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Study Guide
| Question | Answer |
|---|---|
| A corporation that links health care financing, (MCO)administration, and service delivery. | Managed care organization |
| Reason: Medical assistants are not licensed; they are certified or registered. | physician. registered nurse. physical therapist. |
| Courses of study or degree programs are typically completed for | licensure |
| Which of the following are most common reasons for loss of license to practice for health care practitioners? | Poor documentation or record keeping Sexual misconduct Patient abuse |
| Which of the following are examples of professional or personal incapacity? | Senility Personal illness Alcoholism |
| Open access plan (OAP) | Subscribers may see any in-network health care provider without a referral. |
| Point of service plan (POS) | A primary care physician determines necessary services for the patient within a network. |
| Practice acts | State laws written for the express purpose of governing the practice of specific health care professions. |
| Scope of practice | The determination of the duties that a person may or may not perform under the auspices of a specific health care professional's license. |
| Primary care physician | The physician responsible for directing all of a patient's medical care and determining whether the patient should be referred for specialty care. |
| Bodies established by the authority of each state's practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation. | Professional boards |
| A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee. | Managed care |
| Which of the following statements about certification are TRUE? | It shows that an applicant has attained a certain level of skill and knowledge. It is voluntary. |
| Licensure is a ______ credentialing process established by law. | mandatory or required |
| What are the names of some national organizations that offer certifications and registrations depending on the career? | American Medical Technologists (AMT) American Health Information Management Association (AHIMA) |
| In order to be licensed, what must be completed after courses of study? | Examinations |
| Licenses for health care professionals can be ______ under certain circumstances. | revoked or suspended (temporarily recalled) |
| ______determines the scope of practice for health care practitioners. | Licensure |
| Additional reasons whereby a health care practitioner could have his/her license revoked or suspended would include which of the following? | Boundary violations Personal incapacity |
| What is the definition of certification? | A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate. |
| What is an entry in an official registry or record that lists the names of persons in occupations who have satisfied specific requirements? | Registration |
| Which of the following are true about accreditation? | It refers to a process for officially authorizing health care organizations. It refers to a process for officially recognizing quality in health care education programs |
| Courses of study or degree programs are typically completed for | licensure |
| How often are on-site surveys conducted? | Periodically |
| In addition to TJC, other agencies provide accreditation and establish _____ for health care delivery. | standards |
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LaLaa2