everything Flashcards
1
Q
3 foot radius
A
Wear a surgical mask when 3 feet within a patient with droplet spread disease
2
Q
Accounts Receivable
A
matthew buys me starbucks
i owe him $2
matthew has account recivable of $2
i gotta pay him back
3
Q
Adjudicate
A
To review evidence by an insurance company to decide whether to pay in full, partially, or not at all for a claim.
4
Q
Admission Certification
A
A method of assuring that only those patients who need hospital care are admitted.
cant fake those injuries=bad
5
Q
Adverse Selection
A
Market situation where buyers and sellers have different information.
6
Q
Affidavit
A
A written statement made under oath that is typically used in legal proceedings
7
Q
Antiseptic
A
A substance that stops or slows down the growth of microorganisms
8
Q
ASC
A
Ambulatory Surgery Centers
9
Q
Copay
A
A contribution made by an insured person toward the cost of medical treatment
10
Q
CPT-4
A
A uniform coding system consisting of descriptive terms and identifying codes- used for surgeries, diagnostic tests, etc.
11
Q
Current Liabilities
A
A company’s short term financial obligations- typically due within a year
12
Q
Debits
A
The system of collecting life insurance premiums on a weekly or monthly basis involving an actual visit by the agent.
13
Q
Disnfectants
A
Any substance or process that is used primarily on non-living objects to kill germs
14
Q
DNR
A
Do-Not-Resuscitate
15
Q
EHR
A
Electronic Health Record
16
Q
EMR
A
Electronic Medical Record
17
Q
Equal Pay Act
A
Protects workers from discrimination based on sex- equal pay
18
Q
ERIS
A
Employee Retirement Income Security
19
Q
Evidence Based Medicine
A
A medical practice/care that emphasizes the practical application of current research
20
Q
Fair Labor Standards Act of 1938
A
A labor law that created the right to a minimum wage and “time and a half” overtime pay when people work over 40 hours per week
21
Q
FUTA
A
Federal Unemployment Tax Act- provides payments of unemployment compensation to workers who have lost their jobs
22
Q
HCPCS
A
Healthcare Common Procedure Coding System- used for basic health care services; medical devices, supplies, etc.
23
Q
HDHP
A
High Deductible Health Plan- a plan with a higher deductible than a traditional insurance plan
24
Q
HEDIS
A
Healthcare Effectiveness Data and Information Set- plans to measure performance on important dimensions of care and service
25
HIPAA
Health Insurance Portability and Accountability Act- federal law that requires the creation of national standards to protect sensitive patients health info from being disclosed without the patients consent
26
HMO
Health Maintenance Organization- a type of health insurance plan that typically have lower monthly premiums, pay less out of pocket, not flexible w coverage
27
ICD- 9 Codes
International Classification of Diseases- the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the U.S
28
ICD-9 Codes 0-739
Nonallopathic lesions of head region not elsewhere classified
29
ICD-9 Codes 740-999
Anencephalus and similar anomalies
30
Infection Timeline
The invasion and growth of germs in the body
31
In Loco Parentis
Latin for, "in place of a parent", refers to the legal responsibility of a person or organization
32
JCAHO
Joint Commision on Accredidation of Healthcare Organizations- nonprofit organization based in the U.S that accredits over 20,000 healthcare organizations and programs
33
Latent
A conditon that is present but not active or causing symptoms
think trees dormant in winter
34
Managerial Accounting
A practice of identifying, measuring, analyzing, interpreting, and communicating financial information to managers for the pursuit of an organization's role
35
Medicaid
A joint federal and state program the gives health coverage to some people with limited income and resources
36
Medicare
Federal health insurance for anyone over the age of 65
37
Medicare Part A
1. Inpatient care in a hospital
2. Skilled nursing facility care
3. Nursing home care(not custodial or long term care)
4. Hospice care
5. Home health care
38
Medicare Part B
- Medically necessary services
- Preventive services
(ex.)
