Flashcards in " " Deck (126)
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91
Confidentiality
Indicating confidence or intimacy , entrusted with secrets
92
Malpractice
Negligent professional activity by a medical practitioner
93
Negligence
Failure to take proper care in doing something
94
Fraud
Wrongful deception intended to result in financial gain
95
Abuse
Use something to bad effect for a bad purpose
96
Subpoena
ordering a person to attend court
97
Summons
Urgently call to be present as a witness in a law court
98
Deposition
The action of deposing someone
99
Electronic Data Interchange
Transfer of data from one computer to another by standardized message formatting
100
Code Sets
Set of codes used for encoding elements
101
T.P.O
Treatment ,payment , operation; patients rights related to use and disclosure of individuals health information
102
Designated Record Set
A group of records maintained by / for a covered entity that is the medical and billing records about individuals
103
HMO
( health maintenance organization ) structured, once you pick your primary care physician, you can't change
104
PPO
( preferred provider organization ) managed care where you pick your primary care physician and you can change
105
POS
(Point of Service )managed care, you can stay inside the plan but if you go to another doctor , you pay a higher price than your co-pay
106
EPO
(Exclusive Provider Organization) have to use exclusively use that doctors network
107
Group Health Plan
When your employer gives you a health insurance
108
Private Health Insurance
Employer only offers one health insurance coverage
109
Beneficiary
A person that is dependent on someone else's coverage
110
Participating Provider
A person or group in who's name the insurance policy is held in
111
Policy Holder
Primary person who pays for the policy
112
Fee Schedule
A complete listing of fees by Medicare to pay doctors, providers, & suppliers ( RVRBS )
113
Coordination of Benefits
A process where they determine which of your insurance will pay first due to the fact you have 2 insurances
114
Dependent
An insured person who is legible for insurance coverage
115
Self Insure
Employer Pays directly for your health insurance
116
Medicare
Health insurance for people who are 65 and older
117
Medicaid
Health insurance for low-income families
118
TRICARE
Health care insurance for Active Military
119
CHAMPVA
Program for disabled veterans & their families
120
