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Healthcare Structure and Organization Flashcards

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USMLE® Step 1 flashcards
1
Q

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?

A

Outpatient

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2
Q

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?

A

Inpatient

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3
Q

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?

A

Inpatient

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4
Q

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

A

outpatient

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5
Q

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?

A

Outpatient

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6
Q

Patients receive care on an inpatient or outpatient basis. This distinction is an important one for coding and billing services. T/F

A

True

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7
Q

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

A

False

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8
Q

Inpatients stay overnight and can access departments and services within the facility that are not accessed by ambulatory patients. T/F

A

True

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9
Q

Many inpatient facilities offer outpatient services. T/F

A

True

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10
Q

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

A

False

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11
Q

Most large industries have trade associations of one kind or another.T/F

A

True

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12
Q

Trade associations allow individuals and companies to band together to influence regulations and share resources.
T/F

A

True

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13
Q

Trade associations are only effective when they organize on a national level. T/F

A

False

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14
Q

Trade associations provide services to their membership such as networking opportunities, professional tools, and trade publications. T/F

A

true

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15
Q

Healthcare vendors provide the healthcare industry with its tools of the trade. T/F

A

True

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16
Q

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?_____

A

Liability Insurance

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17
Q

Kelly started her new job and signed up for healthcare insurance. Since she is the cardholder she will be the _____.

A

Subscriber

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18
Q

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 _____.

A

Premium

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19
Q

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?_____

A

Workers’ Compensation

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20
Q

Mary added her husband and two children onto her health insurance through work. Mary’s husband and two children are considered _____.

A

dependents

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21
Q

This federal agency is in charge of governing and regulating healthcare in the United States and has several agencies and offices under its umbrella.

A

DHHS

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22
Q

This law was passed to protect patient confidentiality and privacy.

A

HIPAA

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23
Q

This agency under DHHS occupies a central role in setting standards and regulations for healthcare documentation, coding classification and medical billing.

A

CMS

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24
Q

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.

A

OIG

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25
Q

This office helps protect consumers against discrimination by healthcare providers.

A

OCR

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26
Q

CHAMPVA

A

this plan is for non-retired veterans and is managed by the Department of Veterans’ Affairs

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27
Q

TRICARE

A

this plan is managed by the Department of Defense, is funded by federal tax dollars, and covers active military personnel and their families, as well as retired personnel and their families

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28
Q

Workers’ Compensation

A

insurance coverage mandated by law for employees wit work-related injuries or illness

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29
Q

Liability

A

Liability: insurance purchased by an entity or individual to cover costs of individuals injured on their property or using their product or service

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30
Q

Policy

A

binding contract, which includes the benefits and coverage as issued by an insurance company to an individual or group, that promises to pay for healthcare reasonably required by the policyholder to treat illness or injury

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31
Q

Deductible

A

he amount of covered expenses that must be paid by the insured/member before benefits become payable by the insurance carrier/plan

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32
Q

Pre-existing Condition

A

a medical condition that occurred before a program of health benefits went into effect

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33
Q

Premium

A

he cost of coverage for the insurance policy. This is typically paid on a monthly basis. Employees usually share in the cost of the healthcare insurance premium with their employers

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34
Q

Department of Justice

A

a branch of government tasked with prosecuting criminals who engage in fraudulent, abusive, discriminating, or other law-breaking activities

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35
Q

Reactive Audit

A

an inspection or audit carried out in response to a tip, complaint, or concern brought to the attention of the OIG

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36
Q

Proactive Audit

A

an audit where the OIG is routinely inspecting a healthcare provider to make sure documentation and treatment is appropriate

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37
Q

Centers for Medicare and Medicaid Services (CMS)

A

an agency of the Department of Health of Human Services that administers the Medicare and Medicaid programs and the State Children’s Health Insurance Program. CMS is the largest third-party payer of health benefits in the United States and occupies a central role in setting standards and regulations for healthcare documentation

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38
Q

Department of Health and Human Services (DHHS)

A

the federal agency tasked with governing and regulating healthcare in the United States

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39
Q

Medicare Part D

A

Medicare’s prescription plan. It is a fairly new addition to medicare as it only went into effect in 2006. This prescription drug plan offers insurance on medications. It is an optional plan that can be purchased

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40
Q

Medicare Part C

A

also known as Medicare Advantage plan. Part C is a plan that overrides plans A, B, and D. it is a more comprehensive program that is offered through many private insurance companies and works like a managed care plan

