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NHA CCMA Test > Module 1: Health Care System > Flashcards

Module 1: Health Care System Flashcards

(74 cards)

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1
Q

Roles and Responsibilities

Medical Assistant

Medical Personnel are Ultimately Responsible for Care/Well-Being of their Patients

A

administrative: greeting, correspondence, answer phones
clinical: medical history, explaining treatments/procedures, drawing labs, prep/give immunizations

Screen Patients Before Provider, Help Allied Health Services

Where: Hospital, Ambulatory Care Center, Home Health Agency, Hospice, Medical Office

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2
Q

Administrative and Clinical Duties

Medical Assistant

Health Care Providers

A

Greetings, Handling Correspondence, Answering Telephones

Responsible for Clinical Task: Medical Histories, Explaining Treatment, Drawing Labs, Prep/Admin Shots

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3
Q

Medical Doctors (MD)

allopathic providers

Health Care Providers

A

Diagnose Illnesses, Provide Treatments, Perform Procedures (surgical, interventions, and write prescriptions)

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4
Q

Osteopathic Providers (DOs)

similar to MD

Health Care Providers

A

Addition to Modern Medicine, Surgical Procedures, Use Osteopathic Manipulative Therapy (OMT)

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5
Q

Nurse Practitioners

below MD and beyond RN

Health Care Providers

A

Provide Basic Patient Care Services (diagnosing, prescribing medications), Focus on Preventive Care/Disease Prevention

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6
Q

Physician Assistants

supervised by MD or DO

Health Care Providers

A

Able to Make Clinical Decisions/Be Responsible for Variety of Services

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7
Q

Medical Laboratory Technicians

under supervision of medical technologist

Allied Health Personnel

A

Perform Diagnostic Testing
(blood, bodily fluids, other specimens)

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8
Q

Medical Receptionists

works for provider

Allied Health Personnel

A

Check Patients In & Out, Answer Phones,
Perform (filing, faxing, other tasks)

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9
Q

Occupational Therapists

Allied Health Personnel

A

Assist Patients Who Have Developed Conditions that Disable Them

Developmentally, Emotionally, Mentally, Physically

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10
Q

Pharmacy Technicians

Allied Health Personnel

A

Assist Pharmacists with Duties that DO NOT require expertise or judgement of a licensed pharmacist

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11
Q

Physical Therapists

Allied Health Personnel

A

Assist Patients in regaining their Mobility/Improving their Strength/Rang of Motion

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12
Q

Radiology Technicians

Allied Health Personnel

A

Use Various typed of Imaging Equipment to Assist the Provider in Diagnosing/Treating Certain Diseases

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13
Q

Professionalism

A

skills, behavior, appropriate judgment that represent best qualities of person in a specific profession

Exhibit Courteous, Conscientious, Businesslike Manner

Dependability, Initiative, Flexibility, Confidentiality, Good Attitude

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14
Q

Appropriate Dress

A

good personal hygiene, appropriate work attire, avoid perfumes, wear make up conservatively, keep nails clean

clothing should be comfortable/fit, no facial piercings, visible tattoos

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15
Q

Work Ethic

A

A set of values based on the moral virtues of hard work and diligence

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16
Q

Scope of Practice

A

Delegated clinical and administrative duties consistent with education, training, and experience

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17
Q

Standard of Care

A

Degree of care or competence expected in a particular circumstance or role

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18
Q

CPT

Additional Credentials

A

Certified Phlebotomy Technician

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19
Q

CET

Additional Credentials

A

Certified EKG Technician

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20
Q

CBCS

Additional Credentials

A

Certified Billing and Coding Specialist

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21
Q

CEHRS

Additional Credentials

A

Certified Electronic Health Records Specialist

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22
Q

CHC or PN

Additional Credentials

A

Certified Health Coach
Patient Navigator

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23
Q

Computerized Physician Order Entry

CPOE

A

Process of electronic data entry of provider instructions for treatment

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24
Q

Accountable Care Organizations

ACOs

Health Care Delivery Model

A

Groups of physicians, hospitals, other health care providers together voluntarily provide high-quality care to Medicare patients. ACO succeeds delivering high-quality care/spending health care dollars wise, share in savings achieves Medicare program

