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MOT 124

Ch 2 & 11 Test Review

QuestionAnswer
______ 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