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Medical Assisting > Healthcare Fundamentals > Flashcards

Healthcare Fundamentals Flashcards

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USMLE® Step 1 flashcards
1
Q

What do MAs have to know?

A
  • different specialties
  • other health professionals
  • healthcare delivery models
  • basic insurance
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2
Q

What do medical doctors do?

A
  • diagnosis illness
  • provides treatments
  • performs procedures
  • writes prescriptions
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3
Q

What do osteopathic providers (DO) do?

A
  • uses modern medicine techniques and surgical procedures
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4
Q

What do nurse practitioners do?

A
  • diagnose
  • prescribe medications
  • preventative care and disease prevention
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5
Q

What do physician assistants do?

A
  • practices medicine under the direction and supervision of a MD or DO
  • can make clinical decisions
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6
Q

What do medical laboratory technicians do?

A

test blood, body fluids and other specimen

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7
Q

What does a pharmacy technician do?

A

helps phamacists

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8
Q

What do radiology technicians do?

A
  • uses imaging equipment to assist providers in diagnosing and treating diseases
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9
Q

What is integreity?

A

honesty

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10
Q

What is accountability?

A

responsible for your own actions

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11
Q

What is flexibility?

A

ability to adjust to schedule changes

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12
Q

What is open-mindedness?

A

try new things
- open to discussions and listen

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13
Q

What are general providers?

A

able to assess a wide range of symptoms
- diagnose and build treatment plans

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14
Q

What are specialist providers?

A

assess more specific sets of symptoms, diagnoses, conditions

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15
Q

What are general practitioners?

A

medical doctors who treat acute and chronic illnesses and provide preventative care and health education

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16
Q

What are internists?

A

diagnosing and treating chronic conditions
- offers treatment for common illnesses and preventative care

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17
Q

What do cardiologists do?

A

specialized in heart and blood vessel conditions

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18
Q

What do dermatologists do?

A

specializes in skin conditions

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19
Q

What do endocrinologists do?

A

specialize in hormonal and glandular conditions
- diabetes
- thyroid

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20
Q

What do gastroenterologists do?

A

specializes in gastrointestinal tract diseases
- stomach, intestines, esophagus, liver, pancreas, colon, rectum

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21
Q

What do gynecologists do?

A

specialize in female reproductive system

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22
Q

What do nephrologists do?

A

specialize in kidney care and disorders

23
Q

What do obstetricians do?

A

care for women during and after pregnancy

24
Q

What do oncologists do?

A

specialize in cancer treatments

25
Q

What do ophthalmologists do?

A

specialize in eye conditions

26
Q

What do orthopedists do?

A

specialize in bones, joints, muscles, tendons, and ligaments

27
Q

What do otolaryngologists/otorhinolaryngologists do? (ENT)

A

specializes in ear, nose, throat

28
Q

What is an accountable care organization? (ACO)

A

groups of physicians, hospitals, and care providers who come together voluntarily to provide quality care to Medicare patients

29
Q

What is a patient-centered medical home? (PCMH)

A

care delivery model
- PCP coordinates treatment to make sure patients receive required care

30
Q

What is a health maintenance organization? (HMO)

A

connects groups of providers and facilitates preventative and acute care for patients
- requires referrals to specialists and precertification and preauthorization for hospital admissions, outpatient procedures, and treatments

31
Q

What is a preferred provider organization? (PPO)

A

patient isn’t required to have a PCP
- can go directly to a specialist without referrals

32
Q

What type of care are nursing homes and assisted living?

A

long-term care
- requires healthcare on a regular basis
- frail, elderly, disabled

33
Q

What is hospice care?

A

patients with less than 6 months to live
- terminal conditions

34
Q

What is palliative care?

A

relieving pain

35
Q

What is ambulatory care? Give examples.

A

walk in places
- physician offices/clinics
- urgent care centers
- hospitals/emergency department
- surgical centers

36
Q

What is Medicare? Who is it for?

A

government insurance plan
- Part A: hospitalization
- Part B: medical office visits
- Part D: medications
- patients 65+

37
Q

Who is medicaid for?

A

medically indigent or low income

38
Q

Who is tricare for?

A

active duty service and family members

39
Q

Who is CAMPVA for?

A

veterans affairs

40
Q

What are some examples of private individual insurance plans?

A
  • blue cross/shield
  • humana
  • aetna
  • cigna
41
Q

What are examples of private insurance plans?

A

group
individual
worker’s compensation

42
Q

What is an allowed amount?

A

maximum amount insurance will pay for a procedure or service

43
Q

What is a copay?

A

a set amount of money that is paid by the patient at the time of service

44
Q

What is coinsurance?

A

policyholder and insurance carrier share costs

45
Q

What is a deductible?

A

amount of money paid out of pocket before insurance carrier begins paying

46
Q

What is the CMS-1500 form used for?

A

invoice insurance and government plans
- sent electronically to insurance companies and government plans

47
Q

What is direct billing?

A

insurance carrier allows provider to submit directly to insurance company electronically

48
Q

What is clearinghouse?

A

allows provider to submit all insurance claims using software
- audits, sorts, and sends claims

49
Q

When should Medicare and Medicaid claims be electronically submitted?

A

invoice cannot exceed 12 months from service

50
Q

What is managed care?

A

medical plans that provide health care in return for preset schedules payments coordinated through a network of providers and hospitals

51
Q

What is osteropathic?

A

medical care based on how the musculoskeletal system affects other body parts and using various manipulative methods along with conventional medical, pharmacological, and other therapeutic procedures

52
Q

What is professionalism?

A

skills, behavior and appropriate judgment that represent the best qualities of a person in a specific profession

53
Q

What is work ethic?

A

a set of values based on the moral virtues of hard work and diligence

Medical Assisting (23 decks)

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