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mental dental > MD PATIENT MANAGEMENT > Flashcards

MD PATIENT MANAGEMENT Flashcards

1
Q

do no harm

autonomy

nonmaleficence

beneficence

justice

veracity

A

nonmal

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2
Q

truthfullness

autonomy

nonmaleficence

beneficence

justice

veracity

A

veracity

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3
Q

do good

autonomy

nonmaleficence

beneficence

justice

veracity

A

beneficence

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4
Q

patient autonomy is respect to patient what 2 things?

A

self determination

privacy

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5
Q

getting informed concent is dependent on what?

autonomy

nonmaleficence

beneficence

justice

veracity

A

AUTONOMY

consent: share info and obtain consent

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6
Q

if you do not obtain informed consent, what can you be tried with?

A

assualt and battery

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7
Q

who are considered minors?

A

under 18

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8
Q

can minors give consent?

A

NO

can give implied cosnent or assent but not acutal consent

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9
Q

a minor who is amancipated wants to give consent. can they?

A

yes !

they are free from care and control of parents

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10
Q

what are 5 ways a minor can give consent?

A

emergenchy situation

married

parent

pregnant

military

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11
Q

how long to keep patients charts and record?

A

as long as possible

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12
Q

most essential component of risk management?

A

documentation

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13
Q

a dentist who does not know how to do a case but attempts it anyways is violating what?

autonomy

nonmaleficence

beneficence

justice

veracity

A

nonmaleficence ( do nor harm)

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14
Q

taking continuing education course goes under what category

autonomy

nonmaleficence

beneficence

justice

veracity

A

nonmaleficence

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15
Q

acting for others is an example of

autonomy

nonmaleficence

beneficence

justice

veracity

A

beneficence

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16
Q

providing public services is example of

autonomy

nonmaleficence

beneficence

justice

veracity

A

beneficence

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17
Q

a dentist who slanders another patient is violating which ethic code?

autonomy

nonmaleficence

beneficence

justice

veracity

A

justice (fairness)

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18
Q

a dentist advertisement claims “ I do the best witeneing in the planet” this is violating which code of ethic?

autonomy

nonmaleficence

beneficence

justice

veracity

A

veracity

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19
Q

statute of limitations

A

laws that set maximum time after an event within which legal proceedings may be initiated

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20
Q

occurence rule ?

A

statute of limitatins starts to run after injury or malpractice occured ( clock starts ticking)

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21
Q

statute of limitations starts to run after injury or malpractice discovered

A

discovery rule

victim may not reasonably discover the injury until a considerable length of time has elapsed after the negligent act was committed

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22
Q

what is the standard of care?

A

the MINIMUM acceptable care

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23
Q

what is an expert testimony?

A

expert who has expertise in dentistry and can testify to existing STANDARD OF CARE and how it was breached by defendany

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24
Q

what is good samaritan act?

A

offers legal protection to health professionals who would provide reasonable assitance to people who are injjured, ill. in peril

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25
Q

mutual sense of trust and oppeness is called?

A

rapport

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26
Q

active listening examples

A

lean forward

repeat back (PARAPHRASE)

FACE PATIENT

EYE CONTACT

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27
Q

what is the first and most common nonverbal communication reaction?

A

eye and eyebrow movement

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28
Q

T or F saying “dont worry” is bad sign of verbal communication

A

T

do not falsely reassure

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29
Q

which of these should you NOT use

leading quewstions

open ended questions

closed questions

A

leading questions

do not direct patients rsponse a certain way!

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30
Q

a question such as “ do you need meds today?” is an example of

open ended question

closed question

leading question

probing

A

closed question

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31
Q

how should multiple treatment plans be presented to patient?

A

DESCENDING ORDER OF DESIRABILITY

most -> least

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32
Q

after presenting a tmnt plan, how should we asess patient level of understanding ?

A

TEACH-BACK method

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33
Q

what are the ABC of behavior change

A

A: antecedent: factor that facilitates ( causes) behavior

B: behaviour: behavior itself

C: consequence: result of behavior (good or bad)

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34
Q

a main is eating and gets food stuck between his teeth. He flosses to keep himsef from getting bacteria accumulation so he can be healthy.

