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Chapt 123 Key Terms

Medical Law, Ethics and Bioethics

Define Pluralistic Refers to numerous distinct ethnic, religious and cultural groups that coexist in society.
Bond A legal obligation to pay specific sums
Burglary Breaking and entering with intent to commit a felony
Capitation Health care providers are paid a fixed monthly fee for a range of services for each HMO member in thier care
Conglomerate A corporation of a number of different companies operating in a number of different fields
CO-Payment A medical expense that is a member's responsibility; usually a fixed amount of $5 to $20
Deductible A cost-sharing arrangement in which the member pays a set amount toward covered services before the insurer begins to make any payments. Typically HMO members do not pay deductibles.
Fee-for-Service Pays providers for each service performed
Gatekeeper A term referring to HMO primary care providers responsible for referring members to specialists with the intent of matching the client's needs and prefrences with the appropriate and cost-effective use of those specialists services.
Group Practice Type of business management in which three or more individual organize to render professional service and share the same equipment and personnel
Health Maintenance Organization (HMO) Prepaid health care services rendered by participating physicians and providers to an enrolled group of persons.
Joint Venture A type of business management where hospitals, physicians, and clincs form to offer client care.
Liability The state of being liable, responsible, legally bound or obligated, as to make good any loss or damage that occurs.
Managed Care A type of health care plan; generally one of 2 types, namely HMO or preferred provider organization (PPO)
OPT-OUT Option Members or clients can seek treatment from providers outside the health care plan but pay more to do so.
Partnership Type of business management involving the association of two or more individuals who are co-owners of their business
Pay for Performance (P4P) A type of managed care to encourage providers to improve the quality of their client's
Preferred Provider Organization (PPO) A type of busiess agreement between a medical service provider and an insurer organization in which the fees for specific services, are pre-determined for an already establised group of clients assigned to or selected by the provider
Professional Service Corporation Specific type of corporation in which licensed individuals organize to render a professional service to the public. Such licensed individuals include physicians, lawyers and dentist.
Sole Proprietorship Type of business management owned by a single individual
Theft Actual taking and carring of someone else's presonal property without consent or authority and with the intent to permanently deprive a person of it.
Certification Documentation, usually from a professional organization, that an individual has met certain requirement set forth by that organization
Endorsement An agreement in which one state recognizes the licensing procedure of another state, considers it valid, and grants a license to practice. Sometimes referred to as reciprocity.
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) Person who has graducated froma 1 year practicle nurse vocational or college program and has passed the sate licensing examination for practical or vocational nurses.An LPN or LVN works under the direct supervision of a registered nurse (RN)or a physician
Licensure Legal permission, granted by state statues, to perform specific acts; for isntance, a physician is licensed to practice medicine
Medical Assistant (MA) A person who assists the physicians in both administrative and clinical duties; education varies from on-the-job training ro 2 years.May be Certified (CMA) or Registered (RMA)
Medical Laboratory Technician (MLT) Person who has graduated from a certificate program or associate degree program and then works under the supervision of a physician or medical technologist ina laboratory.
(MT) Medical Technologist Person who has graduated from a 2 - 4 year college or university program in medical technology that includes 1 yearof clinical training in the laboratory.
Medical Transcriptionist Person who may or may not, have formal training; will have superior keyboarding and grammer skills; transcribes medical dictation on or off site
(NP) Nurse Practitioner Nurse practitioner is an RN (usually with a bachelors degree) who has successfully completed additional training in an NP Program at the masters or doctoral level.
Professional Coder Coders are responsible for the correct application of procedures, supplies, and diagnostic codes used to billing professional medical services
Reciprocity An agreement by which two states reconize the licensing procedures of each other, consider them valid, and grant licesnes to practice based on the other states licensure, in some states, it is referred to as endorsement.
Registered Nurse A graduate from a 2 year associate degree, 3 year diploma, or a 4-5 year bachelors degree program an dpassed the state licensing examination for RNs. An RN works under the direction of a physician
Registration An entry in an official record listing names of persons satisfying certain requirements and level of education.
Created by: spoon6464