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MOT 124
Ch 2 & 11 Test Review
| Question | Answer |
|---|---|
| ______ refers to the agreement/permission of a patient to allow something to occur. | Consent |
| ______ is a permission given by a competent individual, of legal age, with full knowledge or understanding of the risks, potential benefits, and potential consequences of the permission | Informed Consent |
| ______ is when a patient signs a release that health records may be released to the party who is financially responsible (Grantor; such as mother, father or insurance company) | Prospective Consent |
| The patient may choose to have more control over the release of information about his/her condition; which means that the patient authorized access to the health record after the care has been rendered this is what type of consent? | Retrospective Consent |
| _______ is discretion regarding disclosure of information – simply “keeping a secret | Confidentiality |
| ______ is the right of an individual to control access to medical information. | Privacy |
| Why can you access a patient file? | Treatment (continuing patient care), payment (reimbursement), health care operations, and litigation |
| Why you cannot access a patient file? | Anything beyond regular access. No personal information searching. Subject to criminal charges |
| Patient is in room, you are leaving, how would you place the folder on the door? Facing the wall/door | Facing the wall/door |
| You happen to look into a patient file with no reason, is it subject to criminal acts? | Yes |
| Why is HIPPA so important in healthcare? | Patient confidentiality |
| Fee for service – | Pay for service rendered |
| Discounted fee for service – | Pay for services rendered, but at a rate lower than the usual fee for service |
| Prospective payment – | Pay a flat rate, based on diagnoses, procedures, or combination of the two. |
| Capitation – | Pay a regular, flat rate to the provider, whether or not services are rendered |
| Give an example of why the patient would waive his or her right to confidentiality: | Release to the insurance company, to get the bill paid. |
| What is the legal foundation of confidentiality? | Physician patient privilege |
| Schedule an appt for a flu shot...and show up for the appt. This an example of what? | Implied consent |
| What’s on outside of folder? | Allergies only – no diagnosis |
| Under what circumstances is patient consent not needed in regards to medical information? | Birth defects, cancer, infectious disease, education, child abuse |
| Co-payment – | Type of cost-sharing in which the insured pays out-of-pocket a fixed amount for health care service |
| Deductible – | Amount of cost that the beneficiary must incur before the insurance will assume liability for the remaining cost |
| If you are conscious, alert, oriented, would that make you legal? | If you are of age. 18 years |
| Where can you talk about a patient? | With a patient – face to face, or doctor seeing the patient. |
| True or False: Patient’s information can be discussed with anyone at any time in any place? | FALSE |
| Which of the following elements are caused by a defective release? – | If it is known that it is revoked |
| Which of the following best describes litigation? | Process by which one party sues another in a court of law |
| There are two sensitive record files? | Employee medical files and litigation |
| If the doctor is asking for payment for service, this is called what? | Claim |
| Preferred Provider Organization | The organization contracts with a network of health care provider who agree to certain reimbursement rates, providers are independent contractors |
| Health Maintenance Organization (HMO) | An organization that has ownership or employer control over the health care provider; Patient pays small co-payment; Services must be approved as medically necessary |
| Beneficiary who is it? | Anyone who is authorized to receive benefits |
| Fiscal intermediary what is it? | Contractor that manages the health care claims |
| Specific hazards or conditions that a health care policy will not grant? | Exclusions, preexisting |
| True or False: You must constantly be taught, taking test for HIPPA, constantly be aware of patient record? | TRUE |
| Fee for service – | Pay for service rendered |
| Discounted fee for service – | Pay for services rendered, but at a rate lower than the usual fee for service |
| _________ is a permission given by a competent individual, of legal age, with full knowledge or understanding of the risks, potential benefits, and potential consequences of the permission | Informed Consent |
Created by:
kbcanarr
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