Syllabus – Medical Scribe Program

Syllabus – Clinical Research

MEDICAL SCRIBE OVERVIEW
  • Introduction of clinical research
    Clinical Settings
    Clinical Settings
  • Medical Scribe Role
    Scribe Duties & Scope of Practice
    Scribe Professionalism
    Scribe Attestation
    Typical day of a scribe
  • Physician Reimbursement
    Medical Coding and Billing
    ICD-10 Codes
    CPT Codes
    Medical Coding Changes 1
    Medical Coding Changes 2
  • Electronic Medical Record
    What are Medical Records?
    Who uses Medical Records?
TERMINOLOGY & MEDICAL ABBREVIATIONS
  • Terminology
    Medical Terminology Introduction
    Body Position
    Anatomical Movement
    Conditions & Symptoms
  • Medical Abbreviations
    General Abbreviations
    Prescription Abbreviations
    Common Conditions Abbreviations
    Anatomy Abbreviations
  • Medications
    Medication Overview
    Common Drugs
PATHOPHYSIOLOGY
  • Musculoskeletal System
  • Respiratory System
  • Cardiovascular System
  • Nervous System
  • Endocrine System
  • Gastrointestinal System
  • Urinary System
  • Reproductive System
  • Lymphatic System
  • Immune System
  • Integumentary System
TERMINOLOGY & MEDICAL ABBREVIATIONS
  • Overview of Medical Charts
    SOAP Note
    EHR Charts & Notes
  • Subjective
    Chief Complaint & History of Present Illness
    Review of Systems
    Patient Histories
    Subjective Practice Scenario 1*
    Subjective Practice Scenario 2*
  • Objective: Physical Exam
    Vital Signs
    Physical Exam
    Detailed Exams
    Physical Exam Practice Scenario*
  • Objective: Diagnostic Tests
    Common Lab Tests
    Imaging
    EKG
    Other Diagnostic Tests
    In-office Procedures
  • Assessment & Plan
    Medical Decision Making
    Documenting Medical Decision Making
    Assessment & Plan Practice Scenario*
  • Clinical Practice Scenario
    Full Charting Practice Scenario*
  • Levels of Chart Coding
    Levels of Chart Coding
HIPPA
  • What is HIPAA?
    HIPAA Introduction
    Protected Health Information
    Regulated Entities
    HIPAA Privacy Rule
    HIPAA Security Rule
  • HIPAA in Healthcare
    HIPAA Compliance
    Permissible Disclosure and Use
    HIPAA Violations
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