Confidentiality

Question 1

EPO

Answer 1

exclusive provider org: more restrictive than PPO

Question 2

utilization review

Answer 2

process of reviewing the care delivered by the insurance company

Question 3

preadmission certification

Answer 3

(Prior auth) can apply to therapy and admission. Health care provider must provide authorization of necessity of treatment for the insurance to pay

Question 4

what are the levels of the two tier system

Answer 4

catastrophic care (for all, state determines what is covered) and additional care

Question 5

How does justice value apply to research subjects

Answer 5

determines Prisoners, mentally ill, and children should not be exploited. Informed consent is crucial.

Question 6

‘anti-dumping’ law

Answer 6

Emergency Medical Treatment and Active Labor Act

Question 7

what law requires hospitals to provide stabilizing treatment to any patient arriving at their emergency departments with an emergency medical condition

Answer 7

Emergency Medical Treatment and Active Labor Act