- Clinical research
- Ambulance services
- Durable medical equipment
- Limited outpatient prescription drugs
- Mental Health
- In patient, outpatient, partial
hospitalization
39
Medicare Part C
Medicare Advantage plans- sometimes offered by medicare- approved private companies that must follow rules set by Medicare
40
Medicare Part D
Helps cover cost of perscription drugs- is optional
41
National Relations Labor Act (NRLA)
1935- Labor law that gurantees the right of private sector employees to organize into trade unions, engage in collective barganing, and take collective action such as strikes
42
NCQA
National Commitee for Quality Assurance Exist to improve quality of health insurance - independent non- profit organization
43
NPDB
National Practitioner Data Bank- database that contains medical malpractice payment and adverse action reports on healthcare professionals
DATABASE FOR DOCS WHO MAKE MISTAKES
44
NPI
National Provider Identifier- unique identification number for covered health care providers
also HIPAA standard
45
OASIS
Outcome and Assesment Information Set- database to collect and report assesment data by home and health agencies
HOME HEALTHCARE ASSETMENT
46
Financial Accounting
specific branch of accounting that involves a processing of recording, summarizing, and reporting the myriad of transactions resulting from business operations over a period of time
47
Jurisprudent
the application of medical knowledge to questions of the law affecting life or poverty
48
OSHA
Occupational Safety and Health Standard- ensures healthy and safe working conditions
49
Paitent Bill of Rights
to receive appropriate assessment of and treatment for pain in a consistent manner
50
POMR
Problem Oriented Medical Record- a way of recording patient health information in a way that's easy for physicans to read and revise
51
POS
Point of Service- a type of healthcare plan where members recieve services from a network of providers
52
PPACA
Patient Protection and Affordable Care Act(Obamacare)- a comprehensive healthcare reform law enacted in 2010 in the U.S
53
PPO
Preferred Provider Organization- a type of healthcare plan where members recieve services from a network of preferred providers at a lower cost than non- preffered providers
54
Preliminary Screening
Initial evaluation of a person's health condition to determine the next course of action
55
Premiums
The amount of money that a person or an organization pays to an insurance company in exchange for health insurance coverage
56
Protected Health Information
Confidential medical information that is protected by law and cannot without paitents consent
57
Provisions of HIPAA
The Health Insurance Portability and Accountablity Act establishes standards for the protection and confidentiality of medical information
58
SCHIP
State Children's Health Insurance Program- a U.S governemnt program that provides healthcare coverage
59
Single Payer System
A healthcare system in which the government is the sole payer for healthcare services, rather than private insurance companies
60
Stark Law
Physician Self-Referral Law, a federal law that prohibits physicians from referring patients for certain designated health services to entities in which the physician has a financial interest.
61
Systemic
Pertaining to the whole system or body, rather than just a part.
62
Triage
The process of determining the priority of patients' treatments based on the severity of their conditions.
63
TRICARE
A healthcare program for active-duty and retired military personnel and their families in the US
64
UHDDS
Uniform Hospital Discharge Data Set, a set of standard definitions and codes used to collect and report data on hospital discharges
65
5S Theory
A Japanese management philosophy that focuses on sorting, simplifying, sweeping, standardizing, and sustaining a clean and organized workplace
66
6 Management Functions
Planning, organizing, staffing, directing, controlling, and evaluating
67
15M - sales max SBA loan
A loan from the Small Business Administration with a maximum amount of $15 million for businesses that meet certain criteria.
68
Acceptance Authority Theory
A management theory that emphasizes the importance of empowering employees to make decisions within their areas of responsibility
69
Accountable Care Organization
A type of healthcare organization that aims to coordinate and manage care for a patient population in a cost-effective manner
70
ADR Provision
Alternative Dispute Resolution Provision, a clause in a contract that provides for the resolution of disputes through methods such as mediation or arbitration
71
Adverse Occurrences
Negative events or outcomes, such as patient harm or adverse drug reactions.
72
Affordable Health Choices Act
A proposed healthcare reform bill aimed at making healthcare more affordable and accessible.
73
Age Discrimination in Employment Act
A federal law that prohibits employment discrimination against individuals 40 years of age or older.
74
Aggregate Data
Data that has been compiled from multiple sources and summarized in a way that masks individual identities.
75
Altruism
Unselfish concern for the welfare of others.
76
Americans With Disabilities Act
A federal law that prohibits discrimination against individuals with disabilities in employment, public accommodations, transportation, and other areas.
77
ASC
Ambulatory Surgery Center, a type of healthcare facility that provides same-day surgical procedures.
78
At-Will contract w/ or w/o restrictive covenant
An employment contract in which termination must be following with limits defined by a contract.
79
Fairness and consistency
The principle of treating all individuals or groups in an equitable and impartial manner, following established rules and procedures.
80
Family and Medical Leave Act
A federal law that provides eligible employees with up to 12 weeks of unpaid, job-protected leave for certain family and medical reasons.
