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Ch 2 & 11 Test Review

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
______ refers to the agreement/permission of a patient to allow something to occur.   Consent  
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______ 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  
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______ 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  
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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  
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_______ is discretion regarding disclosure of information – simply “keeping a secret   Confidentiality  
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______ is the right of an individual to control access to medical information.   Privacy  
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Why can you access a patient file?   Treatment (continuing patient care), payment (reimbursement), health care operations, and litigation  
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Why you cannot access a patient file?   Anything beyond regular access. No personal information searching. Subject to criminal charges  
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Patient is in room, you are leaving, how would you place the folder on the door? Facing the wall/door   Facing the wall/door  
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You happen to look into a patient file with no reason, is it subject to criminal acts?   Yes  
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Why is HIPPA so important in healthcare?   Patient confidentiality  
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Fee for service –   Pay for service rendered  
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Discounted fee for service –   Pay for services rendered, but at a rate lower than the usual fee for service  
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Prospective payment –   Pay a flat rate, based on diagnoses, procedures, or combination of the two.  
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Capitation –   Pay a regular, flat rate to the provider, whether or not services are rendered  
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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.  
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What is the legal foundation of confidentiality?   Physician patient privilege  
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Schedule an appt for a flu shot...and show up for the appt. This an example of what?   Implied consent  
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What’s on outside of folder?   Allergies only – no diagnosis  
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Under what circumstances is patient consent not needed in regards to medical information?   Birth defects, cancer, infectious disease, education, child abuse  
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Co-payment –   Type of cost-sharing in which the insured pays out-of-pocket a fixed amount for health care service  
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Deductible –   Amount of cost that the beneficiary must incur before the insurance will assume liability for the remaining cost  
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If you are conscious, alert, oriented, would that make you legal?   If you are of age. 18 years  
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Where can you talk about a patient?   With a patient – face to face, or doctor seeing the patient.  
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True or False: Patient’s information can be discussed with anyone at any time in any place?   FALSE  
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Which of the following elements are caused by a defective release? –   If it is known that it is revoked  
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Which of the following best describes litigation?   Process by which one party sues another in a court of law  
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There are two sensitive record files?   Employee medical files and litigation  
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If the doctor is asking for payment for service, this is called what?   Claim  
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Preferred Provider Organization   The organization contracts with a network of health care provider who agree to certain reimbursement rates, providers are independent contractors  
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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  
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Beneficiary who is it?   Anyone who is authorized to receive benefits  
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Fiscal intermediary what is it?   Contractor that manages the health care claims  
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Specific hazards or conditions that a health care policy will not grant?   Exclusions, preexisting  
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True or False: You must constantly be taught, taking test for HIPPA, constantly be aware of patient record?   TRUE  
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Fee for service –   Pay for service rendered  
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Discounted fee for service –   Pay for services rendered, but at a rate lower than the usual fee for service  
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_________ 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  
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