Intro to Allied Health Flashcards
Healthcare System Definition
Group of people, agencies and/or institutions that provide healthcare services to individuals in a variety of settings
9 Major Areas of Healthcare
1) Ambulatory Care Centers - community centers delivered on an outpatient basis, doesn’t allow overnight stay
2) Acute Care Centers/Hospitals - Provides care for individuals who have disease that comes on quickly or that lasts for a short period of time
3) Long Term Care - Physical/Emotional needs for an extended time
4) Home Care - Works within home
5) Doctor’s Office - Doctor receives and treats medical patients
6) Specialty Hospitals - Specialized care to specific patients, populations, or diseases
7) Health Maintenance Organizations - Provides preventative healthcare options at a reduced cost
8) Rehabilitation Centers - helping patients return to their highest state of optimal health
9) Hospice Care - Provides care to patients who are critically ill and are expected to live 6 months or less
Healthcare Provides are required in all settings, including the community, ambulatory and home healthcare settings (T/F)
True
Healthcare Managers hold ___
Hold leadership roles to oversee healthcare agencies
Medical Assistants
- May ___
- Prepare ___
May Take Vital Signs, prepare patients for tests and other similar tasks
Medical transcriptionists
Transcribe voice recordings into text, including summaries of medical histories, discard summaries and diagnostic report summaries
Home Health Aides
- Assist
- Monitor
- Work
Assist individuals w/ ADLs (activities of daily living), monitor health status and work with families
Opticians
fit and dispense eyeglasses and contact lenses
5 Major hospital based professions
1) Health Information Management (HIM)
2) Medical Biller and coder
3) Occupational Therapy Aide
4) Pharmacy Technician Professional
5) Physical Therapy Aide
Health Information Managers
Collect, process, analyze and distribute important healthcare information to clinical and administrative staff throughout the healthcare organization
Medical Biller and Coder
Examines records, assigns codes and creates reimbursement document
Occupational Therapy Aide
Assists a licensed therapist to provide services to patients who have difficulties in performing work
Pharmacy Technician
Supervised by a pharmacist while supplying prescriptions and medications
Physical Therapy Aide
Works under supervisor and helps patients recover, regain movement and manage pain caused by illness and injury
________: Assembles medicines for prescriptions
________: Monitors and maintains EMRs
________: Assists with splinting
________: Administers heat, water, sound and ultrasound procedures
Physical Therapy Aide, Occupational Therapy Aide, Health Information Manager, Pharmacy Tech
Pharmacy Tech
Health Information Manager
Occupational Therapy Aide
Physical Therapy Aide
Health Insurance can either be run by government (public) or private companies (T/F)
True
3 Types of Public Health Insurance
Medicaid - State run gov’t insurance program that helps people with lower income pay for medical care
Medicare - plan provided by the gov’t for people 65 and older
Affordable Care Act (ACA) an act signed into law in March 2010 by President Obama with the goal of increasing the quality of affordability of health insurance in the US
Private Health Insurance
Provided by employers and other organizations. Employers often pay a portion of the cost of an employee health insurance plan, then the employee pays the rest
3 Types of Managed Care Plans
1) Health Maintenance Organizations (HMOs)
2) Preferred Provider Organizations (PPO)
3) Point of Service: Allows individuals to choose either HMO or PPO each time they receive medical care
Medicaid
State run government insurance program that helps people with lower income pay for medical care
Medicare
Federal insurance program for people who are 65 and older, certain younger people with disabilities and people w/ kidney failure.
People who qualify: must have previously worked and paid taxes to the government.
Affordable Care Act (ACA)
An act signed into law in Mar 3020 by Pres Obama with the gal of increasing the quality or affordability of health insurance in the US
Deductible
The minimum amount that a person must pay out of pocket before a health insurer will pay any expenses to the healthcare provider
Co-payment
Predetermined amount defined by the health insurer that must be paid each time a health service is accessed
Coinsurance
Splitting the cost between individuals and their insurance carrier
4 Major Government health insurance
Medicare - Federal insurance program for people who are 65 and older, certain younger people with disabilities and people w/ kidney failure.
Medicaid -
Tricare
Children’s Health Insurance Program
(Also be aware of Federal Employee Health Benefits, Indian Health Service for those of Native Am descent IHS, Veterans Health Administration, and Program of All Inclusive Care for the Elderly PACE)
Medicare divided into 4 categories
A - Hospital Payment Plan, includes inpatient hospital coverage, skilled nursing care, nursing home care, and hospice care
B - covers services and supplies that are medically necessary to treat your health condition. Your medical insurance plan, outpatient services (lab tests doctors visits DME or any med equipment used in the home. Also covers ambulance and preventative services.
C - Medicare Advantage Plan, enables beneficiaries to select a plan that includes supplemental insurance. Covers ouf ot pocket costs that are not covered by A & B. Allows to choose plan that includes prescription drug coverage at no additional premium or choose a plan without prescription. Private companies run all Medicare Part C Plans which combines coverage for hospital stays w/ coverage for doctors’ visit.
D - Medicare Prescription Drug Benefit, US fed gov’t program that subsidizes the costs of prescription drugs and insurance premiums for medical beneficiaries. Purchased one of two ways: 1) only as Part D, 2) In addition to Part C
Diagnosis Related Groups (DRGs)
Statistical system of classifying any inpatient stay into groups for the purposes of payment. Uses a formula to calculate reimbursement for healthcare providers in acute care settings.
2 Types of diagnosis to DRGs
1) Principal Diagnosis - primary condition being led to the patient being admitted to the hospital
2) Secondary Diagnosis - complications that may affect patients course of treatment or prolong the length of the hospital stay
What is Medicaid? How is it funded and managed?
Largest source of funding for health insurance for low income families in the US
Funded and managed by both federal and state governments but it is only managed at a state level
How do you qualify for Medicaid?
A family must earn a salary that’s below the poverty level
Are there any Medicaid Programs specifically for children?
Children’s Health Insurance Program: Qualified families with children who don’t have health insurance coverage
Families who qualify have healthcare coverage that is either free or low cost.
What’s Tricare? Who manages and regulates it? Does it cover the families of those who have served or are serving?
- Provides civilian health benefits to those who have served or are currently serving in the military
- Dept of Defense manages and regulates Tricare
- Yes, includes uniformed services, retirees, spouses and unmarried children, Medal of honor recipients and their families and reservists and their families.
2 Types of Private Health Insurance
1) Health Maintenance Organizations
2) Preferred Provider Organization
2 Types of Private Health Insurance
1) Health Maintenance Organizations
2) Preferred Provider Organization