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25
Capitation (partial or full) ## Footnote Health Care Delivery Model
patients assigned per-member, per-month payment based on age, race, sex, lifestyle, medical history, benefit design. payment rates tied expected usage regardless how often patients visits, like bundled payment models, providers incentive to help avoid high-cost procedures/tests max compensation, under partial/blended-cap models, only specific types/cat services paid basis of capitation
26
Global Budget ## Footnote Health Care Delivery Model
fixed total dollar amount paid annually all care, providers determine how money spent, limit level/rate increase health care cost, typically include quality component
27
Health Maintenance Organization | HMO ## Footnote Health Care Delivery Model
plan contacts medical center/group of providers to preventive/acute care for insured peron. HMOs require referrals speciaists precertification/preauthorization hospital admissions, outpatient procedures, treatments
28
Patient-Centered Medical Home | PCMH ## Footnote Health Care Delivery Model
primary care provider coordinates treatment to insure patients receive required care when/where they need it, in way they can understand
29
Pay for Performance ## Footnote Health Care Delivery Model
reimbursement model compensates providers only if they meet certain measures quality/efficiency, generating quality benchmark measures connects provider reimbursement directly quality care provide
30
Preferred Provider Organization | PPO ## Footnote Health Care Delivery Model
these plans have more flexibility than HMO plans, insured person doesn't need PCP, but can go directly to specialist without referrals, although patients see providers in or out their network, an in-network provider costs less
31
General V.S Speciality
Generalist Provider: assess wide range of symptoms. diagnoses, conditions to build treatment plan Specialist Provider: assesses more specific set of symptoms, diagnoses, conditions
32
General Practitioners | GPs ## Footnote General Providers
medical doctors who treat acute/chronic illnesses/provide preventive care/health education, GP may take holistic approach into consideration the biological, psychological, social aspects for care
33
Family Practitioners | FP ## Footnote General Providers
offer care to whole family (newborn to older adults), familiar with range of disorders/diseases, preventive care primay concern | most often chosen by physicians
34
Internists | I ## Footnote General Providers
provide comprehensive care of adults, often diagnosing/treating chronic, long-term conditions, offer treatment for common illnesses/preventive care. Internists must have broad understanding of body/ailments able to diagnose conditions/treat them
35
Allergists ## Footnote Specialist Providers
evaluate disorders/diseases of immune system | medications, food, anaphylaxis, problems to autoimmune disease, asthma
36
Anesthesiologists ## Footnote Specialist Providers
manage pain or use sedation during surgery
37
Cardiologists ## Footnote Specialist Providers
diagnosing/treating diseases or conditions of heart/blood vessels
38
Dermatologists ## Footnote Specialist Providers
conditions of the skin
39
Endocrinologists ## Footnote Specialist Providers
hormonal/glandular conditions | often work with diabetes mellitus
40
Gastroenterologists ## Footnote Specialist Providers
managing diseases of gastrointestinal tract | stomach, intestines, esophagus, liver, pancreas, colon, rectum
41
Gynecologists ## Footnote Specialist Providers
female reproductive system/fertility disorders
42
Hematologists ## Footnote Specialist Providers
deal with blood/blood producing organs | often work with anemia, leukemia, lymphoma
43
Hepatologist ## Footnote Specialist Providers
study of body parts on right side of gastro | liver, biliary tree, gallbladder, pancreas
44
Neonatologists ## Footnote Specialist Providers
care of newborns
45
Nephrologists ## Footnote Specialist Providers
kidney care/treating diseases of kidneys
46
Obstetricians ## Footnote Specialist Providers
care of women during/after pregnancy
47
Oncologists ## Footnote Specialist Providers
treatment/care for cancer patients
48
Ophthalmologists ## Footnote Specialist Providers
eye conditions
49
Orthopedists ## Footnote Specialist Providers
bones, joints, muscles, tendons, ligaments
50
Otolaryngologists ## Footnote Specialist Providers
ear, nose, and throat
51
Neurologist ## Footnote Specialist Providers
nervous system
52
Pathologists ## Footnote Specialist Providers
body tissues, blood, urine, other body fluids to diagnose/treat medical conditions
53
Pediatricians ## Footnote Specialist Providers
newborn, infant, child, adolescent health care
54
Psychiatrists ## Footnote Specialist Providers
mental disorders/conditions
55
Radiologists ## Footnote Specialist Providers
use of x-rays, ultrasound, nuclear medicine, computed tomography, magnetic resonance imaging to detect abnormalities throughout body
56
Urologists ## Footnote Specialist Providers
disorders of urinary tract
57
Urgent Care ## Footnote Ancillary Services
alternative emergency department | cost less, shorter wait, location, flexible hours, offer walk-ins
58
Laboratory Services ## Footnote Ancillary Services
diagnostic testing to help provider | blood, body fluids, other specimens
59
Diagnostic Imaging ## Footnote Ancillary Services
take images of body to diagnose condition | x-ray, ultrasound, MRI, CT
60
Occupational Therapy ## Footnote Ancillary Services
assist patients with conditions that disable to rebuild function/compensate for loss of function | developmentally, emotionally, mentally, physically
61
Physical Therapy ## Footnote Ancillary Services
assist patient in regaining mobility/improving strength/range of motion | from accident, injury, result of disease
62
Acupuncture ## Footnote Alternative Therapies
pricking skin/tissues with needles to relieve pain | physical, mental, emotional conditions
63
Chiropractic ## Footnote Alternative Therapies
medicine diagnoses/treats mechanical disorders | musculoskeletal system, spine
64
Energy Therapy ## Footnote Alternative Therapies
calm method of clearing cellular memory through human energy field | health, balance, relaxation ## Footnote idea of connection between physical, emotional, mental states of life in holistic healing
65
Dietary Supplements ## Footnote Alternative Therapies
contains dietary ingredients | vitamins, minerals, herbs, or other botanicals ## Footnote a plant (flowers, leaves, bark, fruit, seeds, stems, root, amino acids)
66
Allopathic ## Footnote Glossary Terms
homeopathic medicine; effort to counteract disease
67
Ambulatory ## Footnote Glossary Terms
able to walk
68
Computerized Physician Order Entry | CPOE ## Footnote Glossary Terms
process of electronic data entry of provider instructions for treatment
69
Managed Care ## Footnote Glossary Terms
umbrella term for plans that provide health care in return for preset scheduled payments/coordinated care through defined network of providers/hospitals
70
Osteopathic ## Footnote Glossary Terms
type of medicine based n concept that disturbances musculoskeletal system affect other bodily parts, causing many disorders improved various manipulative combination | medical, surgical, pharmacologic, other therapeutic
71
Professionalism ## Footnote Glossary Terms
skils, behavior, judgement represent best qualities of person
72
Scope of Practice ## Footnote Glossary Terms
delegated clinical/administrative duties | education, training, experience
73
Standard of Care ## Footnote Glossary Terms
degree of care/competence expected in particular circumstance or role
74
Work Ethic ## Footnote Glossary Terms
set of values based on moral virtues of hard work/diligence

NHA CCMA Test (22 decks)

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