Health Systems and Settings

Question 1

Common administrative roles and responsibilities of MA

Answer 1

Scheduling patients appt
Patient registration
Updating and working in patients records
Sending claims to insurance
Collecting patient responsibility amounts

Question 2

Health care licensure

Answer 2

Regulated by state statues through medical practice acts

Question 3

Certification

Answer 3

Verification by an outside agency that an employer is following established guidelines and standards of care and providing the highest quality of care for their patients.
(Optional for MA)

Question 4

Capitation

Answer 4

A managed care method of monthly payments to the provider based on the number of enrolled patients, regardless of how many encounters a patient may have during the month.

Question 5

Health Maintenance Organization HMO

Answer 5

A medical insurance group that provides coverage of health care services for a period of time and a fixed annual fee.

Question 6

Preferred provider organization

Answer 6

A network of physicians, other health care practitioners, and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee.

Question 7

Accountable Care Organizations ACO

Answer 7

Accountable Care Organizations (ACOs): Groups of doctors, hospitals, and other health care professionals that work together to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs

Question 8

Patient centered medical home PCMH

Answer 8

The primary care medical home provides health care that is relationship-based with an orientation toward the whole person

Question 9

Pay for performance

Answer 9

You pay how much you think health care preformed there duties

Question 10

Preferred provider organization ppo

Answer 10

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers.

Question 11

Allopathic

Answer 11

the treatment of disease by conventional means, i.e., with drugs having opposite effects to the symptoms.

Question 12

Ambulatory

Answer 12

Able to walk around

Question 13

Computerized physician order entry cpoe

Answer 13

Computerized provider order entry (CPOE) refers to the process of providers entering and sending treatment instructions – including medication, laboratory, and radiology orders – via a computer application rather than paper, fax, or telephone.

Question 14

Managed care

Answer 14

a system of healthcare in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.

Question 15

Osteopathic

Answer 15

A whole-person approach to hands-on care. Osteopathic physicians believe there’s more to good health than the absence of pain or disease. L

Question 16

Professionalism

Answer 16

practicing of an activity, especially a sport, by professional rather than amateur players.

Question 17

Scope of practice

Answer 17

Scope of practice refers to those activities that a person licensed to practice as a health professional is permitted to perform

Question 18

Standard of care

Answer 18

Basically, it refers to the degree of care a prudent and reasonable person would exercise under the circumstances.

Question 19

Work ethic

Answer 19

the principle that hard work is intrinsically virtuous or worthy of reward.

Question 20

Health care system

Answer 20

health system as a group of healthcare organizations (e.g., physician practices, hospitals, skilled nursing facilities) that are jointly owned or managed (

Question 21

Affordable Care Act

Answer 21

comprehensive reform law, enacted in 2010, that increases health insurance coverage for the uninsured and implements reforms to the health insurance market

Question 22

Ancillary services in health care example

Answer 22

Ambulance services.
Ambulatory surgery center (ASC) services.
Audiology services.
Behavioral health services (inpatient and outpatient)
Cardiac monitoring.
Dialysis services.
Durable medical equipment (DME)
Hearing services.

Question 23

Alternative therapy

Answer 23

yoga, acupuncture, massage therapy, spinal manipulation, art therapy, music therapy, dance, mindfulness-based stress reduction,

Question 24

Acupuncture

Answer 24

a form of complementary medicine that involves pricking the skin or tissues with needles, used to alleviate pain and to treat various physical, mental, and emotional conditions.