81
Fiduciary
A person or organization that has a legal obligation to act in the best interest of another person or organization, such as a trustee or guardian.
82
Financial Statements
A set of reports that provide information on a company's financial performance, including its income statement, balance sheet, and cash flow statement.
83
Fraud
Deception or dishonesty intended to result in financial or personal gain.
84
GAP Analysis
A method of comparing an organization's current performance with its desired or ideal performance, in order to identify areas for improvement.
85
Governance
The system of rules, practices, and processes by which a company or organization is directed and controlled.
86
Healthcare reform
Changes to the healthcare system aimed at improving access, quality, and affordability of care.
87
Human Resource Management- HRM
The process of managing an organization's workforce, including recruiting, hiring, training, and development.
88
Informed Consent
The process by which a patient provides knowledgeable and voluntary agreement to a proposed medical treatment or procedure.
89
Inteligent Systems
Systems that use artificial intelligence and machine learning algorithms to perform tasks and make decisions, such as expert systems and natural language processing systems.
90
Internal Pressure on HSO’s
Factors within a healthcare service organization that influence its operations and decision-making, such as budget constraints or changing patient needs.
91
Joint Commission
An independent, non-profit organization that accredits and certifies healthcare organizations in the US.
92
Leadership
The ability to influence and guide individuals, groups, or organizations towards a common goal or vision.
93
Legislation
Laws passed by a government or governing body.
94
Liability
Legal responsibility for something, such as for damages or debts.
95
Managed Care
A system of healthcare delivery that emphasizes cost control and quality improvement through mechanisms such as pre-authorization and utilization review
96
Management Information Systems- MIS
A field of study that deals with the development and use of information systems and technology to support decision-making and improve organizational performance
97
Marketing Mix
The four elements of marketing, including product, price, promotion, and place (distribution).
98
Medical Staffing Agencies
Organizations that provide temporary or permanent medical staff to healthcare organizations.
99
Medical-Surgical Nursing
A specialized field of nursing that focuses on the care of adult patients with acute and chronic medical conditions.
100
Medicolegal Issues
Legal and ethical issues arising in the healthcare field, such as informed consent and patient confidentiality.
101
Medigap Insurance
A type of insurance that helps pay for some of the out-of-pocket costs associated with Original Medicare, such as deductibles and copayments.
102
Minority Health
The study of disparities in health outcomes and access to care experienced by racial and ethnic minority groups.
103
Outcome Measures
Indicators of the success or effectiveness of a healthcare intervention or treatment.
104
Patient Confidentiality
The ethical and legal principle that protects a patient's personal and medical information from being disclosed to others without the patient's permission.
105
Patient Satisfaction
A measure of how well a healthcare organization
106
Family Medical Leave Act (FMLA)
Federal law that requires employers to grant eligible employees up to 12 weeks of unpaid, job-protected leave per year for certain medical and family reasons.
107
Fair Labor Standards Act of 1938
A federal law that established minimum wage, overtime pay, recordkeeping, and child labor standards affecting full-time and part-time workers in the private sector and in federal, state, and local governments.
108
External Pressure on HSO’s
Refers to the various forces outside a healthcare organization that affect its operations and decision-making. Examples include regulations, competition, changes in technology, and shifting patient needs and preferences.
109
Exchange Relationships
Relationships between healthcare organizations and other stakeholders, such as patients, insurers, and regulators. These relationships often involve exchange of goods, services, information, or payment.
110
Environment for HSOs
The external and internal conditions and circumstances that influence the operation and performance of healthcare organizations. This includes factors such as regulations, competition, patient needs and preferences, technology, workforce, and finances.
111
Employee Retirement Income Security Act (ERISA)
Federal law that sets standards for private pension plans, including requirements for participation, vesting, funding, and reporting.
112
Employee Polygraph Protection Act
Federal law that prohibits most private employers from using lie detector tests, either for pre-employment screening or during employment
113
Domains of mangement
The broad categories or areas of responsibility in an organization, such as finance, operations, marketing, and human resources.
114
D&O Insurance
Directors and officers insurance, a type of liability insurance that protects individual directors and officers of a company against claims made by shareholders, employees, or other stakeholders for wrongful acts or omissions in their professional capacity.
115
DMAIR
Data, Metrics, Analysis, Improvement, and Reporting. A process used by healthcare organizations to monitor and improve performance by collecting, analyzing, and using data to inform decisions and actions.