Food getting stuck is an example of:

consequence

behavior

antecedent

A

ANTECEDEDNT: factor facilitates behaviour

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35
Q

a main is eating and gets food stuck between his teeth. He flosses to keep himsef from getting bacteria accumulation so he can be healthy.

patient not getting cavities in that area example of:

consequence

behavior

antecedent

A

consequence

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36
Q

WHAT ARE THE 5 STAGES OF CHANGE

A
  1. PRECONTEMPLATION: not considering change
  2. CONTEMPLATION: begins to consider
  3. PREPARATION : expresses desire
  4. ACTION: engaged in taking action
  5. MAINTANENCE : attempt to maintain change

PC- PAM

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37
Q

you speak to someone on the street about a cleaning the patient states “ could you tell me more about xrays? what are the pros and cons?

PRECONTEMPLATION:

CONTEMPLATION:

PREPARATION :

ACTION:

MAINTANENCE :

A

contemplation

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38
Q

patient at the dental office states that “ the first step is i am going to stop going to the candy jar when i pass by it”

PRECONTEMPLATION:

CONTEMPLATION:

PREPARATION :

ACTION:

MAINTANENCE :

A

preparation

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39
Q

patient states “ i made an appointment to have my teeth cleaned”

PRECONTEMPLATION:

CONTEMPLATION:

PREPARATION :

ACTION:

MAINTANENCE :

A

action

he actually made the appt

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40
Q

cognitive perception that you can execute behavior for given situation:

self efficacy

behavioral modeling

social reinforcement

A

SELF EFFICACY

cognitive = internal !!! (thoughts)

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41
Q

I want to stop smoking. my surrounding friends dont smoke so it is easier. what principle is this?

self efficacy

behavioral modeling

social reinforcement

A

behavioral remodeling

learn from models around you

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42
Q

positive social Consequence:

self efficacy

behavioral modeling

social reinforcement

A

social reinforcement

social ( external)

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43
Q

what is social cognitive theory and what are 3 examples ?

A

motivation to change behavior is influenced by several factors

  1. self efficacy (enternal preception that you yourself can execute behavior)
  2. behavioral modeling: learn from models around you
  3. social reinforcement : positive social consequences ex: praises, smiles, etc (external)
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44
Q

a patient truly belives he wont get cavities that is why they will not act on it. this is an example of what?

A

percieved susceptibility

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45
Q

a patient believes thy are susceptible to problems they will do something about it. this is an example of what?

A

cues to action

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46
Q

what are the 3 major types of BEHAVIORAL LEARNING?

A

CLASSICAL CONDITIONING: neural stimulas associated with natural respone ( dog hears whistle for food)

OPERANT CONDITIONING : response increased or decreaed due to reinforcement or punishent ( mouse pullin level for food)

OBSERVATIONAL LEARNING: learning occurs through observation of others

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47
Q

pavlovs dog is an example of what?

operant conditioning

classical conditioning

observational learning

A

classical conditioning

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48
Q

a patient walks into the office. they are absulotely terrified of going to the dental office. they are about to do a restorative procedure what is an example of unconditional stimulus in this situation and unconditional reaction?

A

pain from neefle : US

anxiety: UR

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49
Q

a patient walks into the office. they are absulotely terrified of going to the dental office. they are about to do a restorative procedure what is an example of neutral stimulus in this reaction?

A

dental chair

white coat

(NS: no real response)

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50
Q

after the procedure. describe how a patient becomes fearful of an unconditiones stimulus such as a chair or white coat when they come back to the practice?

A

patient now has an UNCONDITIONAL RESPONSE (anxiety) associated with a NEUTRAL STIMULUS (chair) with an UNCONDITIONED STIMULUS (pain from needle)

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51
Q

a patient starts to brush their teeth after the dentist tells them that brushing your teeth can stop you from getting a cavity filled. EX of what?

positive reinforcement

negative reinforcement

positive punishment

negative punishment

A

NEGATIVE REINFORCEMENT:

do good thing remove bad stimulus (brushing stop cavity)

OPERANT CONDITIONING MODEL: modifying behavior

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52
Q

a unruly child walks into the clinic. you promise them that if they behave they can get a prize. this is an example of what?