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41
Q

Medicare Part B

A

outpatient insurance. It will cover many services provided from physician care, including general exams, laboratory tests, counseling, therapy, and other outpatient care

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42
Q

Medicare Part A

A

Hospital insurance. It will cover most inpatient care up to 90 days and includes hospital, skill nursing facility, hospice, and espie care

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43
Q

Medicare

A

the government-sponsored healthcare program for qualified seniors over age 65 and qualified disabled people under the age of 65. It is a federal program administered by the federal government

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44
Q

Medicaid

A

A joint state and federal healthcare benefit program for qualified individuals administered by each state that individuals who qualify for Medicaid according to state guidelines. It is usually for disabled and low-income individuals who lack resources to private pay or have no access to another third-party payer

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45
Q

Ancillary Healthcare Services

A

goods and/or services provided to patients by healthcare providers to aid in the diagnosis or treatment of an illness or injury

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46
Q

Short-term Care

A

medical attention for patients who have diagnoses that healthcare professionals can resolve quickly

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47
Q

Consulting Physician

A

the physician collaborating and consulting with the attending physician to decide on diagnosis and/or course of treatment

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48
Q

Attending Physician

A

the physician assuming primary responsibility for the treatment of a patient at any given time

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49
Q

Outpatient

A

a patient who does not stay overnight in a healthcare facility

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50
Q

Inpatient

A

A patient who says overnight in a healthcare facility

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51
Q

Admitting Privileges

A

authorization for a physician to admit patients to an inpatient facility (hospital)

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52
Q

Acute Care

A

urgent care for patients who require immediate medical attention for recently developed symptoms

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53
Q

The healthcare vendor’s role is to provide healthcare professionals with updated goods and services. T/F

A

True

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54
Q

Services such as home healthcare, transcription, and coding also have vendors dedicated to providing them with tools of the trade. T/F

A

True

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55
Q

Healthcare industry tools of the trade include medications, surgical instruments, and durable medical equipment. T/F

A

True

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56
Q

This major trade association has both for profit and not-for-profit assisted living, nursing facilities as well as subacute care providers.

A

AHCA

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57
Q

Home healthcare, hospice, medical equipment, suppliers and home care aide organizations belong to this trade association.

A

NAHC

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58
Q

Members/ Mission:

National Association for Home Care (NAHC)

A

Members:
Home care agencies, hospices, home care aide organizations, and medical equipment suppliers.

Mission: NAHC’s mission can be summarized in one line: “We are bringing healthcare back home where it belongs.”

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59
Q

Members/ Mission:

American Medical Association (AMA)

A

Members:
Physicians

Mission: to promote the are and science of medicine and the betterment of public health

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60
Q

members/ Mission:

American Health Data Institute (AHDI)

A

Members:
Coalitions, Employers, Providers, Administrative Organizations (PPOs, TPAs), and Risk Takers

Mission:
Transform healthcare data into actionable intelligence so employers, coalitions, providers, payers, consumers and others can purchase high quality cost effective healthcare.

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61
Q

Members/ Mission:

American Academy of Professional Coders (AAPC)

A

Members:
Medical Coders

Mission:

Dedicated to providing the highest standard of professional coding and billing services to employers, clients, and patients.

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62
Q

Members/Mission:

American Health Information Management Association (AHIMA)

A

Members: Medical Coders

Mission:
To be the professional community that improves healthcare by advancing best practices and standards for health information management and the trusted source for education, research, and professional credentialing.

63
Q

Trade associations provide some or all of what types of services to their membership:

A

~education/educational resources, professional development
~advocacy/professional lobby
~Professional licensure/certification
~Member and industry networking opportunities
~Professional standards development
~Legal services
~Professional tools
~Employment registry
~Trade publications/professional journals
~Public relations/public education

64
Q

Trade Association:

A

group of people or organizations that come together because they share a common interest, goal, or purpose

65
Q

Cindy received a letter from her insurance company stating they had paid $250 on her $500 hospital bill. Because it was the beginning of the calendar year and this was Cindy’s first healthcare visit, the remaining $250 would be Cindy’s responsibility. The provision that patients must pay a certain amount each year before their third-party payer begins paying is a common practice. The portion the patient must pay before third-party payment begins is called the _____.

A

Deductible

66
Q

Claudia went to Wal-Mart to do some shopping. While in the parking lot she twisted her ankle stepping in a pothole. She filed a report with the store manager. The manager agreed to pay for any claims related to this injury. What type of insurance will cover this claim? _____.