116
Direct Care
Healthcare services that are provided directly to patients, typically by physicians, nurses, or other clinical staff.
117
Declining Reimbursement
A decrease in the amount of payment received by healthcare organizations from insurers or government programs for the services they provide to patients.
118
Data Dictionary
A comprehensive listing of data elements, definitions, and attributes used within an organization.
119
Covenant
A legally binding agreement or promise, often between two parties, that imposes obligations or restrictions on one or both parties.
120
Corporate Structure of Hospitals
The organizational and ownership structure of hospitals, which can vary and may include for-profit, non-profit, or government-owned entities.
121
COO
Chief Operating Officer, a senior executive responsible for overseeing the day-to-day operations of an organization.
122
Controlling
A management function that involves monitoring and regulating the activities and performance of an organization to ensure that it stays on track and achieves its goals.
123
Contract with money stability and free agency
A type of employment contract that combines financial stability and job security with the freedom and flexibility for employees to pursue other opportunities.
124
Compliance
Adherence to laws, regulations, standards, and policies, as well as ethical and professional norms. In healthcare, compliance refers to ensuring that healthcare organizations and their staff follow relevant laws, regulations, and standards related to patient care, privacy, and billing
125
COBRA
Consolidated Omnibus Budget Reconciliation Act, a federal law that allows eligible employees and their dependents to temporarily continue their group health coverage when a qualifying event occurs, such as job loss or reduction in hours.
126
CNO
Chief Nursing Officer, a senior executive responsible for overseeing the nursing function
127
Feedback Model
A system in which information about the results of a process is used to continuously improve and adjust the process.
128
First Line Managers
Front-line supervisors who are responsible for managing the day-to-day activities of workers in an organization.
129
Formal Authority Theory
A theory that explains the distribution of power and control within an organization based on formal job titles, hierarchy, and the delegation of authority.
130
Heijunka
A Lean manufacturing concept that involves leveling production, reducing batch sizes, and creating a smooth flow of work.
131
HHS
The United States Department of Health and Human Services, the main federal agency responsible for protecting the health of all Americans and providing essential human services.
132
Hill-Burton Act
A federal law passed in 1946 that provides funding for construction and modernization of healthcare facilities in underserved areas.
133
Immigration Reform and Control Act
A federal law passed in 1986 that provides for the legalization of certain undocumented immigrants and establishes penalties for employers who knowingly hire undocumented workers
134
Increasing Population Need
The growing demand for healthcare services due to the increasing size of the population.
135
Incremental Budget
A budgeting method where only the changes in budget from the previous year are considered, rather than creating a budget from scratch.
136
Indemnity Insurance
An insurance policy that provides reimbursement for specific expenses, rather than paying a predetermined amount for each service.
137
Indirect Care
Healthcare services provided by support staff, such as administration, housekeeping, and maintenance, rather than direct patient care provided by healthcare professionals.
138
Input/Output Management Model
A model that outlines the inputs (resources) and outputs (results) of a process in order to optimize performance.
139
Jidoka
A Lean manufacturing concept that involves stopping the production line when a problem occurs, rather than continuing to produce defective items
140
Integration Clause
A clause in a contract that specifies the terms and conditions for integrating all previous negotiations and agreements into the final contract.
141
Joint Several Liability
A legal concept where two or more parties are held jointly responsible for the same debt or obligation.
142
Key LEAN Principles
Principles of continuous improvement, waste reduction, and customer focus that are central to the Lean manufacturing philosophy.
143
Laissez Faire
A philosophy of minimal government intervention in economic affairs, allowing the market to operate freely.
144
LLC
A limited liability company, a type of business structure that provides limited liability protection to its owners while allowing for flexible tax treatment and management.
145
Line Managers
Managers who are responsible for the direct supervision of workers and the execution of specific functions within an organization.
146
Lean
A philosophy of continuous improvement that emphasizes minimizing waste, maximizing efficiency, and putting the customer first.
147
Matrix Management Method
A management approach where individuals report to multiple managers, creating cross-functional teams and combining expertise to achieve common goals.
148
MDS Version 2.0
The latest version of the Minimum Data Set, a standardized tool for collecting patient assessment data in long-term care facilities.
149
Maximum Notice Possible and Severance
The maximum amount of notice an employer must give an employee before terminating their employment, as well as any severance pay that may be required.
150
Middle Managers
Managers who are responsible for overseeing the work of line managers and implementing the strategies and policies set by top management.
