Chapter 1 Flashcards
AHCCS
Arizona Healthcare Cost Containment System - A unique form of Arizona welfare, used instead of Medicaid
APC
Ambulatory
Patient
Classification
- System implemented in 2000, determines payment to hospitals for outpatient services
CLI88
Clinical Laboratory Improvements of 88 - mandates that all labs use the the same standards regardless of type, location, or size
CEU’s
Continuing
Education
Units
- Credits for some form of continuing education to continually upgrade skills and knowledge
CPT
Current
Procedural
Terminology
- Coding system for billing at physician’s offices
DRG’s
Diagnosis
Related
Groups
- Hospitals are reimbursed at a set amount for each patient procedure using established disease categories
HIPPA
Health Insurance Portability Accountability Act - Enacted in order to secure patient information and regulate patient privacy
HMO
Health
Maintenance
Organization
- Group practices are reimbursed on a prepaid, negotiated, discounted basis
ICD-9-CM
International Classification of Disease Ninth Revision Clinical Modifications - Coding system that groups together familiar disease and operations for reimbursement
MCOs
Managed
Care
Organizations
- Groups that contract with local providers to establish a complete network of healthcare services
PHS
Public
Health
Service
- Federal agency offering monitoring, screening, and education of the public
PPO
Preferred
Provider
Organization
- Independent group of physicians or hospitals that offer services to employers at discounted rates in exchange for a steady supply of patients
PPS
Prospective
Payment
System
-Limits the standardized Medicare/Medicaid payments made to hospitals, started in 1983
TAT
Turn
Around
Time
- time it takes for the laboratory test request to be completed and charted
Patients Bill of Rights
An accepted statement of principles that guides healthcare workers in their dealing with patients while in a hospital or other healthcare facility
Barriers
Anything interfering with communication, such as personal bias or cultural diversity
Certification
A process indicating completion of a defined academic and training requirements and a satisfactory score on a national examination
Entitlement Programs
Right, such as Social Security, earned through employment
Exsanguinate
Blood loss to the point of being life-threatening (Hint: Poor George Washington)
Gatekeeper
Primary care physicians in a managed care plan who coordinates the patient’s healthcare needs
Kinesic Slip
When nonverbal messages do not match verbal messages
Kinesics
Study of body motion and language, such as facial expressions, gestures, and eye contact