MD PATIENT MANAGEMENT Flashcards
1
Q
do no harm
autonomy
nonmaleficence
beneficence
justice
veracity
A
nonmal
2
Q
truthfullness
autonomy
nonmaleficence
beneficence
justice
veracity
A
veracity
3
Q
do good
autonomy
nonmaleficence
beneficence
justice
veracity
A
beneficence
4
Q
patient autonomy is respect to patient what 2 things?
A
self determination
privacy
5
Q
getting informed concent is dependent on what?
autonomy
nonmaleficence
beneficence
justice
veracity
A
AUTONOMY
consent: share info and obtain consent
6
Q
if you do not obtain informed consent, what can you be tried with?
A
assualt and battery
7
Q
who are considered minors?
A
under 18
8
Q
can minors give consent?
A
NO
can give implied cosnent or assent but not acutal consent
9
Q
a minor who is amancipated wants to give consent. can they?
A
yes !
they are free from care and control of parents
10
Q
what are 5 ways a minor can give consent?
A
emergenchy situation
married
parent
pregnant
military
11
Q
how long to keep patients charts and record?
A
as long as possible
12
Q
most essential component of risk management?
A
documentation
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)
14
Q
taking continuing education course goes under what category
autonomy
nonmaleficence
beneficence
justice
veracity
A
nonmaleficence
15
Q
acting for others is an example of
autonomy
nonmaleficence
beneficence
justice
veracity
A
beneficence
16
Q
providing public services is example of
autonomy
nonmaleficence
beneficence
justice
veracity
A
beneficence
17
Q
a dentist who slanders another patient is violating which ethic code?
autonomy
nonmaleficence
beneficence
justice
veracity
A
justice (fairness)
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
19
Q
statute of limitations
A
laws that set maximum time after an event within which legal proceedings may be initiated
20
Q
occurence rule ?
A
statute of limitatins starts to run after injury or malpractice occured ( clock starts ticking)
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
22
Q
what is the standard of care?
A
the MINIMUM acceptable care
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
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
25
mutual sense of trust and oppeness is called?
rapport
26
active listening examples
lean forward
repeat back (PARAPHRASE)
FACE PATIENT
EYE CONTACT
27
what is the first and most common nonverbal communication reaction?
eye and eyebrow movement
28
T or F saying "dont worry" is bad sign of verbal communication
T
do not falsely reassure
29
which of these should you NOT use
leading quewstions
open ended questions
closed questions
**leading questions**
do not direct patients rsponse a certain way!
30
a question such as " do you need meds today?" is an example of
open ended question
closed question
leading question
probing
closed question
31
how should multiple treatment plans be presented to patient?
DESCENDING ORDER OF DESIRABILITY
most -\> least
32
after presenting a tmnt plan, how should we asess patient level of understanding ?
TEACH-BACK method
33
what are the ABC of behavior change
A: **antecedent**: factor that facilitates ( causes) behavior
B: **behaviour**: behavior itself
C: **consequence**: result of behavior (good or bad)
34
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
ANTECEDEDNT: factor facilitates behaviour
35
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
consequence
36
WHAT ARE THE 5 STAGES OF CHANGE
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
37
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?
## Footnote
PRECONTEMPLATION:
CONTEMPLATION:
PREPARATION :
ACTION:
MAINTANENCE :
contemplation
38
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 :
preparation
39
patient states " i made an appointment to have my teeth cleaned"
PRECONTEMPLATION:
CONTEMPLATION:
PREPARATION :
ACTION:
MAINTANENCE :
action
he actually made the appt
40
**cognitive** perception that you can execute behavior for given situation:
self efficacy
behavioral modeling
social reinforcement
SELF EFFICACY
cognitive = internal !!! (thoughts)
41
I want to stop smoking. my surrounding friends dont smoke so it is easier. what principle is this?
self efficacy
behavioral modeling
social reinforcement
behavioral remodeling
learn from models around you
42
positive **social** Consequence:
self efficacy
behavioral modeling
social reinforcement
**social reinforcement**
social ( external)
43
what is social cognitive theory and what are 3 examples ?
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_*)
44
a patient truly belives he wont get cavities that is why they will not act on it. this is an example of what?
percieved susceptibility
45
a patient believes thy are susceptible to problems they will do something about it. this is an example of what?
cues to action
46
what are the 3 major types of BEHAVIORAL LEARNING?
