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Ch 3 HIT 110

Chapter 3 Green

Diagnosis related group- DRG calssify inpatient hospotal cases into groups thar are expected to comsume similare hospital resourses.
Acute Care Facility- ACF a hospital that provide health services to patients who have serious, sudden or acute illness or who need certin surgeries
Anciallary Service diagnositce and theraputic serviesd provided to inpatients and outpatients.
single hospitals are not contained within a larger organization
multi-hospital systems are two or more hospitals owned, managed or leased by one organization
bed size/bed count the total number of inpatient beds for which a facility is liscensed by the state
short term length of stay 4 to 5 days with a total of 25 days
long term average stay over 25 days
crutucal access hospitals CAH located more than 35 mles away from any other hospital or another CAH or they are state cartified as being a necessary provider to area residents
swing bed criteria that allows a rural hospital to admit a nonacute care patient
general hospital provides emergency care, general surgery, admit patients by being liscensed with the state
speciality hospitals concentrate on a particular population of patients or disease categories
rehabilitation hospitals admit patients who are diagnosed wit trauma
behavorial health hospitals specialize in treating individuals with mental health diagnoses
HOSPITALISTS physcians who spend most of their time in a hospital setting admitting patients to their inpatient services from local primary care providers
ambulatory patients- outpatients treated and released the same day and do not stay overnight or past the 24 hour mark
ambulatory surgery patients undergo a certin procedure thaty can performed on an outaptient basus with them being there up to the 24 hour mark
emergency care patients are treated for urgent problems and are either released or admitted to the hospital
inpatients are admitted into the hosptaland stay over 24 hours
newborn patients recieve infant care upon birth and if necessary they recieve neonatal intensive care at the hopital or are transfered to another facility
observation patients recieve services futnished on a hospitals premises that are prdered by a physcian ro authorized person.this includes the use of a bed and periodic nurse monorting
subacute care is provided in hospitals that provide specialized long term acute care such as chemotherapy, rehab, venilator support
ventilator support breathing machine
ambulatory surgical center ASC outpatient surgery center stnd alone facility
clinical laboratory stand alone lab tht performas kab test
heart and vascular center provides ambulatory cardiovascular services that include diagnosis and treatment, disease preventiopn, research, education, rehabilitation
staff model health managed organization similar to large group practices that may be partially owned by a physcian or employees
imaging center free standing facility that does xrays and other imaging services
industrial health clinic located on a business setting that emphizes employee saftey
unfusion center freestanding center that dispenses medication that is perscribed my a liscensed physican
neighboorhood health clinic healht care is provided to fininacially disadvantages families and treatment is given because illnesses my be cause by crowded oving conditions.
pain management center specializes in treatment of acute and chronic pain syndromes using proven medications and procedures
solo physcian practices are a one doctor office, they ahve no partners or aren't affiliaed with any other organizations
single speciality group physcian practices comsists of 2 or more physcians that specialize in one certin type of care
multi speciality group physcian practices various types of medical specilizations in one organization
internal medicine physcians specialize in the care of adults
peditricians specialize in the care of children
family practicioners provide care for the entire family
primary care center offers adults and family care medicine in the listed areas above
public health department provides preventitive medicines such as vaccinations and baby well clinics
student health center health center that offers wellness clinics to students
urgent care gives emergency care to anyone and is provided y an on site ohyscian.
clinic outpatient recieves scheduled diagnositce and theraputic care
reffered outpatient recieves diagnositc and theraputic care because primary care provides can't provide the care needed
partial hospitalization program for hospital patients who regurlary use the hospital facilities for a large amount of hours during a day or night
hospital owned physcian practice are partially owned by a hospital and the physcians particiapte in a compensation plan
satellite clinics ambulatory care clinics that are established remotely from the hospital primary care is provided by and on duty physcian
chemical dependancy programs provides 24 hour medically directed evaluation and withdrawl management in an acute care setting
crisis services provides short term crisis intervention and treatment
day treatment program intensive treatment program provided to patients who live in the community
developmentally disabled faciities these facilites give treatment and provide care to those who are disabled
family support services services are provided to assist familes in caring for a patient
intensive case management specially trained individuals that coordinate and provide serices to those in the community
residential treatment facility disturbed patients recieve intensive and comprhensive psychatric care
respite care care is provided by specially trained individuals in a setting other that the patients home to offer relief and rest for family
theraputic group home 6 to 10 individuals are provided with supervised houseing
skilled care includes services that are ordered by a physcian and provided under supervision
durable medical equipment medical equipment such as canes, walkers, wheel chairs etc...
