Studied by 11 people
Key terms quiz
internal milieu
internal environment
hospitalist
someone who assumes the care of someone who is hospitalized in place of their primary care provider
pluralistic
a society that has numerous distinct ethnic religious and cultural groups that coexist
bond
a contractual obligation to pay a sum of money to an employer due to the actions of an employee
capitation
an amount of money given to healthcare providers determined by the amount of patients they have
complementary medicine
the usage of medicine that complements traditional medecin with alternative medicine
conglomorate
a group of different companies that operate in many different fields
co payment
a medical expense that is a fixed amount paid by people with insurance
deductible
a payment put down by the customer before the insurance makes any payments
fee for service
providers are paid for each service performed
gatekeeper
Someone who regulates medical care
group practice
three or more individuals organize to supply professional service and share equipment and staff
health maintenenance organization (HMO)
a type of managed care insurance plan offered to patients at a fixed annual fee, providing service from participating physicians
integrative medicine
medicine that helps the whole person (body, mind, spirit, and lifestyle), using all appropriate therapies, both traditional and alternative
joint venture
a collaberation between clinics and other providers (physicians, hospitals, etc.)
managed care
a type of healthcare plan with predetermined fees, usually HMO or PPO
opt out option
clients can get treatment from outside of the health care plan but pay more to do so
partnership
two or more individuals are co owners of a business
pay for performance (P4P)
a type of managed care that encourages providers to improve the quality of their service, they are reimbursed for progress towards a set goal
preferred provider organization (PPO)
a business agreement between a provider and an insurer where fees for certain services are predetermined for an established group of clients assigned to or selected by the provider
professional service corporation
a corporations where licensed individuals organize to render a professional service to the public
sole proprietorship
business owned by single individual
certification
certificate that signifies that someone has met requirement needed to be a professional
clinic manager
someone with additional education to manage a facility
continuing education units (CEUs)
awarded to professionals in specific feilds after gaining additional knowledge at a workshop/seminar
credential
evidence to one’s knowledge or experiance
endorsement
when one state supports another
licensed practical nurse (LPN) or licensed vocational nurse (LVN)
a graduate from a 9-month to 1-year college program
licensure
legal permission to perform certain acts (for example a physician to practice medicine)
medical assistant (MA)
someone who assists a provider in both administrative and clinical duties
medical professional coder
someone who has education and experiance in current procedural terminology and international classification of diseases, responsible for correct applications of codes for procedures, supplies and diagnoses used for billing proffessionals for medical services
medical laboratory technician (MLT)
someone with a certificate or associate degree who works under supervision of a provider or medical technologist in a laboratory preparing specimens and operating automated analyzers
medical technologist (MT)
a graduate from a 4 year college program in medical technology that includes 1 year of clinical experience in the laboratory. Performs complex tests and analyses, ensures accuracy of testing, and may supervise medical laboratory technicians
medical transcriptionist
may or may not have a formal education, will have superior medical terminology knowledge and keyboarding and grammar skills, transcribes medical dictation
nurse practitioner (NP)
an RN usually with a bachelor of science in nursing, who has additional education in nursing at the masters or doctoral level
physician
a provider who is identified by law as a doctor of medecine (MD) or a doctor of osteopathic medicine (DO)
physician assistant (PA)
someone with 1-4 years of education in an approved program, works under the supervision of a physician
provider
any health care professional who examines, diagnoses, and treats individuals (includes MDs and DOs)
reciprocity
an agreement by which two states recognize the licensing procedures of each other, consider them valid, and grant licenses to practice based on the other state’s licensure, sometime refered to as “endorsement”
registered nurse (RN)
a graduate from a 2 year associate degree, 3 year diploma, or 4-5 year bachelor’s degree program who passed the state licensing examination for for their field, works under a physicians direction
registration
an entry in an official record listing names of people with certain requirements and education levels
scope of practice
what is allowed for a person to do depending on education, experience, and competency
tickler file
a chronological file used as a reminder to do specific tasks on schedule, usually daily, weekly, or monthly
administer a drug
introduce a drug into a client’s body
controlled substances act
federal law that regulates the administration, dispensing, and prescribing of particular substances that are categorized into five schedules
drug enforcement administration (DEA)
branch of the department of justice that enforces drug laws
drug formulary
an insurance carrier’s list of preferred drugs
health insurance porability and accountability act (HIPPA)
national standards to protect health information
medical practice acts
state statutes that define the practice of medicine, decribe methods of licensure, and set guidelines for suspension or revocation of a license
National Provider Identification (NPI)
A 10-digit unique number given to a health care provider for idnetification purposes under HIPAA regulations
prescribe a drug
issue a drug order for a client
privacy rule
a portion of HIPPA that regulates the confidentiality of a clien’ts health record while still allowing that information to flow properly and effectively in order to treat the client
protected health information (PHI)
all the past, present, and future physical and mental conditions of an individual’s health care
agent
a healthcare employee appointed by a principal party (physician or provider) to perform authorized acts in the name and under the control and direction of the principal party
alternatice dispute resolution (ADR)
methods outside the judicial system used to solve potential malpractice actions, methods include arbitration and mediation
assault
a threat to inflict injury with an apparent ability to do so
battery
the unlawful touching, beating, or laying hold of persons or their clothing without consent
breach of contract
failure to comply with the terms of a valid contract
civil liability
identifies conflicts between individuals, corporations, government bodies, and other organizations
compliance plan
guidelines established to protect a clinic from fraud and litigation charges
contract
a voluntary agreement between parties
criminal liability
when an individual commits an act that is considered to be an offense against society as a whole
defamation
spoken or written words concerning someone that tend to injure that person’s reputation and for which damages can be recovered, the two types are libel and slander
libel
false, defamatory writing, such as published material, effigies, or pictures
slander
false, malicious, or defamatory spoken words
fiduciary
holding in confidence or trust
malfeasance
commission of an unlawful act
medical malpractice
professional negligence fo physicians or providers
misfeasance
improper performance of an act resulting in injury to another
negligence (medical)
doing some act that a reasonable and prudent provider would not do, or failing to do some act that a reasonable and prudent provider would do
nonfeasance
failure to perform an act when there is a duty to do so
res ipsa loquitur (latin phrase)
the thing speaks for itself, a doctrine of negligenge law
respondeat superior (latin phrase)
let the master answer, the provider is responsible for employee acts
tort
wrongful act committed by one person against another person or against propery, distinguished from a breach of contract
vicarious liability
legal doctrine assigns liability for injury to a person of institution who did not cause the injury but who has a particular legal relationship to the person who did act negligently
appellant
one who appeals a court decision to a higher court
arraignment
the procedure of calling someone before a court to answer a charge
civil case
court action between private parties, corportatoins, government bodies, or other organizations. comensation is usually monetary.
closing arguments
summary and las statements made by opposing attorneys at a hearing or trial
congress
the law making body of the federal government, made up of two seperate groups, the house of representatives and the senate
court of appeals
court that reviews decisions made by a lower court; may reverse, remand, modify, or affirm lower court decision
court order
an order issued only by a judge to appear or to request certain records, does not require clients permission
criminal case
court action brought by the state against individuals or groups of people accused of committing a crime; punishment is usually imprisonment and/or a fine; includes recovery of rights of society
cross-examination
examination of a witness by an opposing attorney at a hearing or trial
defendant
the person or group accused in a court action
Note 
Flashcard (107)