**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: l**earning occurs through observation of others
47
pavlovs dog is an example of what?
operant conditioning
classical conditioning
observational learning
classical conditioning
48
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?
pain from neefle : US
anxiety: UR
49
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?
dental chair
white coat
(NS: no real response)
50
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?
patient now has an **UNCONDITIONAL** RESPONSE (anxiety) associated with a **NEUTRAL** STIMULUS (chair) with an **UNCONDITIONED** STIMULUS (pain from needle)
51
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
**NEGATIVE REINFORCEMENT:**
do good thing remove bad stimulus (brushing stop cavity)
OPERANT CONDITIONING MODEL: modifying behavior
52
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?
## Footnote
positive reinforcement
negative reinforcement
positive punishment
negative punishment
**positive reinforcement**
do good get rewarded
53
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
**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
54
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
**NEGATIVE PUNIHSMENT**
do bad and remove good stimulus
55
ASKING AN ANXIOUS OR UNCOOPERATIVE CHILD TO OBSERVE THEIR SIBLING EXAMPLE OF WHAT?
OBSERVATIONAL LEARNING
board ?
56
what is the premack principle?
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)
57
internal vs external motivation
which one is more successful at changing behavior
IM: more successful. failed but knew you tried your best
EM: failed so you blamed the teacher
58
percon centered counseling style to assist in resolution from ambivalence ( not caring) to change
motivational interviewing
59
WHAT DOES OARS STAND FOR IN MOTIVATIONAL INTERVIEWING?
board ?
O: OPEN QUESTIONS
A: AFFIRMATION
R: REFLECTIVE LISTENING
S: SUMMARIZING
60
match motivation interiewing terms :
exploring motivation, goals, values,
ENGAGING, FOCUSING, EVOKING, PLANNIG
FOCUSING
61
FORMING A RELATIONSHIP:
ENGAGING
FOCUSING,
EVOKING
PLANNIG
engaging
62
elicint their own motivations:
ENGAGING, FOCUSING, EVOKING, PLANNIG
evoking
63
exploring how one might move towards change
ENGAGING, FOCUSING, EVOKING, PLANNIG
planning
64
sustain talk
change talk
commitment talk
favors change
ready to chance
not ready to change
ST: not ready
CT: favors change
Commit Talk: ready to change
65
percieved threat to ones well being
Stress
anxiety
STRESS
66
T or F an anxious person is more likely to sit still and not talk during procedure?
T
67
anxious patients typically require more __ to be comfortable
interpersonal space
68
#1 stress management for patients
#1 = TRUST
let patient know what to expect
patient can raise hand to break
use a timer
69
#2 stress management
COMFORT
be empathetic :
i can see that ..
it seems like ...
it soundsl ike ...
70
**diaphragmatic breathing** is deep breathing triggerieng psysiologic relaxation response. this is an example of what stress management ?
COPING (use cognitive behavioral intervention
71
tensing and relaxing of muscle groups focusing on differensce between tension and relaxation. this is called what? example of what stressm management?
**progressive muscle relaxation**
COPING
copin stress management:
diphragmetic breathing and muscle relaxation
72
stress management using systemic desensitization chart?
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
73
decrease in response that occurs as a result of repeated or prolonged exposure to **conditional stimulus**
HABITUATION
74
4 KEYS OF COGNITIVE APPRASIAL OF THREAT ? \*\*\*
board ?
**CONTROLLABILITY**: how controllable siuation is
**FAMILIARITY** : how familir the situation is
**PREDICTABILITY**
**IMMINENCE** : if situation seems to be approaching near
75
child behavioral management 5 things
child oriented environment
ask them to be helpers
tell-show-do
ask about fears
count
76
pain involves what 2 things ?
cognition (acquiring knowledge)
emotion
77
what people are more likely to report pain and discomfort?
anxious
78
what is useful for ongoing assessment of pain experience in children
wong baker faces pain scale
79
start with simpler procedure or bigger procedure to get it out the way?
always start with simpler and least invasive procedure
80
nitrous oxide what you feel before and after ?
before: TINGLING
after: NASEUA
81
study of distribution and determinants of disease
public health or epidemiology
epidemiology !
82
DMFT:
what is it?
measure of? (public heath or epidemiology)
reversible or irreversible?
**DMFT** is the sum of the number of Decayed, Missing due to caries, and Filled Teeth in the _permanent_ teeth.
epidemiological
IREVERSIBLE
83
what are EPIDEMIOLOGICAL MEASURE and are they irreversible or reversible \*\*\*
board ? !!
