FINAL Added Info Flashcards by Sally June

A legal entity that requires no state filing to create it

Sole proprietorship

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Simply one person operating a business for profit

Sole proprietorship

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Person has unlimited personal liability for the business

Can have employees

Sole proprietorship

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Simplest and most basic business structure and appeals to a person who wants to be independent and free from the laws that govern other legal entities

Individual ownership - sole proprietorship

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Two or more people who combine their work, money, and talents to achieve a common goal

Partnership

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Many states require a document or registration that serves as notice to the public that the partnership members are doing business together

Partnership

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All partners are bound by

Acts of others

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Legal entitiy, created by one or more individuals or other legal entities, to further a common goal and to create ground rules for matters such as ownership, profit distribution, liability, taxes, and control

LLC - limited liability company

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Individuals who have an interest in an LLC are usually referred to as

Members

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Most states have laws that govern LLC. T/f

True

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Protection from being held personally reliable

LLC

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Physicians, lawyers, architects, and accountants

Professional limited liability company - PLLC

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Limits of liability may only be applied to certain aspects of the business, such as creditors

PLLC

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One of the most desirable features of a corporation is the protection given to

Investors

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Only the capital of the corporation is available for

The payment of debts

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Management responsibility is in th ehands of the corporation’s

Board of directors

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Directors answer to

Stockholders, who elect and can terminate them

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Officers of a corporation include

President
Vice president
Treasurer
Secretary
Any other officers in board of directors appoints

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Profits of a corporation are distributed to stockhoolders as

Dividends

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persons holding formal positions of trust in an organization, especially those involved in high levels of management

Officers

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Those elected and terminated by stockholders to manage a corporation

Directors

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Those who hold an interest (stock) in a corporation

Stockholders

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Units of stock giving the possessor part ownership in a corporation investment expenditure of resources (money, effort, etc) to secure income or profit

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Regulations adopted by a corporation or association to govern its internal affairs dividends distributed profits of a corporation

Bylaws

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Managed care contracts with

Doctors Hospitals Clinics Other health care providers to create provider networks

An in-network physician or health care facility is part of a MCO’s network if there is a preexisting agreement between the MCO and the

Health care provider

The agreement dictates the protocols for patient care and the compensation system

Managed care organizations

A physician or health care facility that does not have an agreement with the MCO

An out-of-network provider

To discourage the use of out-of-network providers, a patients reimbursement for services provided is not compensated at the same level as

An in-network provider

Managed care focuses on varous aspects of health care and can include characteristics such as

Networks of health care providers or facilities Who have agreed to predetermined protocols and compensation PCPs Coordiante all patient’s health care Preauthorizaiton for specific tx Limited reimbursement for out-of-network providers Claim filing assigned to the provider rather than the patient And tiered coverage of prescription drugs

Employment law

Interviewing Pre-employment testing Civil rights act of 1964q

Employers are not allowed to ask interview questions involving

Race Religion Age Whether a woman is pregnant

Employers are allowed to test potential employees as part of the hiring process but such tests must be carefully constructed usually by experts to ensure

That they only measure the skills and abilities necessary to do the job

The opportunity to do so cannot be denied employees on the basis of race, color, religion, sex, or national origin

Civil rights act of 1964

Unwanted sexual attention from anyone the victim may interact with on the job in which the victim’s response may be restrained by fear of reprisals

Sexual harassment

Harassment occurs against

The victim’s wishes

Sexual harassments can include

``` Peers Subordinates Supervisors Customers Clients ```

Sexual harassment range of behavior

``` Verbal comments Subtle pressure for sexual activity Leering Pinching Patting Other forms of unwanted touching as well as rape and attempted rape ```

Requires employers of 50 or more people to provide up to 12 weeks of unpaid leave each year for the serious health condition of an employee or member of the employee’s immediate family or for the birth or adoption of a child

Family and medical leave act of 1993 (FMLA)

FMLA covers

All public employers Private employers who have 50 or more employees on the payroll during each of 20 or more calendar workweeks in either the current or preceding calendar year Employees who have been employed for at least 12 months and who have worked at least 1250 hours in the 12 months preceding commencement of the FMLA leave

A physical or mental impairment that substantially limits one or more of hte major life activities of an individual or a record of such impairment or being regarded as having such an impairment