151
Accounts Payable (Meena)
A record of money owed by a business to its creditors or suppliers for goods or services purchased on credit.
152
Acute Infection
An infection that comes on suddenly and is usually severe in nature
153
Bioethics
The branch of ethics concerned with the relationships between biology, medicine, and ethical principles.
154
Cellular Telephone
A type of mobile phone that uses cellular networks to communicate.
155
Charges
A payment demanded for a serice or product
156
Cheif Complaint
The primary reason for which a patient seeks medical attention.
157
Claim Form
A document used to request payment from an insurance company for medical services rendered
158
Coding
The process of assigning codes to medical diagnoses, procedures, and treatments in order to accurately report and bill for healthcare services
159
CPT- Code
A code used to identify a medical service or procedure for billing purposes
160
EMTALA
The Emergency Medical Treatment and Active Labor Act, a federal law that requires hospitals to provide emergency medical treatment to anyone who comes to the emergency room, regardless of their ability to pay.
161
EOB
Explanation of Benefits, a document provided by an insurance company that explains the payment and coverage details of a medical claim.
162
Etiquette
A code of behavior that defines socially acceptable behavior in a particular setting.
163
Flexible Spending Account
An employer-sponsored benefit that allows employees to set aside pre-tax dollars to pay for certain medical expenses.
164
Healthcare Power of Attorney
A legal document that designates a person to make healthcare decisions on behalf of another person in the event that person becomes unable to make decisions for themselves.
165
Infectious Waste
Waste materials that have the potential to spread disease, including medical waste such as used needles, gowns, and other materials contaminated with bodily fluids.
166
Malfeasance
Improper or illegal conduct, especially by a public official.
167
Ophthalmology
The branch of medicine that deals with the anatomy, physiology, and diseases of the eye.
168
OTC Drugs
Over-the-counter drugs, which can be purchased without a prescription.
169
PHI
Protected Health Information, a type of personal health information that is protected by federal law.
170
Shock
A medical emergency in which the body is not getting enough blood flow, which can lead to organ failure and death.
171
Supplemental Insurance
Insurance coverage that provides additional benefits to a primary insurance policy.
172
Systemic Infection
An infection that has spread throughout the body
173
DE
Disease Entity, a specific type of medical condition or illness.
174
Subpoena
A legal order requiring a person to appear in court or produce evidence.
175
Summary Report
A brief report that provides a summary of important information.
176
The Intent of HIPAA Law
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of individuals' health information and establishes standards for electronic health information. The intent of the law is to ensure the confidentiality and security of health information while promoting its use to improve the quality of healthcare.
177
ICD
Internation Classification of Diseases, a coding system used to classify diseases and other health problems.
178
Modifers of Code
Additional codes used to provide additional information about a medical service or procedure for billing purposes.
179
Time Specific (stream) scheduling
Scheduling that is based on the amount of time needed to complete a task
180
Wave Scheduling
A scheduling system in healthcare administration in which patients are scheduled in groups, or "waves," based on similar treatment needs or resource requirements. This allows for efficient use of resources and improved patient flow, while reducing wait times and improving patient experience.
181
EPA
Environmental Protection Agency, a U.S. federal agency responsible for protecting human health and the environment by enforcing environmental laws and regulations.
182
HIV
Human Immunodeficiency Virus, a virus that attacks the immune system and can lead to AIDS.
183
HBV
Hepatitis B Virus, a virus that attacks the liver and can cause chronic liver disease.
184
HCV
Hepatitis C Virus, a virus that attacks the liver and can cause chronic liver disease.
185
SOAP Charting
A documentation method in healthcare where information is recorded using the acronym SOAP (Subjective, Objective, Assessment, and Plan), to provide a comprehensive and organized record of a patient's care.
186
Five Vital Signs
A set of five medical measurements commonly taken to assess a patient's basic health status, including body
1. temperature
2.pulse rate
3.breathing rate
4.blood pressure
5.oxygen saturation.
187
Clinical Laboratory Improvement Amendments (CLIA) of 1988
U.S. federal regulations that set standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results.
188
MRI Machine
Magnetic Resonance Imaging, a medical imaging technique that uses a strong magnetic field and radio waves to produce detailed images of internal organs and tissues.
189
FEMA
Federal Emergancy Management Agency - US government agency that coordinates the responses to disasters.
190
CEU
Continuing Education Unit
191
CMS
Centers for Medicated Services