**IRREVERSIBLE**: DMFT (measures caries)
**REVERSIBLE**: GIngival index, *Perio* index, Oral hygeien index
84
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
85
measure gingival index?
0= normal
1= mild inflammation
2= moderate inflammation
3= severe inflmmation , ulcerated tissue
86
periodontal index?
87
ORAL HYGEINE INDEX
good
fair
poor
88
periodontal disease is disease of what?
gums
89
early childhood caries
previously called what?
what is it defined as?
baby bottle tooth decay
1 or more **DMFS** between **_birth_** and **_71 months_** of age
5% infant and todler population
90
early childhood caries mostly occurs what age?
mostly involves what teeth?
3-5
max incisors and molars
91
MOST COMMON ORAL CAVITY CANCER SITE ?
tongue
92
PRIMARY SECONDARY AND TERTIARY PREVENTION EXAMPLES? \*\*\*
board ?
PRIMARY: sealants and flouride (diseae before occurs)
SECONDARY: restorations ( elimate after occurs)
TERTIARLY: prosthodontics ( rehab after disease)
93
WHAT IS THE MOST EFFECTIVE AND PRACTICAL PREVENTITIVE MEASURE OF TOOTH DECAY?
board ?
community water flupridation !!!
94
OPTIMAL AMOUNT OF FLUORIDE PER L OF WATER??
1 ppm !! ( 1 mg fluroide per L water)
95
fluoridated water becomes odorless, colorless, tasteless when proper range of ___ to __ ppm?
.7 - 1.2 ppm
96
how many people in US live in flurpidated communites?
210 million ( 74%)
97
school water fluroidation vs community water fluouridation
COMMUNITY: 4.5x concentration
98
best fluroide method for developing countries?
salt flupridation
200-350 mg flupride per kg slat
99
flupride treatment for children \> 3
Tablets and lozanges
100
fluoride treatment for children \<3
Drops
101
flupride tmnt for **\>6**
mouth rinse
102
rules when not to use supplemental fluoride?? \*\*
RULE OF 6
no supplemental systemic flurpde if
fluouride level in drinking water **\> .6 ppm**
Patient is **\< 6 months** old
Patient is **\> 16**
103
which fluroide is best for smooth surfaces?
TOPICAL FLUORIDE
104
This fluoride is used as an antimicrobial as well but causes STAINING
stannous fluoride
105
what is fluroide lethal and toxic dosage?
**RULE OF 5 !!**
TOXIC : **5 mg/ kg**
LETHAL: **5g** for adult
106
sealants are recommended on what teeth?
first and second ***permanent*** molars for children
107
T or F. Education is the best method for diseaes prevention
false!!!
**behavioral modifications** is a better method
108
MAIN CAUSE OF CARIES AND PERIO DISEASE ?
board ?
***_DENTAL PLAQUE !!!_***
109
children under what age should be supervised when brushing with flupride?
6
110
T OR F flossing does not prevent tooth decay
T!
it does **NOT** prevent tooth decay but helpful for gingival health !!!!!!
111
what is the most important measurement of consuming sugar?
frequency
amount
\*\*\*\*\*\*
frequency !!!!
112
WASH HANDS MINIMUM OF HOW LONG?
FLUSH ULTRASONIC MINIMUM HOW LONG?
boards ?
15 SECONDS
20-30 SECONDS
113
contact via fomite from instrument, clothing, furniture is what type of route of transmission
direct contact
indirect contact
droplets
parenteral contact
INDIRECT CONTACT
114
CONTACT VIA NEEDLE STICK WHAT TYPE
direct contact
indirect contact
droplets
parenteral contact
PARENTERAL OCNTACT ( IV, IM, SUBCUTANEOUS)
115
contact via PERSON is what type of transmission
direct contact
indirect contact
droplets
parenteral contact
direct contact
116
match hepatitis with way of transmission
Hep: A,B,C,D,E
fecal-oral,
contaminated blood
direct contact
A,E: Fecal-oral
C,B: contaminated blood
**D: direct contact only get if youve had B!!!!!**
**C**ontaminated **B**lood ; f**E**c**A**l-oral
117
which hepatitis has NO vaccine available ?
A,B,C,D,E
hep C
but prophylacis available
118
HOW DO WE DIAGNOSE HIV?
board ?
when antibodies to HIV detected in blood by **ELISA** test
119
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
hepatitis B, hepatitis C, and HIV.
120
which is DNA and RNA Virus?
Hep A, B, C, D
HIV
TB
**B**: DNA virus (Dane particle)
**C**: and **HIV:** RNA
121
which hepatitis has highest risk transmission for percutaneous injury?
