Working In Healthcare

Question 1

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

Answer 1

Licensure

Question 2

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

Answer 2

Examinations

Question 3

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

Answer 3

Revoked

Question 4

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

Answer 4

Boundary violations; personal incapacity

Question 5

What is the definition of certification?

Answer 5

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

Question 6

Healthcare practitioners working in healthcare facilities today are:

Answer 6

Licensed; registered; certified

Question 7

Courses of study or degree programs are typically completed for…

Answer 7

Licensure

Question 8

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

Answer 8

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

Question 9

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

Answer 9

Patient abuse, sexual misconduct, poor documentation or record keeping

Question 10

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

Answer 10

Scope of practice

Question 11

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

Answer 11

Senility, alcoholism, personal illness

Question 12

What are some statements about certification that are true?

Answer 12

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

Question 13

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

Answer 13

Accreditation

Question 14

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

Answer 14

Licensure

Question 15

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

Answer 15

Patient records

Question 16

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

Answer 16

Registration

Question 17

________ determines the scope of practice for healthcare practitioners

Answer 17

Licensure

Question 18

What are accrediting agencies that establish standards for healthcare delivery?

Answer 18

URAC, NCQA, AAAHC

Question 19

What is an agency that reviews clinical labs for accreditation?

Answer 19

The joint commission

Question 20

What is true about accreditation?

Answer 20

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

Question 21

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

Answer 21

AAAHC

Question 22

How often are on-site surveys conducted?

Answer 22

Periodically

Question 23

CAAHEP oversees ________ different allied health education programs.

Answer 23

30

Question 24

What do practice acts define?

Answer 24

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

Question 25

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

Answer 25

Standards

Question 26

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

Answer 26

Health plan organizations

Question 27

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

Answer 27

Ambulatory

Question 28

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

Answer 28

CAPTE

Question 29

What is used to define unprofessional conduct?

Answer 29

Each states practice acts

Question 30

What are primary mandates of practice acts?

Answer 30

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

Question 31

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

Answer 31

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

Question 32

When applying for licensing what must applicants generally do?

Answer 32

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

Question 33

What types of acts are generally classified as fraud?

Answer 33

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

Question 34

What is an agency that reviews clinical labs for accreditation?

Answer 34

The joint commission 

Question 35

Managed care organizations are a…

Answer 35

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

Question 36

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

Answer 36

AAAHC

Question 37

How are physicians in PGP’s paid?

Answer 37

As a salaried employee of the HMO

Question 38

What are examples of unprofessional conduct?

Answer 38

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

Question 39

Physician hospital organizations are a type of…

Answer 39

Managed care plan

Question 40

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

Answer 40

The healthcare practitioner

Question 41

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

Answer 41

Intent to deceive

Question 42

What statements describe a point of service plan?

Answer 42

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

Question 43

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

Answer 43

Capitation

Question 44

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

Answer 44

HMO

Question 45

What are part of physician hospital organizations?

Answer 45

Nursing homes; laboratories; surgery centers

Question 46

What are true about high deductible health plans?

Answer 46

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.

Question 47

Which is one of the accrediting agencies that review PCMH?

Answer 47

NCQA

Question 48

Features of a managed healthcare plan include…

Answer 48

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

Question 49

General types of HMO, models include…

Answer 49

Group and staff

Question 50

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.

Answer 50

HDHP, HSA

Question 51

The goals of PCMH are to offer patient with …

Answer 51

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