A

Liability Insurance

67
Q

A person who purchases a healthcare policy directly from an insurance provider or agent for themselves and/or their family is buying what type of insurance?

A

Individual Healthcare Policy

68
Q

Managed by CMS, it covers people over the age of 65 and some disabled people under 65.

A

Medicare

69
Q

Places of business and sometimes homeowners have this type of insurance just in case an individual should fall or have some other type of accidental injury on their property.

A

Liability Insurance

70
Q

Covers disabled veterans and/or families of deceased military.

A

CHAMPVA

71
Q

Managed by CMS and each state, coverage is for low income families who meet state guidelines

A

Medicaid

72
Q

This out-of-pocket expense must be met every calendar year before benefits are paid by the insurance carrier.

A

Deductible

73
Q

Managed by DHHS, funded by federal income tax and federal grants. A group of individuals covered under this plan are Alaska natives.

A

Indian Health Services

74
Q

The cost of coverage for an insurance policy (usually paid on a monthly basis.)

A

Premium

75
Q

Managed by Department of Defense, it covers active military personnel and their families.

A

Tricare

76
Q

Description:
Insurance purchased by an entity or individual to cover costs of individuals injured on their property or using their product or service

Beneficiaries:
Individuals injured or sickened where another is liable

Examples:
Geico, Progressive, AAA, State Farm, All State, Citizen, Kemper

What am I?

A

Liability Insurance

77
Q

Description:
Insurance coverage for automobiles and drivers that protects against losses and liability that may result from an accident

Beneficiaries:
Automobile driver, passenger injured in auto accidents

Examples:
Geico, Progressive, AAA, State Farm, Allstate

What am I?

A

Automobile Insurance

78
Q

Group/individual policies sell healthcare coverage plans to individual, employers, or other affiliated groups. T/F

A

True

79
Q

Individuals injured or sickened where another is liable are covered under group/individual policies. T/F

A

False

80
Q

Liability is to cover automobile drivers or passengers injured in auto accidents. T/F

A

False

81
Q

An employee sick or injured on the job would be a beneficiary of an industrial/workers compensation plan. T/F

A

True

82
Q

Description:
A company in the business of selling healthcare coverage plans to individuals, employers, or other affiliated groups

Beneficiaries:
Insured/Subscriber and dependents

Examples:
Kaiser Permanente, Cigna, Private Health Care Services (PHCS), UnitedHealthcare, Aetna, Beech Street

What am I?

A

Group/individual policies

83
Q

This plan is for non-retiree veterans is managed by the Department of Veterans’ Affairs.

A

CHAMPVA

84
Q

This plan is managed by the Department of Defense, is funded by federal tax dollars, and covers active military personnel and their families, as well as retired personnel and their families.

A

TRICARE

85
Q

An insurance plan covered by federal income taxes and federal grants; managed by DHHS; one of the patient populations this plan covers is the Alaska natives.

A

Indian Health Services

86
Q

Managed by:
DHHS — Indian Health Services

Beneficiaries:
American Indians and Alaska Natives

Founding Source:
Federal income taxes, some federal grant money

What am I?

A

Indian Health Services (IHS)

87
Q

Managed by;
Department of Defense

Beneficiaries:
Active duty military; some benefit for families with military personnel overseas

Founding Source:
Federal income taxes

What am I?

A

TRICARE

88
Q

Managed by:
Department of Veterans’ Affairs

Beneficiaries: Military veterans; spouses/families of disabled/deceased veterans

Founding Source:
Federal income taxes

What am I?

A

CHAMPVA

89
Q

Managed by:
Center for Medicare and Medicaid; Designated agency within each state

Beneficiaries:
Qualified low income families; indigent (eligibility requirements vary by state)

Founding Source:
Federal and state income taxes

What am I?

A

Medicaid

90
Q

Managed by:
Centers for Medicare & Medicaid (CMS)

Beneficiaries:
Qualified individuals over the age of 65; people with certain disabilities under the age of 65; people of all ages with permanent kidney failure

Founding Source:
Payroll taxes, federal income taxes, some beneficiary premiums

What am I?

A

Medicare

91
Q

What are the five main categories third-party payers in the United States fall into?

A 
~Government
~Commercial
~Industrial
~Liability
~automobile insurance
92
Q

Bob designated several people as beneficiaries when he signed up for his health insurance. His wife, daughter, and two sons are all covered under his policy. Bob is covered as the subscriber; his family is covered as Bob’s _____

A

dependents

93
Q

Marilyn was informed by her employer that she has an out-of-pocket expense of $250.00 each calendar year before her insurance plan will pay any benefits. This out-of-pocket expense before her insurance starts providing benefit is called the _____.