personal care and support services provides assistance in performing daily activities
home infusion care provided by home health care agencies when intravenous administration od medication is approiate
chemotherapy IV administration of chemical medications that have toxic effects and are used to kill diseases
drug therapy UV admin of other drugs
hydration therpay IV admin of fluids, electrolytes, and other additvatives
pain management IV admin of narcotics and other drugs used to relieve pain
total parenatal nutrition admin of nutritional substances by pheriphal or central IV infusion
hospice care proveides comprehensive medical and supportive care to patients and their families when a patient is seriously ill
palliative care comfort care for family and patient in the last link of time
curative care theraputic car provided in the home
long term care care facilites that prvide care and service for a wide range of people usually elderly for long periods of time over 30 days
adult day care provides care an supervision in a structured manner to seniors with physcial or mental limitations
assisted living facilities a combonation of housing and supportative services including personal care and household management
dementia care facilities// alzheimers treatment canters they ahve the same characteristics as assisted living facilities but the are specialized for patients with dementia and alzhimers
continuing care retirement communities differenmt levels of care based o the residents needs from independent living apartments to skilled nursing facilites
intermediate care facility provides developmentally disabled people with medical care and supervision, nursing services and therapy
federal certification measures the ability of health care faciliteies to deliver care that is safe and adequate
long term care hospital is defined in medicare alws as hospitals that have an average stay greater than 25 days
residential care facility provides non-medical custodial care which can be provided in a single family residence, a retirement place, and any other care facility that is approiate
activites of daily living` daily activities such as bathing, dressing, eating, walking
skilled nursing facility provides medically necessary care to onpatients on a daily basis that is performed by or under supervision of medical personnel
managed care orginally refered to as prepaid health care sectors such as HMOs which combined health care delivery with the financing of health care services
exclusive provider organization provides benefits to subscribers ho receive health care services from network providers
subscrubers individuals who pay premiums
network providers physcians and health care facilities inder contact to the managed care plan
integrated delivery system organization of affiliated provider sites that offer joint health services to subscribers
group practice withour walls managed care cintract in which physcians maintain their own offices and share services with plan members
medical foundation non profit organization that contracts with and acquires the clinical and business assets of physcian offices
integragted provider organization manafe health care serives provided by hospitalsm ohyscians, and other health care organizations
managemtnt services organizations provides oractice management services including support services to individual physcian practices
phyhscian hospital organization managed care contracts are neogatied by hospitals and physcian groups. physcians maintain their own practices and orivide services to plan memners
health maintence organization alternative to traditional health insurance coverage. they provide comprehensive health care services to members on a prepaid basis/
closed pannel HMO includes groups and staff models that provide services at HMOowned health centers
open pannel HMO includes direct contract, individual practice sassociations and network models
group model HMO participating physcians who are members of an independant multi speciality group that provides health care services
direct contract model HMO individual physcians in the community deliver contracted health services
individual practive association physicans who remain in the independent office setting proveide contracted health care services to subscribers
network model HMO 2 or more physcians multi speciality group practices proveide contracted services
point of service plan patients have the freedom to use an HMO panel of providers or to self refer to non HMO providers
coepayment a fixed amount a subscriber must pay when seeking medical treatment
perferred provider organization a network of ohyscians and hospitals join together to contract with third part payers to proved health care to subscrubers at a discount
triple option plan provides subscribers and employees with a choise of HMO, PPO< or traditional health insurance plan
utilization management controls health care costs and the quality of care by reviweing cases
preadmission certification is a form of utilization management that involves the review for medical necessity of inpatient care prior to admission.
medical necessity rewuires the documentation of services or supplies that are proper and needed for the daignosis, direct care and treatment of a medical condition
correctional facilities provide inamtes with medical care, secure hpuding and an enviromnet that offers educational and vocational advancment
bureau of prisions provides necessary medical, dental and mental care to inmates on a professional level
federal medicine centers provide major medical care to inmates
national commission on correctional health care was established in the 1970s to provide and external peer review process for correctional instutitions that wish to meet its nationall accepted standards for health services
militay health system administers health care for active members of the uniformaed service and provided by military treatment facilities and networks of civilian health care professionals
military treatment centers a clinic orhospial located on a US military base
militay medical support office coordinates civilian health care services when the MTF service aren't available
veterns health administration an agency in the department of vetrans affairs, provides medical care to veterans of the armed services
veterans integrated service networks administer and provide health care at VA medical centers and community based outpatient clinics
public health service commissions corps is one of seven inofromed services of the US and provides highly trained health professionals who carry out programs to promote the nations health
administration for children and families is responsible for service that ssist needy children and familes
temporary assistance to needy families welfare
administration on aging supports a nationwide aging network providing services to the elderyly
agency for healthcare research and quality supports research designed to omprove the outcomes and quality of health care, reduce costs and address patient safety and quality of care
agency for toxic substances and disease registry works with states and other fedral agencies to prevent exposure to hazardour materai l
centers for disease control and prevention provides a systems of health surveillance to monitior and prevnet outbreak of diseases
centers for medicare and medicaid administers medicare and medicaid and childrens health insurance
food and druf administration assures the safety of food, drugs cosemetics, and other medicaldevices
health resources and services administration provides heakth resources for medically inderdeserved populations, works to build health care workforces, maintains the national health serives corps
indian health services supports a network of hospitals, clinics, schools, to american indian tribes
national instutites of health with seperate instutites its the worlds premier medical research organization, supporting research projects on diseases
office of pyblic health and science directed by the assistance secretary for health serves as a focal point of leaderships and coordinates progams across the US
office of the secretary of health and human services advises the president on health, welfare, income security plans, etc
program support centers a service for free organizations that utilizes business enterprose approach to provide governemnt support services
substane abuse and mental health administration works to improve the quality and availability of substance abuse preventions, addictions, and treatments
capitation payment lump sum payment
Created by: ashbug207