Medical Assistant Practice Flashcards Pack 3

Code of ethics

A list of specific behaviors and efforts expected of employees within a company.

Fraud

The intentional alteration of records, such as a receptionist changing a treatment date to ensure insurance coverage, or intentionally double-billing for procedures.

Punitive damages

Damages awarded to the plaintiff specifically to punish the defendant’s actions.

Medical liability insurance

Insurance usually carried by a doctor that covers the physician, their staff, and anyone they contract with for services relating to the practice in cases of accident or negligence.

Testimony

The sworn statement of witnesses and experts given while on the witness stand in court.

Security Standard

A regulation requiring appropriate security safeguards to protect electronic protected health information (ePHI) that may be at risk.

Office for Civil Rights

The entity responsible for enforcing HIPAA Privacy and Security Standards.

False Claims Act

The legal basis for the prosecution of healthcare fraud and abuse claims.

Insurance audit

A thorough review by an insurance company of a claim and all related documentation, often triggered by unusual claim numbers or inaccurate codes.

Compliance plans

Formalized processes designed to identify, investigate, and prevent violations, fraud, and abuse in health care.

Administrative Simplification Compliance Act

An act that sets up nationally consistent regulations, focusing on areas such as privacy and security.

Resolution agreement

A contract between HHS and a covered entity to perform certain obligations and make reports for a period of, generally, three years following a violation.

Binding arbitration

A dispute resolution process where the ruling is final and must be obeyed.

HCQIA

The Health Care Quality Improvement Act, which creates a national tracking system for physicians to identify a history of malpractice.

Detoxification

The process occurring when eosinophils neutralize poisons and other harmful substances.

Median cubital vein

The vein most commonly used for blood collection through venipuncture.

Capillary puncture

A method used to obtain drops of blood through a skin puncture.

Adult female hematocrit value

A normal