A

deductible

94
Q

Waiting Period:

A

The period of time specified in a health insurance policy that must pass before some or all of the policyholder’s healthcare coverage begins.

95
Q

Limits:

A

The maximum amount payable by the insurer for covered expenses. It may be a yearly or lifetime maximum

96
Q

Exclusions

A

The types of health care services that a health insurance company won’t pay for. They may exclude a pre-existing condition or a service that is medically unnecessary.

97
Q

Pre-existing Condition

A

A medical condition that occurred before a program of health benefits went into effect.

98
Q

Copayment

A

also known as a copay) The amount an insurance company requires the policyholder or patient to pay to a healthcare provider for services rendered

99
Q

Dependent

A

Refers to the individual(s) eligible to be designated as a beneficiary on a policy. Commonly these are restricted to those with a legal relationship to the subscriber.

100
Q

Benefit

A

The amount payable by the insurance carrier toward the cost of the medical services for which the policyholder is eligible

101
Q

Policy

A

The binding contract which includes the benefits and coverage as issued by an insurance company to an individual or group that promises to pay for healthcare reasonably required by the policyholder to treat illness or injury.

102
Q

This agency falls under the umbrella of DHHS and is responsible for performing both proactive and reactive audits

A

OIG

103
Q

This agency does not fall under the umbrella of DHHS

A

Department of Justice

104
Q

Many healthcare providers work with this non-profit group to maintain accreditation to help reduce the possibility of investigation and punitive action by government agencies.

A

Joint Commission

105
Q

This federal agency that is tasked with governing and regulating healthcare in the United States

A

DHHS

106
Q

A joint federal-state program which provides coverage to 51.6 million low-income persons, including 25.1 million children.

A

Medicaid

107
Q

This agency oversees two programs which provide healthcare to about one in every four Americans.

A

CMS

108
Q

This agency not only protects individuals from discrimination in healthcare but also investigates violations to their privacy.

A

OCR

109
Q

This agency has primary responsibility to investigate complaints due to HIPAA violations. _____

A

OCR

110
Q

A patient receives a bill from the Brookdale Medical Group that includes charges for a chest x-ray and blood test. The patient calls the billing department to inform them they never had blood work or an x-ray performed. The billing specialist says nothing can be done at this point and the patient must pay the bill. The patient calls CMS with a complaint and the complaint is turned over to this agency for further investigation. _____

A

OIG

111
Q

_____ is governed by a 29-members Board of Commissioners which includes, physicians, administrators, nurses, a labor representative, health plan leaders, quality experts, ethicists, a consumer advocate and educators.

A

Joint Commission

112
Q

Participation in Joint Commission accreditation assists the healthcare provider in achieving compliance with industry and government standards.T/F

A

True

113
Q

Healthcare providers are required to belong to and participate in audits by The Joint Commission.T/F

A

False

114
Q

Administrative assistants could, during the course of their career, be directly involved in an audit by The Joint Commission. T/F

A

True

115
Q

Healthcare providers voluntarily participate in Joint Commission accreditation for three reasons:

A
  1. assists the healthcare provider in achieving compliance with industry and government standards.
  2. demonstrates to consumers the healthcare providers’ commitment to quality patient care.
  3. reduces the possibility of investigation and punitive action by government agencies.
116
Q

The joint commission’s corporate members are

A 
~The american college of physicians
~The american college of surgeons
~The american dental association
~The american hospital association
~The american medical association
117
Q

Governed by a 29-member Board of Commissioners that includes:

A 
~Physicians
~Administrators
~Nurses
~Employers
~a labor representative
~Health plan leaders
~Quality experts
~Ethicists
~A consumer advocate
~Educators
118
Q

Joint Commission

A

is an accrediting body that reviews healthcare providers to ensure they are meeting standards of care

119
Q

CMS prosecutes criminals who engage in fraudulent or abusive billing activities.T/F

A

False

120
Q

The OCR has primary responsibility for HIPAA enforcement. T/F

A

True

121
Q

The Department of Justice works hand in hand with the OCR and OIG; all three departments fall under the DHHS. T/F

A

False

122
Q

Department of Justice

A

separate branch of government tasked wth prosecuting criminals who engage in fraudulent, abusive, discriminating, or other law-breaking activities

123
Q

CMS provides:

A

~Rules
~Regulations
~Standards

124
Q

CMS provides reference and resource information with regard to coding and billing standards, HIPAA, _____, and other topics of importance tomedical office staff.

