Unit 1 Flashcards
Abuse
Any action that intentionally harms or injures another person; an inappropriate use of any substance
CHAMPVA
“Civilian Health and Medical Program of the Veterans’ Administration”
- federal third-party reimbursement system to pay for care rendered by nurse-midwives and nurse practitioners
Ex) TRICARE
CLIA
“Clinical Laboratory Improvement Amendments”
- Federal legislation and the personnel and procedures for the surveillance and regulation of all clinical laboratory procedures in the United States
COBRA
“Consolidated Omnibus Reconciliation Act”
- Federal act which requires employers to offer employee health coverage under the employer’s group health plan for a period of time after a spouse’s death, job loss, work hour reduction, or divorce, allowing them to purchase continuation of health care coverage under the group’s medical plan
Copayment
A fixed or set amount paid for each health care or medical service; the remainder is paid by the health insurance plan
Fraud
An act of deliberate deception performed to acquire an unlawful benefit
Authorization
A written consent to release protected health information
Clearinghouse
A company providing billing services for providers and insurance companies
Consent
Agreement to an action based on knowledge of what the action involves and it’s likely consequences
Standard
Something that serves as a basis for comparison; a technical specification or written report by experts
Transaction
Interaction arising from the encounter of two or more persons; in transactional analysis, the unit of analysis involving a social stimulus and a response
Disability Insurance
Medical practice; an insurance policy that pays a person in the event of temporary or permanent disability
AMA
“American Medical Association”
- precessional association whose membership is made up of the largest group of physicians and medical students in the US
CCI
“Correct Coding Initiative”
- computerized editing system for health insurance claims to avoid overpayments on covered procedures
HIPAA
“Health Insurance Portability and Accountability Act”
- a comprehensive and uniform federal standard for ensuing privacy of genetic information
