think osha or another federal agency has placed restrictions on who is allowed to take x-rays. ma doesn't need license?? no. all they do is go through a training program that usually lasts no longer than a year. they do not learn the intensive amount of theory behind what they are doing like licensed nurses do. much of the time licensed nurses are learning "why" they are doing the things that they do. that is why they have to take courses like chemistry, anatomy and physiology, pathophysiology and psychology before they even get into their nursing classes. they also learn what doctors will normally order for patients with all kinds of different diseases. this is almost never a part of the focus in ma programs. you must understand that mas do not make the kind of money that an lpn or rn does even though they may be doing some of the same things in a doctor's office. with all the training that licensed nurses get, they are expected to be able to make some decisions about care and they are specifically licensed to do that. mas are not. mas follow orders and directions of the doctor they work with. they are medical assistants.