Contemporary Medical Office Procedures

Medical offices have to consider clinical and administrative procedures when coming up with their procedure handbook. According to the Texas Medical Association, contemporary medical office procedures include topics as varied as patient privacy, medical records maintenance and insurance policies. Staff who manage medical offices must be familiar with the range of procedures in order to provide effective, quality services to patients.

Patient Privacy

HIPAA, the Health Insurance Portability and Accountability Act, was instituted by the U.S. Congress in 1996 as a result of there not being adequate privacy practices in place to protect patient health information. Since 1996, medical offices across the United States have been mandated to adopt HIPAA standards into their procedures.



Under HIPAA medical offices must explain what HIPAA is to new patients and provide them with information about the Act. Patients are asked to sign a document stating that they received the HIPAA information and are aware of its provisions. Next, medical offices are required to ask patients if they want their health information shared with family members or friends. Patients who say yes must write the name of the person on a formal document, which is known as a disclosure consent form. This form gives the medical office the right to release the patient's health care information to the individual on the list.

Medical Records

All health care information must be maintained in patients' medical records. Some medical offices use hard files for medical records, while others have converted to electronic health records. Electronic health records are stored on the office's internal server, which can be accessed only by authorized employees. Everything about the patient, from contact information to medication lists, is housed in the medical record.



Physical medical records, according to HIPAA standards, must be stored in a locked room that cannot be accessed by patients, housekeeping staff or visitors. If a company has electronic medical records, HIPAA's security rule says that computers must be password protected to prevent unauthorized users from accessing the electronic medical records from an employee computer.

Insurance Policies

Not every patient has insurance, so it is important for medical offices to have procedures in place to assist patients with and without health coverage. Patients with health insurance will be asked to fill out an insurance form that gives the medical office information on whom to bill and what the patient's account number is with the carrier. If patients do not have insurance, they may be asked to set up payment plans with the medical office to cover the expense of their medical treatment.



Going hand-in-hand with insurance policies is that of claims appeals. Medical offices must have procedures in place to deal with patients who wish to appeal to their insurance company due to denied claims. Typically, a billing specialist or administrative employee is responsible for helping patients file an appeal with their insurance company and can assist with advocating for the patient if necessary.