positive reinforcement

negative reinforcement

positive punishment

negative punishment

A

positive reinforcement

do good get rewarded

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53
Q

a unruly child walks into the clinic. you tell them not to moce around or they could get hurt. patient starts to move and bur punctures their cheek. what is this an example of ?

positive reinforcement

negative reinforcement

positive punishment

negative punishment

A

POSITIVE PUNISHMENT

do something bad and get punished ( basically do something and recieve consequence)

another example guy eat spoiled food and gets a stomach ache

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54
Q

a unruly child walks into the clinic. you give the kid a prize to calm down. kid does not behave so it is taken away. what is this an example of?

positive reinforcement

negative reinforcement

positive punishment

negative punishment

A

NEGATIVE PUNIHSMENT

do bad and remove good stimulus

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55
Q

ASKING AN ANXIOUS OR UNCOOPERATIVE CHILD TO OBSERVE THEIR SIBLING EXAMPLE OF WHAT?

A

OBSERVATIONAL LEARNING

board ?

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56
Q

what is the premack principle?

A

telling a kid we will only read bedtiem story if they floss

( making behaviour that has higher probability of being performed contingent pn something that has a lower probability of being perfomred)

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57
Q

internal vs external motivation

which one is more successful at changing behavior

A

IM: more successful. failed but knew you tried your best

EM: failed so you blamed the teacher

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58
Q

percon centered counseling style to assist in resolution from ambivalence ( not caring) to change

A

motivational interviewing

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59
Q

WHAT DOES OARS STAND FOR IN MOTIVATIONAL INTERVIEWING?

board ?

A

O: OPEN QUESTIONS

A: AFFIRMATION

R: REFLECTIVE LISTENING

S: SUMMARIZING

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60
Q

match motivation interiewing terms :

exploring motivation, goals, values,

ENGAGING, FOCUSING, EVOKING, PLANNIG

A

FOCUSING

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61
Q

FORMING A RELATIONSHIP:

ENGAGING

FOCUSING,

EVOKING

PLANNIG

A

engaging

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62
Q

elicint their own motivations:

ENGAGING, FOCUSING, EVOKING, PLANNIG

A

evoking

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63
Q

exploring how one might move towards change

ENGAGING, FOCUSING, EVOKING, PLANNIG

A

planning

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64
Q

sustain talk

change talk

commitment talk

favors change

ready to chance

not ready to change

A

ST: not ready

CT: favors change

Commit Talk: ready to change

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65
Q

percieved threat to ones well being

Stress

anxiety

A

STRESS

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66
Q

T or F an anxious person is more likely to sit still and not talk during procedure?

A

T

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67
Q

anxious patients typically require more __ to be comfortable

A

interpersonal space

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68
Q

1 stress management for patients

A

1 = TRUST

let patient know what to expect

patient can raise hand to break

use a timer

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69
Q

2 stress management

A

COMFORT

be empathetic :

i can see that ..

it seems like …

it soundsl ike …

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70
Q

diaphragmatic breathing is deep breathing triggerieng psysiologic relaxation response. this is an example of what stress management ?

A

COPING (use cognitive behavioral intervention

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71
Q

tensing and relaxing of muscle groups focusing on differensce between tension and relaxation. this is called what? example of what stressm management?

A

progressive muscle relaxation

COPING

copin stress management:

diphragmetic breathing and muscle relaxation

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72
Q

stress management using systemic desensitization chart?

A

basically managing anxiety throug relaxation. you expose patient to heirchy of increasing feared stimuli and you pair relaxation response with it until fear is diminished

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73
Q

decrease in response that occurs as a result of repeated or prolonged exposure to conditional stimulus

A

HABITUATION

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74
Q

4 KEYS OF COGNITIVE APPRASIAL OF THREAT ? ***

board ?

A

CONTROLLABILITY: how controllable siuation is

FAMILIARITY : how familir the situation is

PREDICTABILITY

IMMINENCE : if situation seems to be approaching near

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75
Q

child behavioral management 5 things

A

child oriented environment

ask them to be helpers

tell-show-do

ask about fears

count

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76
Q

pain involves what 2 things ?

A

cognition (acquiring knowledge)

emotion

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77
Q

what people are more likely to report pain and discomfort?

