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Quiz 4

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.

Fair Debt collection Practices Act (FDCPA)   Debt collectors cannot use unfair or abusive practices to collect payments  
False Claims Act   Protects the government from being overcharged for services provided or sold, or substandard goods or services  
Final Rule   Strengthens the HIPPA ruling around privacy, security, breach notification, and penalties  
formulary   A list of prescription drugs covered by an insurance plan  
fraud   Making false statements of representations of material facts to obtain some benefit or payment for which no entitlement would otherwise exist  
gatekeeper   Provider who determines the appropriateness of the health care service, level of heath care professional called for, and settling for care  
general ledger key   Two- or three-digit number that makes sure that a line item is assigned to the general ledger in the hospital's accounting system  
group code   Code that determines the party financially responsible for a specific service the general ledger in the hospital's accounting system  
group or plan number   Unique code used to identify a set of benefits of one group or type of plan  
group practice model   HMO that contracts with an outside medical group for services  
Health Insurance Portability and Accountability Act (HIPPA) of 1996   Legislation that includes Title II, the first parameters designed to protect the privacy and security of patient information  
health maintenance organization (HMO)   Plan that allows patients to only go to physicians, other health care professionals, or hospitals on a list of approved providers, except in an emergency  
health record number   Number the provider uses to identify an individual patient's record  
ICD-10-PCS   Coding and classification system developed for use in the US only. Specific to inpatient hospital procedures, ICD-10-PCS correlates to Volume 3 in ICD-9-CM.  
implied consent   A patient presents for treatment, such as extending an arm to allow a venipuncture to be performed  
independent practice association (IPA) model   HMO that contracts with the IPA, which in turn contracts with individual health providers  
individually identifiable   Documents that provide the person or provider enough information so that the person could be identified  
informed consent   Providers explain medical or diagnostic procedures, surgical interventions, and the benefits and risk involved, giving patients an opportunity to ask questions before medical intervention is provided  
managed care organization   Organization developed to manage the equality of health care and control costs  
Medicaid   A government-based health insurance option that pays for medical assistance for individuals who have low incomes and limited financial resources. Funded at the state and national level. Administered at the state level.  


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Created by: sbogle