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Medical Law > Working In Healthcare > Flashcards

Working In Healthcare Flashcards

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1
Q

What is a mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors?

A

Licensure

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2
Q

In order to be licensed, what must be completed after courses of study?

A

Examinations

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3
Q

Licenses for healthcare professionals can be _________ or suspended under certain circumstances.

A

Revoked

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4
Q

Additional reasons whereby a healthcare practitioner could have his/her license, revoked or suspended would include….

A

Boundary violations; personal incapacity

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5
Q

What is the definition of certification?

A

A voluntary credentialing process, whereby applicants who meet specific requirements may receive a certificate

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6
Q

Healthcare practitioners working in healthcare facilities today are:

A

Licensed; registered; certified

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7
Q

Courses of study or degree programs are typically completed for…

A

Licensure

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8
Q

What are the names of some national organizations that offer certifications and registrations depending on the career?

A

American health information management association (AHIMA), American medical technologist (AMT)

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9
Q

Which of the following are most common reasons for loss of license to practice for healthcare practitioners?

A

Patient abuse, sexual misconduct, poor documentation or record keeping

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10
Q

What determines the duties/procedures that a person may or may not perform under the spices of a specific healthcare professional’s license?

A

Scope of practice

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11
Q

Which of the following are examples of professional or personal incapacity?

A

Senility, alcoholism, personal illness

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12
Q

What are some statements about certification that are true?

A

It shows that an applicant has attained a certain level of skill and knowledge; it is voluntary

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13
Q

Official authorization or approval for conforming to a specialized standard is called….

A

Accreditation

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14
Q

What is a mandatory crediting process established by law, usually at the state level, that grants the right to practice certain skills and endeavors?

A

Licensure

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15
Q

As part of the accreditation review process during the on-site survey, what are some areas that committees review?

A

Patient records

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16
Q

What is an entry in an official registry or record that lists the name of persons in occupations, who have satisfied specific requirements?

A

Registration

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17
Q

________ determines the scope of practice for healthcare practitioners

A

Licensure

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18
Q

What are accrediting agencies that establish standards for healthcare delivery?

A

URAC, NCQA, AAAHC

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19
Q

What is an agency that reviews clinical labs for accreditation?

A

The joint commission

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20
Q

What is true about accreditation?

A

It refers to a process for officially authorizing healthcare organizations. It refers to a process for officially recognizing quality and healthcare education programs.

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21
Q

What agency credits, community health centers, medical, home organizations, and Gabby centers, and Office based surgery centers?

A

AAAHC

22
Q

How often are on-site surveys conducted?

A

Periodically

23
Q

CAAHEP oversees ________ different allied health education programs.

A

30

24
Q

What do practice acts define?

A

What is meant by the practice of the individual profession in each state

25
Q

In addition to TJC, other agencies provide accreditation and establish _______ for Health Care delivery.

A

Standards

26
Q

What is an institution reviewed for accreditation by the national committee of quality assurance(NCQA)?

A

Health plan organizations

27
Q

The accreditation Association for __________ healthcare, accredited, urgent care centers, office, surgery centers, and endoscopy centers.

A

Ambulatory

28
Q

What organization provides accreditation to physical therapists and physical therapy assistants?

A

CAPTE

29
Q

What is used to define unprofessional conduct?

A

Each states practice acts

30
Q

What are primary mandates of practice acts?

A

Explain requirements and methods for licensure; give conditions for license renewal

31
Q

What are some of the things that Health Care practitioners are responsible for knowing regarding professional and statutory guidelines?

A

Recertification knowledge; requirements for renewal of license, payment of fees for certification

32
Q

When applying for licensing what must applicants generally do?

A

Provide proof of education and training, pass an examination designed to assess their knowledge; reveal information about past, medical history, arrests, and convictions

33
Q

What types of acts are generally classified as fraud?

A

Falsifying, medical, licenses or credentials; falsifying medical reports; billing a government agency for services, not rendered 

34
Q

What is an agency that reviews clinical labs for accreditation?

A

The joint commission 

35
Q

Managed care organizations are a…

A

Corporation that link, Health Care , financing, administration, and service delivery

36
Q

What agency accredits, community health centers, medical, home organizations, and endoscopy, sinners, and office-based surgery centers?

A

AAAHC

37
Q

How are physicians in PGP’s paid?

A

As a salaried employee of the HMO

38
Q

What are examples of unprofessional conduct?

A

Physical abuse of a patient; failure to meet continuing education requirements 

39
Q

Physician hospital organizations are a type of…

A

Managed care plan

40
Q

Who is responsible for understanding, and knowing the laws and rules pertaining to his or her job duties and requirements of their profession?

A

The healthcare practitioner

41
Q

A healthcare professional could be considered guilty of fraud if what can be shown?

A

Intent to deceive

42
Q

What statements describe a point of service plan?

A

Patient need a referral to visit an out of network provider; insured chooses a PCP from a list of participating providers 

43
Q

The set advance payment made to providers based on the calculated cost of medical care of a specific population of subscribers is called 

A

Capitation

44
Q

Under what plan are all health services delivered and paid for through wooden organization?

A

HMO

45
Q

What are part of physician hospital organizations?

A

Nursing homes; laboratories; surgery centers

46
Q

What are true about high deductible health plans?

A

They can have low monthly premiums; they have a higher cost before the insurance company begins to pay; they are often used in conjunction with an HSA.

47
Q

Which is one of the accrediting agencies that review PCMH?

A

NCQA

48
Q

Features of a managed healthcare plan include…

A

Monitoring of the amount and patterns of care delivered; a network that coordinates in refers patient to its healthcare providers

49
Q

General types of HMO, models include…

A

Group and staff

50
Q

I identify the features of managed care plans that can be combined, allowing the insured to pay for certain medical expenses with money free from federal taxes.

A

HDHP, HSA

51
Q

The goals of PCMH are to offer patient with …

A

Emphasis are preventative services enhanced to patient access; improved quality of care

Medical Law (8 decks)

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