A

anxious

78
Q

what is useful for ongoing assessment of pain experience in children

A

wong baker faces pain scale

79
Q

start with simpler procedure or bigger procedure to get it out the way?

A

always start with simpler and least invasive procedure

80
Q

nitrous oxide what you feel before and after ?

A

before: TINGLING
after: NASEUA

81
Q

study of distribution and determinants of disease

public health or epidemiology

A

epidemiology !

82
Q

DMFT:

what is it?

measure of? (public heath or epidemiology)

reversible or irreversible?

A

DMFT is the sum of the number of Decayed, Missing due to caries, and Filled Teeth in the permanent teeth.

epidemiological

IREVERSIBLE

83
Q

what are EPIDEMIOLOGICAL MEASURE and are they irreversible or reversible ***

board ? !!

A

IRREVERSIBLE: DMFT (measures caries)

REVERSIBLE: GIngival index, Perio index, Oral hygeien index

84
Q

components of DMFT:

DMFS: decayed missing filled surfaces due to caries

DEFT: decayed, extracted filled teeth due to caries

DMFT: decayed missing filled primary teeth

rememver these are epidemiological irreversible measurs

A
85
Q

measure gingival index?

A

0= normal

1= mild inflammation

2= moderate inflammation

3= severe inflmmation , ulcerated tissue

86
Q

periodontal index?

A
87
Q

ORAL HYGEINE INDEX

A

good

fair

poor

88
Q

periodontal disease is disease of what?

A

gums

89
Q

early childhood caries

previously called what?

what is it defined as?

A

baby bottle tooth decay

1 or more DMFS between birth and 71 months of age

5% infant and todler population

90
Q

early childhood caries mostly occurs what age?

mostly involves what teeth?

A

3-5

max incisors and molars

91
Q

MOST COMMON ORAL CAVITY CANCER SITE ?

A

tongue

92
Q

PRIMARY SECONDARY AND TERTIARY PREVENTION EXAMPLES? ***

board ?

A

PRIMARY: sealants and flouride (diseae before occurs)

SECONDARY: restorations ( elimate after occurs)

TERTIARLY: prosthodontics ( rehab after disease)

93
Q

WHAT IS THE MOST EFFECTIVE AND PRACTICAL PREVENTITIVE MEASURE OF TOOTH DECAY?

board ?

A

community water flupridation !!!

94
Q

OPTIMAL AMOUNT OF FLUORIDE PER L OF WATER??

A

1 ppm !! ( 1 mg fluroide per L water)

95
Q

fluoridated water becomes odorless, colorless, tasteless when proper range of ___ to __ ppm?

A

.7 - 1.2 ppm

96
Q

how many people in US live in flurpidated communites?

A

210 million ( 74%)

97
Q

school water fluroidation vs community water fluouridation

A

COMMUNITY: 4.5x concentration

98
Q

best fluroide method for developing countries?

A

salt flupridation

200-350 mg flupride per kg slat

99
Q

flupride treatment for children > 3

A

Tablets and lozanges

100
Q

fluoride treatment for children <3

A

Drops

101
Q

flupride tmnt for >6

A

mouth rinse

102
Q

rules when not to use supplemental fluoride?? **

A

RULE OF 6

no supplemental systemic flurpde if

fluouride level in drinking water > .6 ppm

Patient is < 6 months old

Patient is > 16

103
Q

which fluroide is best for smooth surfaces?

A

TOPICAL FLUORIDE

104
Q

This fluoride is used as an antimicrobial as well but causes STAINING

A

stannous fluoride

105
Q

what is fluroide lethal and toxic dosage?

A

RULE OF 5 !!

TOXIC : 5 mg/ kg

LETHAL: 5g for adult

106
Q

sealants are recommended on what teeth?

A

first and second permanent molars for children

107
Q

T or F. Education is the best method for diseaes prevention

A

false!!!

behavioral modifications is a better method

108
Q

MAIN CAUSE OF CARIES AND PERIO DISEASE ?

board ?

A

DENTAL PLAQUE !!!

109
Q

children under what age should be supervised when brushing with flupride?

