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ch 5 UHI & ch 3 MOM
vocab
| Term | Definition |
|---|---|
| abuse | actions inconsistent with accepted practices |
| ANSI ASC X12N 837 | variable-length file format used to bill institutions |
| confidentiality | restricting patient information access to those with proper authorization |
| civil law | laws not classified as criminal |
| deposition | legal proceeding during which a party answers questions under oath (but not in open court) |
| EDI | electronic data interchange - computer-to-computer exchange of data between provider and payer |
| federal register | legal newspaper published every business day by the National Archives and Records Administration |
| informed consent | physicians must give patients all information about a procedure, including risks and alternatives to the procedure |
| NCCI | national correct coding initiative, promotes correct coding methods |
| NDC | national drug code -maintain by the food and drug administration; identifies prescription drugs and come over the counter products |
| NPI | national provider identifier - unique identifier to be assigned to health care providers as and 8- or possibly 10- character alphanumeric identifier |
| PHI | protected health information - any patient information that includes identifiers that could be used to identify the patient |
| DHHS | department of human health services - conducts investigations for fraud |
| RAC | recovery audit contractor - finds and corrects improper medicare payments paid to health care providers in fee-for-service medicare |
| subpoena | an order of the court that requires a witness to appear at a particular time and place to testify |
| transmittal | letter provides the recipient with a specific context in which to place the larger document and simultaneously gives the sender a permanent record of having sent the material |
| stark physician self-referral law | prohibits physicians from referring medicare patients to clinical laboratory services in which the physicians or their family member has a financial ownership/investment. |
| standard of care | the amount and type of care a reasonable prudent person would provide, given the same training and circumstances |
| subpoena duces tecum | requires documents to be produced |
| malpractice | medical negligence that results in a patient being harmed in some way |
| three types of malpractice | malfeasance - wrong treatment misfeasance - treatment performed incorrectly nonfeasance - failing to preform treatment |
| security rule | HIPAA standards and safeguards that protect health information collected, maintained, used, or transmitted electronically |
| fraud | intentional deception or misrepresentation that could result in an unauthorized payment |
| privileged communication | private information shared between a patient and healthcare provider |
| tort | wrongful act that leads to damages sustained by another |
| release of information |
Created by:
Mika42016
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