A

Fraud reporting and prevention

125
Q

CMS works jointly with private and public organizations to provide _____ to apply in the handling and transmission of medical records.

A

Regulations and standards

126
Q

This agency governs and regulates Medicare and works with individual states to govern and regulate Medicaid programs in the United States.

A

CMS

127
Q

Private organizations work with this U.S. government agency to set standards for the handling of medical records.

A

CMS

128
Q

Guidelines for billing Medicare and Medicaid fall under CMS. CMS falls under _____.

A

Department of Health and Human Services

129
Q

CMS administers the Children’s Health Insurance Program (CHIP) in each state. T/F

A

True

130
Q

An agency of the Department of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS) administers the federal Medicare program. T/F

A

True

131
Q

Walter Jones was admitted to TriCare Community Hospital for treatment of a bleeding ulcer. Because of the severity of the bleed he is admitted to the ICU for intensive skilled nursing care. The nursing care is considered _____.

A

Inpatient services

132
Q

Ancillary Healthcare Services

A

goods and/or services provided to patients by healthcare providers to aid in the diagnosis or treatment of an illness or injury
~My be either diagnostic or therapeutic in nature

133
Q

The physician who has the primary responsibility for directing care and treatment of a patient.

A

Attending physician

134
Q

Individuals who support patient care but do not actually provide the patient care.

A

Healthcare support professionals

135
Q

The physician who is asked by the attending physician to collaborate in diagnosis and/or treatment of the patient.

A

Consulting physician

136
Q

Healthcare workers who take an active role in the diagnosis and treatment of patient care.

A

Healthcare provider

137
Q

A physician who turns over the care of a patient to another physician.

A

Referring physician

138
Q

Sarah was admitted to the hospital for congestive heart failure. She spent 5 days in the hospital, improved and was ready for discharge. Sarah received her care on an _____ basis.

A

Inpatient

139
Q

Lynn left her physician’s office with a prescription for an antibiotic. She went to the pharmacy to have the pharmacist fill her prescription. What role does Lynn have in the healthcare delivery system?

A

Healthcare consumer

140
Q

Mary is seen by her family physician in his office for a cough, which she has had for 1 month. After the exam, the physician orders a chest x-ray to be taken immediately at the nearby hospital. Mary leaves the office and goes to the hospital with the order for the chest x-ray in hand. What type of service will the chest x-ray be?

A

outpatient

141
Q

Sally (a neighbor) is going to a durable medical equipment store for Laura (the patient) who needs crutches. Laura has a broken leg. Since Sally purchased the crutches, she is considered the healthcare provider. T/F

A

False

142
Q

A female patient goes to a free-standing radiology clinic to have a mammography performed; this would be considered outpatient care. T/F

A

True

143
Q

A patient goes to the emergency room for treatment of a possible fracture of the radius and ulna. After arriving at the ER it was decided that he needed to be admitted for surgery. Because the patient came through the ER, his entire stay is considered outpatient.
T/F

A

False

144
Q

When a patient is admitted to the hospital, no treatment can be provided to a patient without a physician first evaluating the patient and deciding on the appropriate course of treatment. T/F

A

True

145
Q

Healthcare support professionals take an active part in direct patient care—treating and assessing patients. T/F

A

False

146
Q

administrative assistants provide a key role in helping healthcare providers provide quality healthcare to their patients. T/F

A

True

147
Q

Healthcare consumers include a group of people referred to as patients. T/F

A

True

148
Q

A consulting physician collaborates with the attending physician to decide on a diagnosis and/or course of treatment. T/F

A

True

149
Q

The attending physician has the primary responsibility for the care and treatment of a patient. The attending physician never changes throughout a patient’s course of treatment. T/F

A

False

150
Q

The Commission on Consumer Protection and Quality in Healthcare Industry took 2 major elements “consumer protection” and “ensuring quality care” and they drafted the “Patients’ Bill of Rights.”
T/F

A

True

151
Q

First Party Payer

A

the person who receives the healthcare goods or services

152
Q

Third-party payer

A

the person who receives the services does not pay a portion of the bill

some patients don’t pay any of the bill

part of all of the payment comes from another party or organization

153
Q

Primary Payer

A

The first-party or third-partty payer is responsible for paying most of the bill

Medical Assistant (1 decks)

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