A

6

110
Q

T OR F flossing does not prevent tooth decay

A

T!

it does NOT prevent tooth decay but helpful for gingival health !!!!!!

111
Q

what is the most important measurement of consuming sugar?

frequency

amount

******

A

frequency !!!!

112
Q

WASH HANDS MINIMUM OF HOW LONG?

FLUSH ULTRASONIC MINIMUM HOW LONG?

boards ?

A

15 SECONDS

20-30 SECONDS

113
Q

contact via fomite from instrument, clothing, furniture is what type of route of transmission

direct contact

indirect contact

droplets

parenteral contact

A

INDIRECT CONTACT

114
Q

CONTACT VIA NEEDLE STICK WHAT TYPE

direct contact

indirect contact

droplets

parenteral contact

A

PARENTERAL OCNTACT ( IV, IM, SUBCUTANEOUS)

115
Q

contact via PERSON is what type of transmission

direct contact

indirect contact

droplets

parenteral contact

A

direct contact

116
Q

match hepatitis with way of transmission

Hep: A,B,C,D,E

fecal-oral,

contaminated blood

direct contact

A

A,E: Fecal-oral

C,B: contaminated blood

D: direct contact only get if youve had B!!!!!

Contaminated Blood ; fEcAl-oral

117
Q

which hepatitis has NO vaccine available ?

A,B,C,D,E

A

hep C

but prophylacis available

118
Q

HOW DO WE DIAGNOSE HIV?

board ?

A

when antibodies to HIV detected in blood by ELISA test

119
Q

Percutaneous injuries (PI) pose the greatest risk for occupational exposure to bloodborne pathogens. The most serious exposures include ?

Hep A

Hep B

Hep C

Hep D

Hep E

HIV

TB

A

hepatitis B, hepatitis C, and HIV.

120
Q

which is DNA and RNA Virus?

Hep A, B, C, D

HIV

TB

A

B: DNA virus (Dane particle)

C: and HIV: RNA

121
Q

which hepatitis has highest risk transmission for percutaneous injury?

A

Hepatitis: 30%

hep C: 1.8%

HIV: .3 %

122
Q

How is TB spread?

A

inhalation of infected droplets

123
Q

is it okay for patient with active tb to have elective dental care?

A

NO

124
Q

HOW FREQUENT SHOULD HEALTH CARE WORKERS HAVE TUBERCULIN SKIN TEST?

board ?

A

ONCE A YEAR !

125
Q

WHO IS MOST AT RISK FOR EYE INJURY?

DENTIST

PATIENT

ASSITANT

A

DENTIST!

126
Q

T OR F YOU CAN USE 1 GOWN FOR THE WHOLE DAY

A

T

127
Q

T or F according to OSHA, dental workers must be offered free hepatitis C vaccines?

A

F

must be offered HEPATITIS B !!!!

128
Q

what does osha say about clothing worn in the dental office?

A

CANNOT BE WASHED AT HOME!!

129
Q

WHAT IS ROLE OF EPA VS OSHA?

A

OSHA: protects healthcare workers from occupational hazards (INSIDE OFFICE)

EPA (Environmental Protection Agency): regulates transportation of dental waste outside offices. ( OUTSIDE OFFICE)

130
Q

what is EPA establishment for max exposurel evels for Hg?

A

.1 ug/kg

131
Q

sterilization is destruction of what 3 lifef roms?

A

bacteria

virus

spores

basically everything

132
Q

sterlizaytion cavispray and wipes made of what ingredient?

A

GLUTARALDEHYDE

cold solution used for heat sensitive itames

133
Q

PRESSURE STERILIZATION WHAT SHOULD TEMPERATURE, PRESSURE, TIME BE?

how does it destroy?

BOARD ?

A

121 Celcius / 15 psi / 20 minutes

DENATURATION of proteins

134
Q

DRY HEAT STERILIZATION: TEMPERATURE AND TIME? HOW DOES IT DESTROY BACTERIA?

A

160 FOR 60 MINUTES

COAGULATION OF PROTEINS

ONLY GLASS OR METAL OBJECTS

135
Q

DISINFECTION VS STERILIZATION vs ANTISEPSIS

what do they kill?

how long do they require ?

used for innanimate or living object?