Hepatitis: 30%
hep C: 1.8%
HIV: .3 %
122
How is TB spread?
inhalation of infected droplets
123
is it okay for patient with active tb to have elective dental care?
NO
124
HOW FREQUENT SHOULD HEALTH CARE WORKERS HAVE TUBERCULIN SKIN TEST?
board ?
ONCE A YEAR !
125
WHO IS MOST AT RISK FOR EYE INJURY?
DENTIST
PATIENT
ASSITANT
DENTIST!
126
T OR F YOU CAN USE 1 GOWN FOR THE WHOLE DAY
T
127
T or F according to OSHA, dental workers must be offered free hepatitis C vaccines?
F
must be offered HEPATITIS B !!!!
128
what does osha say about clothing worn in the dental office?
CANNOT BE WASHED AT HOME!!
129
WHAT IS ROLE OF EPA VS OSHA?
OSHA: protects healthcare workers from occupational hazards (INSIDE OFFICE)
EPA (Environmental Protection Agency): regulates **transportation** of dental waste outside offices. ( OUTSIDE OFFICE)
130
what is EPA establishment for max exposurel evels for Hg?
.1 ug/kg
131
sterilization is destruction of what 3 lifef roms?
bacteria
virus
**spores**
**basically everything**
132
sterlizaytion cavispray and wipes made of what ingredient?
GLUTARALDEHYDE
**cold solution** used for heat sensitive itames
133
PRESSURE STERILIZATION WHAT SHOULD TEMPERATURE, PRESSURE, TIME BE?
how does it destroy?
BOARD ?
121 Celcius / 15 psi / 20 minutes
DENATURATION of proteins
134
_**DRY HEAT** STERILIZATION_: TEMPERATURE AND TIME? HOW DOES IT DESTROY BACTERIA?
160 FOR 60 MINUTES
COAGULATION OF PROTEINS
ONLY GLASS OR METAL OBJECTS
135
DISINFECTION VS STERILIZATION vs ANTISEPSIS
what do they kill?
how long do they require ?
used for innanimate or living object?
**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
most chance for injury at dental practice?
cleaning up
137
noninfectious wastes like cups, bibs, etc go where?
normal trash
138
spaulding classifcation system
CLASS 1, 2, 3 ?
1: CRITICAL: contacts sterile tissue ex: needle
2: semicritical: contact mucosa Ex: mirror
noncritical: contact skin: BP cuff (only requires disinfection)
139
biggest risk for mercury is what? how to treat spill?
inhalation
sulfer powder and vacuum
140
acute mercury toxicity signs and symptoms?
HYPOTONIA
ALOPECIA
WEIGHT LOSS
EXHAUSTIAN
LOW ENERGY, LOW MUSCLE, LOW HAIR, LOW WEIGHT
141
WHAT ARE 2 TYPES OF AIRBORNES PARTICLES?
ARE THEY VISIBLE?
SIZE?
FALL FAST OR REMAIN IN AIR?
PATHOGENS and infections THEY CARRY?
board ?
**_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
HEARING LOSS CAN BE CAUSED BY WHAT DB?
\> 90 dB
143
OSHA or EPA controls water lines?
EPA
144
EPA REQUIRES HOW MANY CFU (COLONY FORMING UNIT) OF HETEROTROPHIC BACTERIA PER ML OF WATER?
\<500 !!!!
145
WHO SUPPLIES MSDS? (MEDICAL SAFETY DATE SHEET)
from 0-4 whats most dangerous \>
board ?
**_MANUFACTURER_**!!!!
not OSHA !!!
1- most severe
4- least severe
146
person with the insurance plan
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
beneficiary (myself)
147
the insurance company
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
benefactor
148
monthly payment you pay to have insurance?
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
premium
149
predetermined rate you pay at time of care
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
copayment
150
what insurance pays for dental services covered under contract
## Footnote
benefactor
beneficiary
benefits
premium
copayment
deductible
coisnurance
out-of-pocket maximum
benefits
151
predetermined rate you pay at time of care
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
copayment
152
what you need to pay before insurance kicks in
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
deductible
153
percentage of charge that you pay
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
coinsurance
154
the most you have to pay before isnurance covers 100% of bill
## Footnote
benefactor
beneficiary
premium
copayment
deductible
coisnurance
out-of-pocket maximum
out of pocket maximum
155
what are third party payers?
