Healthcare Structure and Organization Flashcards
Bobby was playing in the backyard and cut his foot on a piece of glass. His mother took him to their primary care physician’s office. The physician sutured the laceration and gave him a tetanus shot and then he was sent home.
Is he an Inpatient or an Outpatient?
Outpatient
Debbie delivered a baby via c-section. There were no complications during the c-section. She and the baby spent 3 days in the hospital and then they were both discharged to home. She was instructed to see her physician in 6 weeks. Is she an Inpatient or Outpatient?
Inpatient
Susan underwent an appendectomy at the same-day surgery unit at the hospital. The surgery went well and she was taken to the recovery room. While she was in the recovery room the nurse checked her temperature and she had a fever of 103 degrees. She was admitted to the hospital to determine the cause of the fever.
Is she an inpatient or outpatient?
Inpatient
Frank was painting his house and fell off the ladder and landed on his arm. He went to the emergency room because he was in extreme pain. The emergency room physician took an x-ray of his arm and determined that he fractured his radius. He was placed in a cast and sent home. Is he an inpatient or outpatient
outpatient
David had tubes placed in both of his ears due to chronic otitis media. Following the surgery he was taken to the recovery room. After a couple of hours in the recovery room he was discharged home. Is he an inpatient or outpatient?
Outpatient
Patients receive care on an inpatient or outpatient basis. This distinction is an important one for coding and billing services. T/F
True
A patient who comes to the hospital for an MRI is always considered an inpatient because Dr. Smith, the hospital radiologist, does the test at the hospital. T/F
False
Inpatients stay overnight and can access departments and services within the facility that are not accessed by ambulatory patients. T/F
True
Many inpatient facilities offer outpatient services. T/F
True
A patient who comes to the emergency room for treatment because of acute exacerbation of asthma who is observed for 12 hours and then discharged is considered an inpatient. T/F
False
Most large industries have trade associations of one kind or another.T/F
True
Trade associations allow individuals and companies to band together to influence regulations and share resources.
T/F
True
Trade associations are only effective when they organize on a national level. T/F
False
Trade associations provide services to their membership such as networking opportunities, professional tools, and trade publications. T/F
true
Healthcare vendors provide the healthcare industry with its tools of the trade. T/F
True
Kathy went shopping at a large discount store and slipped on the wet floor in the produce department, twisting her ankle. She made a report to the store manager. What type of third-party payer would likely cover Kathy’s healthcare expenses related to her ankle injury?_____
Liability Insurance
Kelly started her new job and signed up for healthcare insurance. Since she is the cardholder she will be the _____.
Subscriber
Bill went to an independent insurance agent to purchase health insurance for himself and his family. He was informed that his monthly payment would be $600.00. This monthly payment is known as _____.
Premium
Joe was working in a warehouse when a forklift hit him. He was taken to the local ER for his injuries. What type of third-party coverage is Joe’s employer required to have to cover this type of on-the-job injury?_____
Workers’ Compensation
Mary added her husband and two children onto her health insurance through work. Mary’s husband and two children are considered _____.
dependents
This federal agency is in charge of governing and regulating healthcare in the United States and has several agencies and offices under its umbrella.
DHHS
This law was passed to protect patient confidentiality and privacy.
HIPAA
This agency under DHHS occupies a central role in setting standards and regulations for healthcare documentation, coding classification and medical billing.
CMS
The mission of this office is to protect the integrity of DHHS programs, as well as the health and welfare of the beneficiaries of those programs. To accomplish this they perform audits.
OIG