A

STERILIZATION (cavi):

all life forms (bacteria, virus, spores)

requires long time

DISINFECTION:

innanimate objects

doesnt kills spores but kills MYCOBACTERIUM TB

sit for 10 minutes then wipe

ANTISEPSIS:

living tissue

alcohol: denature protein

CHX: substantivity ( contunous effect)

Detergents: loosen and remove microbes

QUaternary ammonium compod (QUATS): lethal to all except ENDOSPORES and TB

136
Q

most chance for injury at dental practice?

A

cleaning up

137
Q

noninfectious wastes like cups, bibs, etc go where?

A

normal trash

138
Q

spaulding classifcation system

CLASS 1, 2, 3 ?

A

1: CRITICAL: contacts sterile tissue ex: needle
2: semicritical: contact mucosa Ex: mirror
noncritical: contact skin: BP cuff (only requires disinfection)

139
Q

biggest risk for mercury is what? how to treat spill?

A

inhalation

sulfer powder and vacuum

140
Q

acute mercury toxicity signs and symptoms?

A

HYPOTONIA

ALOPECIA

WEIGHT LOSS

EXHAUSTIAN

LOW ENERGY, LOW MUSCLE, LOW HAIR, LOW WEIGHT

141
Q

WHAT ARE 2 TYPES OF AIRBORNES PARTICLES?

ARE THEY VISIBLE?

SIZE?

FALL FAST OR REMAIN IN AIR?

PATHOGENS and infections THEY CARRY?

board ?

A

SPLATTER:

  • visible >50um
  • FALL within 3 feet of patients mouth
  • carry blood-bourned pathogens

AEROSOLS

  • invisible <50 um
  • FLOAT in air for HOURS
  • only carry r_espiratory infections_
142
Q

HEARING LOSS CAN BE CAUSED BY WHAT DB?

A

> 90 dB

143
Q

OSHA or EPA controls water lines?

A

EPA

144
Q

EPA REQUIRES HOW MANY CFU (COLONY FORMING UNIT) OF HETEROTROPHIC BACTERIA PER ML OF WATER?

A

<500 !!!!

145
Q

WHO SUPPLIES MSDS? (MEDICAL SAFETY DATE SHEET)

from 0-4 whats most dangerous >

board ?

A

MANUFACTURER!!!!

not OSHA !!!

1- most severe

4- least severe

146
Q

person with the insurance plan

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

beneficiary (myself)

147
Q

the insurance company

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

benefactor

148
Q

monthly payment you pay to have insurance?

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

premium

149
Q

predetermined rate you pay at time of care

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

copayment

150
Q

what insurance pays for dental services covered under contract

benefactor

beneficiary

benefits

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

benefits

151
Q

predetermined rate you pay at time of care

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

copayment

152
Q

what you need to pay before insurance kicks in

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

deductible

153
Q

percentage of charge that you pay

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

coinsurance

154
Q

the most you have to pay before isnurance covers 100% of bill

benefactor

beneficiary

premium

copayment

deductible

coisnurance

out-of-pocket maximum

A

out of pocket maximum

155
Q

what are third party payers?

A

third party negotiates payments between providers and patients for services

156
Q

Third party payers:

lists max amount a plan will pay for each procedure but allows dentists to charge more if they want

TABLE OF ALLOWANCE

FEE SCHEDHULE

USUAL CUSTOMARY RESONABLE (UCR)

A

TABLE OF ALLOWANCE :

if something is 150 and isnurance covers 100, then i pay 50

157
Q

Third party payers:

reasonable fee based on geographic location

TABLE OF ALLOWANCE

FEE SCHEDHULE

USUAL CUSTOMARY RESONABLE (UCR)

A

UCR: incurance should cover most it

158
Q

Third party payers:

lists of fees the edntist has agreed upon fir debtak servuces abd insurance will cover in full

TABLE OF ALLOWANCE

FEE SCHEDHULE

USUAL CUSTOMARY RESONABLE (UCR)

A

fee schedhule

159
Q

DENTIST IS PAID PER RPROCEDURE :