third party negotiates payments between **providers** and **patients** for services
156
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)
TABLE OF ALLOWANCE :
if something is 150 and isnurance covers 100, then i pay 50
157
Third party payers:
reasonable fee based on geographic location
TABLE OF ALLOWANCE
FEE SCHEDHULE
USUAL CUSTOMARY RESONABLE (UCR)
UCR: incurance should cover most it
158
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)
fee schedhule
159
DENTIST IS PAID PER RPROCEDURE :
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
FEE-FOR-SERVICE
160
COST OF TREATMENT IS ADJUSTED BASED ON PATIENT INCOME AND ABILITY TO PAY
## Footnote
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
SLIDING SCALE FEE
161
DENTIST CHARGES THE REMAINING BALANCE BETWEEN TOTAL FEE AND WHAT INSURANCE COMPANY COVERED
## Footnote
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
BALANCE BILLING
162
DENTIST IS PAID PREDETERNINED FIXED AMOUNT BEFORE TREATMENT IS PROVIDED
## Footnote
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
PROSPECTIVE REIMB (FQHC)
like working CHC
163
dentist is paid per capita ( fee for each patient seen)
## Footnote
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
HMO capitation plan
164
CAP ON HOW DENTIST IS PAID
## Footnote
capitation plan (HMO)
Sliding scale fee
fee for service
balance billing
prospective reimbursement (FQHC)
HMO (CAPITATION PLAN)
165
when is it dentists loss and dentists gain when these 2 correlate?
VALUE OF SERVICE and PAYMENT
board ?
Value \> payment: LOSS
Payment \> value: GAIN'
THIS IS CAPITATION PLAN (HMO) CAP ON HOW DENTIST IS PAID/ PAID BY NUMBER PATIENTS SEEN
166
this type of fraud is **_sperating_** of dental procdures into component parts
UNBUNDLING
167
this type of fraud is **_combining_** of dental procdures
BUNDLING
168
reporting more complex or higher cost procedure than actually performed
BUNDLING
UPCODING
DOWNCODING
OVERBILLING
upcoding
169
code changed to less complex or lower cost procedure than reported
BUNDLING
UPCODING
DOWNCODING
OVERBILLING
upcoding
170
charging more than legally or ethically acceptable
BUNDLING
UPCODING
DOWNCODING
OVERBILLING
overbilling
171
US healthcare:
MANAGED CARE EXAMPLE?
boards?
HMO
PPO
172
US health care:
GOVERNMENT HEALTH PROGRAMS
medicare
medicaid
CHIP
Indian Health cervies
veterans health admin
173
HMO
what is it?
how are doctors paid?
insurance that limits coverage to medical care providers thorugh specific providers who are **under contract**
CAPITATION PLAN ( paid per ptnt)
174
PPO
what is it?
how are doctors paid?
panel of providers agree to accept less than usual fees in exhcange for higher volume of patients
175
HMO VS PPO
higher provider choice?
pay higherp premiums ?
higher premiums: PPO
higher provider choice: PPO `
176
close panel vs open panel for dentists?
Open: dentists can see any patient
CLosed: dentist contracted and can only see members of the plan
177
ELDER ABUSE reported to what ?
board ?
Department of Health and Himan Servoces (HHS)
178
provides comprehesnive ear;y cjo;dhppd education, health, nutrition, to low income children and their families
Head Start
179
Medicare vs Medicaid
Medicar**e**: **e**lderly
Medicai**d:** **d**estitute (poor)
180
does medicare cover dental care for the elderly?
NO
181
this act funds medical and dental cae for people woth HIV/AIDS
RYAN WHITE CARE ACT
182
this orfanization provides oral health surveilance , water fluoridation, cancer related ossies. and state support oral health
CDC
183
evaluates medical devices, drugs, and food based on efficacy and safety
FDA
184
**biomedical** and **public health** research organization
National Insitute of Health (NIH)
185
this agency measures quality of care at a location and acceass to care.
AHRQ
Agency for healthcare research and quality
186
what is considered CRITICAL spaulding classsification system
**sterile** tissue or **vascular** tissue.
requires sterilization
NEEDLES
187
what is considered semi-critical spaulding classsification system
contact MUCOSA
mirror
188
what is considered noncritical spaulding classsification system
contact skin
blood pressure cuff
189
destruction of spores:
sterilization
disenfection
Antisepsis
sterilization
190
used on living tissue:
sterilization
disenfection
Antisepsis
antisepsis
191
destruction of mycobacterium TB:
sterilization
disenfection
Antisepsis
