Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Certified Medical Assistant > Module 1: Healthcare Systems and Settings > Flashcards

Module 1: Healthcare Systems and Settings Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

roles and responsibilities of CMA

A
  • administrative: greeting pts, answering phones
  • clinical duties: obtaining med history, explaining Tx/procedures, drawing lab tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

medical doctor (MD)

A
  • allopathic
  • Dx, Tx, Rx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

osteopathic providers (DO)

A
  • similar to MD
  • osteopathic manipulative therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

nurse practitioners (NP)

A
  • Dx, Rx
  • training beyond RN degree, lots of clinical experience
  • preventative care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

physician assistants (PA)

A
  • under the direction and supervision of MD or DO
  • make clinical decisions, responsible for variety of services
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

medical laboratory technician

A
  • diagnostic testing on body fluids
  • under supervision of medical technologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

medical receptionist

A
  • check pt in/out, phones, filing, faxing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

occupational therapist

A
  • assist pts with conditions disabling them developmentally, emotionally, mentally, or physically
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pharmacy technician

A
  • assist pharmacists
  • tasks not requiring expertise or judgement of pharmacists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pharmacy technician

A
  • assist pharmacists
  • tasks not requiring expertise or judgment of pharmacists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

physical therapist

A
  • assist pts in regaining mobility, strength, ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

radiology technician

A
  • imaging equipment to assist in Dx and Tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

professionalism in CMAs

A
  • appropriate dress
  • phone use
  • punctuality
  • boundary respect
  • motivation
  • work ethic
  • integrity
  • accountability
  • flexibility
  • open mindedness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

scope of practice

A
  • duties that can be delegated based on education, training, and experience
  • state regulations and specific office policies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

standard of care

A
  • degree of care expected in particular circumstance or role
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how much department of labor projects medical assistant field will grow from 2014 to 2024

A

23%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

average occupation growth

A

7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CPT

A
  • certified phlebotomy technician
  • additional credential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CET

A
  • certified EKG technician
  • additional credential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CBCS

A
  • certified billing and coding specialist
  • additional credential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CEHRS

A
  • certified electronic health records specialist
  • additional credential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

certified health coach or patient navigator

A
  • directs pt through health care system, organize care, provide resources
  • may have chronic disease focus
  • additional credential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

licensure

A
  • state regulated
  • mandatory for physicians
  • CMA not required to be licensed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how licensure is accomplished

A
  • examination: state board exam
  • reciprocity: recognize requirements from other state
  • endorsement: graduates of med school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

certification

A
  • generally optional
  • may be required to administer meds, perform phlebotomy, enter prescription into CPOE
  • continuing education to keep current
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

advantages of certification

A
  • increased initial job placement
  • higher wages
  • career advancement opportunities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

health care delivery

A
  • organization of individuals, establishments, and resources to deliver health care services and meet health needs of specific populations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

affordable care act

A
  • promoted newer healthcare systems and payment models
  • move from reimbursement structure to value of care model
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

accountable care organizations (ACO)

A
  • group of physicians, hospitals, and other health care providers
  • voluntary care to Medicare pts
  • shares savings with Medicare programs if spends money wisely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

capitation

A
  • pt assigned monthly payment based on age, race, sex, lifestyle, medical history, benefit design
  • payment tied to expected usage
  • partial/blended: only specific services are paid on basis of capitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

global budget

A
  • fixed total amount paid annually for all care
  • participating providers determine how money is spent
  • limit increase in healthcare costs
  • include quality component
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

health maintenance organization (HMO)

A
  • medical center/group of providers give preventative and acute care
  • require referrals, precertification, preauthorization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

patient centered medical home (PCMH)

A
  • PCP coordinates Tx
  • pt receives care in a way they can understand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

pay for performance

A
  • reimbursement model compensates providers only if they meet quality and efficacy standards
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

preferred provider organization (PPO)

A
  • more flexible than HMO
  • doesn’t need PCP, referrals
  • providers in network cost less
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

general practitioner (GP)