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

FEE-FOR-SERVICE

160
Q

COST OF TREATMENT IS ADJUSTED BASED ON PATIENT INCOME AND ABILITY TO PAY

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

SLIDING SCALE FEE

161
Q

DENTIST CHARGES THE REMAINING BALANCE BETWEEN TOTAL FEE AND WHAT INSURANCE COMPANY COVERED

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

BALANCE BILLING

162
Q

DENTIST IS PAID PREDETERNINED FIXED AMOUNT BEFORE TREATMENT IS PROVIDED

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

PROSPECTIVE REIMB (FQHC)

like working CHC

163
Q

dentist is paid per capita ( fee for each patient seen)

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

HMO capitation plan

164
Q

CAP ON HOW DENTIST IS PAID

capitation plan (HMO)

Sliding scale fee

fee for service

balance billing

prospective reimbursement (FQHC)

A

HMO (CAPITATION PLAN)

165
Q

when is it dentists loss and dentists gain when these 2 correlate?

VALUE OF SERVICE and PAYMENT

board ?

A

Value > payment: LOSS

Payment > value: GAIN’

THIS IS CAPITATION PLAN (HMO) CAP ON HOW DENTIST IS PAID/ PAID BY NUMBER PATIENTS SEEN

166
Q

this type of fraud is sperating of dental procdures into component parts

A

UNBUNDLING

167
Q

this type of fraud is combining of dental procdures

A

BUNDLING

168
Q

reporting more complex or higher cost procedure than actually performed

BUNDLING

UPCODING

DOWNCODING

OVERBILLING

A

upcoding

169
Q

code changed to less complex or lower cost procedure than reported

BUNDLING

UPCODING

DOWNCODING

OVERBILLING

A

upcoding

170
Q

charging more than legally or ethically acceptable

BUNDLING

UPCODING

DOWNCODING

OVERBILLING

A

overbilling

171
Q

US healthcare:

MANAGED CARE EXAMPLE?

boards?

A

HMO

PPO

172
Q

US health care:

GOVERNMENT HEALTH PROGRAMS

A

medicare

medicaid

CHIP

Indian Health cervies

veterans health admin

173
Q

HMO

what is it?

how are doctors paid?

A

insurance that limits coverage to medical care providers thorugh specific providers who are under contract

CAPITATION PLAN ( paid per ptnt)

174
Q

PPO

what is it?

how are doctors paid?

A

panel of providers agree to accept less than usual fees in exhcange for higher volume of patients

175
Q

HMO VS PPO

higher provider choice?

pay higherp premiums ?

A

higher premiums: PPO

higher provider choice: PPO `

176
Q

close panel vs open panel for dentists?

A

Open: dentists can see any patient

CLosed: dentist contracted and can only see members of the plan

177
Q

ELDER ABUSE reported to what ?

board ?

A

Department of Health and Himan Servoces (HHS)

178
Q

provides comprehesnive ear;y cjo;dhppd education, health, nutrition, to low income children and their families

A

Head Start

179
Q

Medicare vs Medicaid

A

Medicare: elderly

Medicaid: destitute (poor)

180
Q

does medicare cover dental care for the elderly?

A

NO

181
Q

this act funds medical and dental cae for people woth HIV/AIDS

A

RYAN WHITE CARE ACT

182
Q

this orfanization provides oral health surveilance , water fluoridation, cancer related ossies. and state support oral health

A

CDC

183
Q

evaluates medical devices, drugs, and food based on efficacy and safety

A

FDA

184
Q

biomedical and public health research organization

A

National Insitute of Health (NIH)

185
Q

this agency measures quality of care at a location and acceass to care.

A

AHRQ

Agency for healthcare research and quality

186
Q

what is considered CRITICAL spaulding classsification system

A

sterile tissue or vascular tissue.

requires sterilization

NEEDLES

187
Q

what is considered semi-critical spaulding classsification system

A

contact MUCOSA

mirror

188
Q

what is considered noncritical spaulding classsification system

A

contact skin

blood pressure cuff

189
Q

destruction of spores:

sterilization

disenfection

Antisepsis

A

sterilization

190
Q

used on living tissue:

sterilization

disenfection

Antisepsis

A

antisepsis

191
Q

destruction of mycobacterium TB:

sterilization

disenfection

Antisepsis

A

mental dental (18 decks)

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