CH # 1: The Health Care System Flashcards
Medical care that is provided on a outpatient basis.
Ambulatory care
When the patient comes 2 the facility providing care and return home after having received services
Outpatient care
A set payment provided by managed care insurance per patient per month regardless of the amount of services received
Capitation
A treatment that cures disease
Curative treatment
Learned from observation or experiment
Empirical
A means of payment 4 health care in which the cost of each service provided is reimbursed in full or in part
Fee-4-service
A list of prescription drugs covered or preferred by a managed care insurance company
Formulary
The purchase of protection 4 covered services related 2 health care
Health insurance
Considering the whole person when providing health care; physical, mental and spiritual components
Holistic
A system that manages the delivery of health care w/the intention of controlling costs
Managed care
Therapy that reduces the effects of a disease or condition but does not remove the disease itself
Palliative treatment
A model of primary care that emphasizes patient-centered health care based on a personal relationship among a patient, a physician and the patient’s care team
Patient-centered medical home
PCMH
A program that provides training in a medical speciality 2 a physician who has finished medical school
Residency
Therapy 4 symptoms of a disease or condition that does not remove the disease itself
Symptomatic treatment
An assessment of medical services 2 determine whether they r appropriate, necessary and of high quality
Utilization review
An organization that defines health as being the absence of illness or disease and a state of being in which the individual feels well and is able 2 carry out daily functions of life w/no difficulties and no pain
World Health Organzation
WHO
A 4th century BCE Greek physician believed that disease was not punishment 4 transgressions against the gods but the result of physiologic and environmental factors that could b studied
He is considered 2 b the beginnings of Western medicine
Hippocrates
A government program that provides health care 2 low income people
Medicaid
A government program that initiated health insurance 4 the elderly, disabled and those w/end stage kidney disease
Medicare
An organization formed w/the belief that consistent, routine care would help prevent later expensive care
In the 1970’s, they pushed traditional health insurance companies 2 provide routine check ups
Health maintenance organizations
HMO’s
Became law in 2010
Expanded insurance coverage 4 an estimated 32 million Americans who were previously uninsured
Protected people w/preexisting health conditions from being excluded from getting health insurance
The Patient Protection and Affordable Care Act
“Obama Care”
Members include physicians, NP’s, MA’s, RN’s, a business manager, a receptionist, a medical secretary, file clerks and 1 or more insurance specialists
Health Care Team
2 types of occupations that assigns codes 2 patient charges and diagnoses 4 insurance billing
There r many coding certifications depending on knowledge and speciality
Certified Professional Coder
(CPC)
Certified Coding Associate
(CCA)
An occupation where the individual performs ultrasound scans in hospitals and ambulatory care facilities
Ultrasound uses high frequency sound waves 2 produce images
Diagnostic Medical Sonographer
DMS