Disability

Prohibits employment discrimination and places the burden on an employer to prove that the requirements of a specific job could not be changed to accomodate a disabled applicant

Title 1 of americans with disabilities act

Guarantee the disabled access to teh workplace. Professional offices of health care providers are in the public sector and as such require an employer to make reasonable modificaitons for hte disabled to gain access

Titles 2 and 3 of americans with disabilities act

Conditions that are not impairments - americans with disabilites act

Pregnancy Physical characteristics like hair or eye color Common personality traits Nomal deviations in height or weight

In defining undue hardship, the ADA requires consideration of

The nature and cost of accommodation needed The overall finances of the facility The overall resources of the covered entity The type of operation or operations of the covered entity

Provides that workers over the age of 40 cannot arbitrarily be discriminated against because of age in any employment decisions

Federal age discrimination in employment act

Federal minimum wage, mandates extra pay for overtime work, regulates employment of children and is administered by the department of labor

Fair labor standards act (FLSA)

Guaranteeing renewal and transferability of health insurance coverage to those who already have coverage adn to their dependents

HIPAA | Health insurance portability and accountability act of 1996

HIPAA nondiscrimination provision generally prohibits group health plans and group health insurance issuers from

Discriminating against participants or beneficiaries based on any health factor

Written standard office procedures help maintain

High standards of patient care Protect against omission of important steps Ensure compliance with government adn third party regulations Decrease the possibility of a malpractice aciton

Aid in achieving the risk managment goals for the office as well as maintaining quality assurance

Procedures manual

Usually provides personnel policies and related instructions. It includes information about work hours, sick leave, pension benefits, evaluation procedures, and so on

Employee handbook

Voluntary agreement between two or more parites that establishes a legally enforeable obligation Oral Written

Contract

Parties enter into a contractual relationship by mutual agreement, also referred to as assent or meeting of the minds

Contract

A clear, definitive agreement between two or more parties

Express contract

An actual agreement between the parties, the terms of which are openly stated in distinct and explicit language either orally or in writing

Express contract

An agreement not indicated by direct words but evident from the conduct of the parties

Implied contract

Gives rise to contractual obligations by some action or inaction without specifically stating the terms orally or in writing

Implied contract

Foundation of medical practice

Patient-physician relationship

Elements of a contract

Offer Acceptance Consideration

A proposal to perform or refrain from a certain action

Offer

An agreement to the terms of an offer

Acceptance

Something promised that results in making an agreement a lawful, enforceable contract

Consideration

By entering into a relationship with a health care provider, the patient makes the offer of

His or her person for treatment

By opening office doors or scheduling a patient’s appointment the health care facility

Accepts patient’s offer

In a patient-physician contract, the patient promises to pay a fee for the medical care received ant eh physician promises to provide

The agreed—upon treatment | Consideration

To form a contract, there must be

A clear understanding between parties, known as mutual agreement, assent or meeting of the minds

Legal duties and obligations exist once a patient-physician relationship exists so it is important to understand when the relationship begins and ends

Mutual agreement

St. John v Pope

Mutual agreement

Wax v Johnson

Mutual agreement

Lack of legal capacity for mutual agreement

Legal disability

Persons who are under the age of majority as set forth by state law

Minors

In most states the age of majority is

18 years but a few are 19 and 21

Those who lack necessary qualifications to perform a duty

Incompetent persons

Being influenced by threat to do something one would not ordinarily do

Duress

A physicians terminations of a patient should be with a written notice sent by certified mail, return receipt requested, and filed in patient’s chart and it should explain the patient’s medical problems

Termination of contracts

One the parties does not keep a promise - by not performing not paying for services not keeping to scheudle, or not doing the procedure as had been agreed

Breach of contract

Occurs when one party prevents the other party from performing

Breach of contract

Patient does not pay bill | When physicial makes a warranty that the physician will cure the patient but fails to do so

Examples of breach

An agreed-upon addition signed by all parties to the original contract

Amendment

Details specific terms, clauses, sections and definitions to be changed in the original contract but otherwise leaves it in full force adn effect

Changes to written contract

The goal when writing a contract amendment is to only change

The parts that all parties want to change while not creating any loopholes or unintended consequences in the agreement as it stands in writing

Including an additional document in the already existing one

Addendum