A
  • general medicine
  • acute and chronic illness
  • preventative care and education to pts
  • holistic approach
37
Q

family practitioner

A
  • general medicine
  • care for whole family (newborn to adult)
  • familiar with range of disorders/diseases
  • primary concern is preventative care
  • most often chosen
38
Q

internist

A
  • general medicine
  • comprehensive care of adults
  • often chronic conditions
  • also common illness and preventative care
  • need broad understanding of body
39
Q

allergist

A
  • disorders/diseases of immune system
  • reactions to medications and food, anaphylaxis, autoimmune disease, asthma
40
Q

anesthesiologist

A
  • manage pain or use sedation during surgical procedures
41
Q

cardiologist

A
  • Dx and Tx heart and blood vessel conditions
42
Q

dermatologist

A
  • skin conditions
43
Q

endocrinologist

A
  • hormonal and glandular conditions
  • diabetes pts
44
Q

gastroenterologist

A
  • GI tract
45
Q

gynecologist

A
  • female reproductive system, fertility disorders
46
Q

hematologist

A
  • blood
  • anemia, leukemia, lymphoma
47
Q

hepatologist

A
  • liver, biliary tree, gallbladder, pancreas
48
Q

neonatologist

A
  • newborns
49
Q

nephrologist

A
  • care and Tx of kidneys
50
Q

obstetricians

A
  • care of women during and after pregnancy
51
Q

oncologist

A
  • care of Tx of pts with cancer
52
Q

ophthalmologist

A
  • eye conditions
53
Q

orthopedist

A
  • bones, joints, muscles, tendons, ligaments
54
Q

otolaryngologist

A
  • ear, nose, throat
55
Q

neurologist

A
  • nervous system
56
Q

pathologist

A
  • body tissues/fluids to Dx or Tx conditions
57
Q

pediatricians

A
  • infant to adolescent care
58
Q

psychiatrist

A
  • mental disorders and conditions
59
Q

radiologist

A
  • use xray, ultrasound, nuclear medicine, CT, MRI to detect abnormalities
60
Q

urologist

A
  • urinary tract disorders
61
Q

urgent care

A
  • ancillary service
  • alternative to ED
  • cost less, shorter wait, conveniently located, flexible hours, offer walk ins
62
Q

laboratory services

A
  • ancillary service
  • diagnostic testing on specimens to conclude Dx
63
Q

diagnostic imaging

A
  • ancillary service
  • xray, ultrasounds, MRI, CT
  • further Dx condition
64
Q

occupational therapy

A
  • ancillary service
  • assist pts with conditions disabling them developmentally, physically, emotionally, mentally
  • compensate for loss of function
65
Q

physical therapy

A
  • ancillary service
  • pts regain mobility, strength, ROM
  • often after accident, injury, disease
66
Q

acupuncture

A
  • alternative therapy
  • pricking skin with needles to relieve pain
  • treat physical, mental, emotional conditions
67
Q

chiropractic

A
  • alternative therapy
  • Dx and Tx mechanical disorders of musculoskeletal system, often spine
68
Q

energy therapy

A
  • alternative therapy
  • clearing cellular memory through human energy field
  • promotes health, balance, relaxation
  • idea of connection between physical, mental, emotional, states of life
69
Q

dietary supplements

A
  • alternative therapy
  • vitamins, minerals, herbs, other botanicals
70
Q

advance beneficiary notice (ABN)

A
  • form provided to pt when provider believes Medicare won’t cover service
71
Q

allowed amount

A
  • max insurance will pay for service
72
Q

copayment

A
  • paid at time of medical service
73
Q

coinsurance

A
  • policyholder and insurance company share cost in ratio
  • 80:20
74
Q

deductible

A
  • specific amount pt must pay before insurance begins paying
75
Q

explanation of benefits (EOB)

A
  • statement from insurance detailing what was paid, denied, or reduced
76
Q

participating provider (PAR)

A
  • providers who agree to write off difference between amount charged and approved fee from insurance
77
Q

Medicare

A
  • over 65
  • part A (hospitalization)
  • part B (routine medical office visits)
78
Q

Tricare

A
  • dependents of military personnel treated at expense of federal government
79
Q

CHAMPVA

A
  • surviving spouses and children of veterans who died as result of service related disabilities
80
Q

Medicaid

A
  • medically indigent
  • cost sharing program between federal and state govs
81
Q

workers compensation

A
  • protects wage earners against loss of wages and cost fo care resulting from occupational accident/disease as long as employee is not proven negligent
82
Q

managed care

A
  • umbrella term for plans providing health care in return for scheduled payments and coordinated through network of providers/hospitals
83
Q

examples of private insurance plans

A
  • Blue Cross Blue Shield
  • Aetna
  • United Healthcare
84
Q

America’s oldest and largest system of independent health insurers

A

Blue Cross Blue Shield

85
Q

CMS 1500

A
  • form for insurance claims
  • 33 blocks in 3 sections
  • maintained by National Uniform Claim Committee (NUCC)
  • new versions approved by Office of Management and Budget (OMB)
86
Q

direct billing

A
  • providers submits insurance claims directly to carrier electronically
87
Q

clearinghouse submissions

A
  • providers submit all insurance claims and clearinghouse sends to each company
88
Q

time period Medicare and Medicaid claims must be filed

A

no later than 12 months after date of service

Certified Medical Assistant (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions