Question | Answer |
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 |