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HIT Study Guide

Chapters 2&3

The payer had an agreement with the physician to pay the usual and customary fee, less than 10% .. this is an example of? discounted fee for service
The payment rate established by an insurance company , based on its knowledge of the regional charges for service is called? usual & customary charges
An organization that insures covered lives as well as owns(exerts employer control over) the health care provider is a? HMO- insurer and provider
an HMO contracted with a group of physicians to provide healthcare services to its members, this is a characteristic of a ? group practice model HMO
Major differences between a PPO and an HMO is? PPO- combo of HMO and indemnity features, providers are independent contractors, HMO- must be medically necesssary-covered services
Contractor who manages health care claims for Medicare is a? Fiscal inermediary
Clinical pathways are based on what factors? experience, successful outcomes, research
The ability of a pt to see a physician without an app is called? open access
clinical data is? compromises all of the data that has been recorded about the pts health including dx and procedures
another term for demographic data is indicative data
the study of health trends or patterns is called? epidemiology
a pt has unsual lesions on the skin, a fever, dehydration, of the different types of data, which would be most helpful in developing a list of potential dx? socioecomonic
person or organization that is responsible for paying a hospital bill is called guarantor
pt complains of dizziness and shortness of breath... this is an example of which SOAP subjective
pupils equal,round and reactive to light and accomodation... this is an example of which SOAP objective
rule out congestive heart failure vs. cerebrovascular accident... this is an example of SOAP Assessment
chest x-ray to rule out CHF....which SOAP Plan
benefits of a problem list improves communication amoung caregivers, facilitates management of pt care,becomes pt history
in creating a data collection device, what are the most important considerations? purpose of the form
in creating an electronic data collection screen, what are the most important considerations? sequence & purpose of the data that is being collected
what consideration is more important when creating an electronic data collection screen than it is in a paper form? sequence of data that is being collected
components of a problem list data- description,problem date of initial dx, current treatment-comments,procedures
SOAP notes are examples of what type of data? clinical
Created by: KimNorton