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Management > Risk Management > Flashcards

Risk Management Flashcards

1
Q

The insurance perspective are 2 types of risk. What are they

A
  1. Speculative
  2. Pure
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2
Q

What is specultive risk?

A

Involves a chance to gain or benefit or a chance to lose
* not insurable

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3
Q

What is pure risk?

A

Risk where there is only the opportunity of sustaining a loss with no oppotunity for fain
* Accidental, unanticipated, unavoidable

Insurance can be used to manage exposure to risk

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4
Q

What is the purpose of developing a risk management strategy?

A

Protect the vital assets of a pharmacy, analyze and identify strategies to manage risk threats

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5
Q

What are the steps of a risk management process?

A
  1. Establish context: goals and vulnerability
  2. Identify and analyze risk: all aspects of pharmacy and potential risks
  3. Evaluate and prioritize risks: which has greater potential for loss
  4. Select an approriate risk management strategy and implement the technie: develop policy, insurance, riders, what risks can be avoided
  5. Monitor decision and update risk management program
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6
Q

What are riders?

A

Supplemental policies that provide coverge not covered in an original policy

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7
Q

What are the techniques used to manage risks?

A
  1. Risk avoidance
  2. Risk prevention/modification
  3. Risk absorptin/retention
  4. RIsk sharing/transfer
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8
Q

What is risk avoidance?

A

Impractical in community pharamcies, because can’t avoid dispensing med do to risk of med error

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9
Q

What is risk prevention/modification?

A

Reduces the chances of a risk occuring

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10
Q

What is risk absorption/retention?

A

Retaining or absorbing a certain degree of risk

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11
Q

What is risk sharing/transfer?

A

Aother party is involved
Ex: insurance company negotiate an agreement with the provider

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12
Q

Scope (extent) of protection provided under an insurance contract

A

Coverage

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13
Q

Provision that requires the insured part to share (absorb) some costs of covered services or losses on a fixed percentage basis

A

Co-insurance

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14
Q

Fixed $ amount of an insured loss to be paid (or absorbed) by the policyholder

A

Decuctible

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15
Q

Type of health insurance that provides monthly income to the policyholder if he or she becomes unable to work because of an illness or accident

A

Disbility insurance

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16
Q

Party covered by the insurance contract or persons entitled to benefits under the terms of the policy (i.e., family members)

A

Insured

17
Q

Individual responsibility for causing injury to another person or damage to another person’s property through negligence

A

Liability

18
Q

Failure to use reasonable care (i.e., failure to do something a reasonably prudent person would do in similar circumstances)

A

Negligence

19
Q

Insurance term for risk, possible cause of injury, or event causing damage or loss

A

Peril

20
Q

Written contract for insurance between an insurance company & insured party

A

Policy

21
Q

Term used to describe a document that amends or changes the original policy

A

Rider

22
Q

Form of insurance protection in excess of the amount covered by other liability insurance policies, which also protects the insured in situations not covered by usual liability policies

A

Umbrella liability

23
Q

Policy that pays benefits to an employee (or family) for job-related injury or death

A

Worker’s compensation

24
Q

What is property insurance?

A

Provides protection for the property and physical assets of a business (building, equipment, supplies, money, accounts, records)

25
Q

What is liability insurance?

A

Protects a business against clainswhen its being sued for damages/injuries caused by neglegience

26
Q

What is business owner’s policy?

A

COmbines property and liability coverage in the same policy for small business owners
* Broader coverag with less expensive premiums
* <100 employes
* DOesn’t include professional liability coverage, worers compensation, employee health insurance

27
Q

What is individual professional liability insurance?

A

Protects an individual against claims resulting from actual or alleged errors, omissions, or negligence
* Organization’s policy are designed to protect the org not the individuals

28
Q

What is ker person insurance?

A

Protect a business from loss if key individual (partner, owner) were to die or experience a disability

29
Q

What is umbrella/excess liability?

A

Possibility for a lawsuit to exceed the limits of a primary liability protection policy

THis covers the difference between the base liability limits and the judgement amount

30
Q

What is worker’s comp?

A

Covers med expenses to employees who have a job-related accident

31
Q

Wha is diability insurance?

A

Provides income for an employee and family if an event prevents the employee from working

32
Q

What is short term disability insurance?

A

<6 months, provides replacement for employee who are temporarily out of work

33
Q

What is long term diability insurance?

A

Replaces employees salary if employee is unable to work >6 months, or premenantly diabled

34
Q

Insurance coverage that is specialized to pharmacies, individualized to their specific needs?

A

Independent pharmacy insurance

35
Q

What are the components of OBRA 90?

A

Required pharmacist providng medications to state Medicaid recipients to:
* Conduct DUR
* Provide patient counseling
* Maintain proper patient records

36
Q

What is the purpose for HIPPA?

A

Health info proatbility and accountability act: created privacy standards for patients and health info
* Protects all “individually identifiable health information” held or transmitted by a covered entity

37
Q

What type of info is protected by HIPAA?

A
  1. Demographic
  2. Health care provided
  3. Payment
38
Q

How do you manage HIPAA in pharmacies?

A
  1. COnducting risk assessment
  2. Appointing securit and privacy officers to ensure compliance

Management (12 decks)

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