FBLA health care administration test

FUTA
Allows collection of taxes in order to fund state programs
Adjudicate
Settles payment on insurance claims. Also refers to review of evidence in a trial
Latent
Incubation period. Infections are persistent and go into relapse
JCHAO
Reviews and accredits hospitals
NCQA
Reviews and accredits health plans
ASC
Ambulatory services center. Line by line billing allows for less costs
Adverse selection
Attracting patients that are sicker than usual
Admission Certification
Admitting patients that need more care
Single Payer System
Government Run. Care Triad (Cost, quality, access)
Evidence Based Medicine
Uses EMR of patient to determine the best treatment
National Labor Relations Act
Allows hospital/heath care providers to use bargaining units
Fair Labor Standards Act of 1938
Establishes Minimum Wage, Ages, overtime pay for workers
Equal Pay Act
Pay equality amongst genders
HEDIS
Compares health plan performance
OASIS
Reimbursement for home health care plans
UHDDS
Uniform health discharge data set. Needed for Medicare reporting
OSHA
Establishes and regulates workplace safety
Protected Health Information
Records of a patient’s past and present health condition, how the care was provided and how the patient paid
HIPPA
Health Information Privacy and Portability act
Provisions of HIPPA
Cannot be denied coverage for group insurance, coverage wait cannot exceed 12-18 months, safeguards electronc information, privacy of health records
Copay
Payment defined by policy that grants access to the treatment
Premiums
Money paid to insurers to negate the risk of loss. Lower payments result in high treatment costs
HMO
Health Maintenance Organization: Individuals pay a fixed amount and get access to facilities within the plan
PPO
Typical insurance style. Individuals pay a fee for service along with copay and deductables through a network of providers
POS
Similar to a HMO, but with extentions through payment similar to a PPO plan
HDHP
Insurance plan for high risk individuals. Low premium but has high deductables
Medicare
Health care plan entitled to people 65 and older
Medicaid
Health care plan granted by states to low income individuals
ERISA
Act that allows employers to set up insurance plans. Also allows funding for Medicaid
Medicare Part A
Inpatient coverage, home health, hospice. Also defines limits of Medicare usage
Medicare Part B
Outpatient care. Extends Medicare to supplemental treatments, and physicians
Medicare Part C
Allows people with Medicare to enroll in supplemental indemity plans
Medicare Part D
Medicare drug coverage
TRICARE
Military health insurance progra
Managerial Accounting
Financial data for internal users: Board, executives and managers
Financial Accounting
Financial data for external users: Stockholders, lenders, insurers, government
HCPCS
Healthcare Common Procedure Coding System: Codes used for outpaint services and supplies
EMR
Electronic record for individual patients
EHR
Electronic record for a population
Triage
Determining which patients to admit first
Systemic
Disease affects multiple organs
NPDB
Records of practitioner credentials
DNR
Do not recessetate order
Stark Law
Prohibits physicians from making referrals to Medicare
Affadavit
Sworn statement of facts in an incident
In Loco Parentis
Court makes decesions in place of the parents
Credits
Positive account changes. Right (middle) side of ledger
Debits
Negative account changes. Left side of ledger
Accounts Receivable
Payers who still need to send funds. Assets are still accessable, but not tangible (liquid)
ICD-9 Codes
International Disease Classification codes
ICD-9 Codes 0-739
Codes for diseases or disorders
ICD-9 Codes 740-999
Codes for injuries
Current Liabilities
Expenses to be paid
SCHIP
Program that helps needy families with children get insurance
3 ft Radius
Droplet isolation zone
Preliminary Screening
Interview of patient to obtain signs and symptoms
Antiseptic
Inhibits microbrial growth on surfaces and tissues
Disinfectants
Destroy microbes on non living matter
PPACA
“Obamacare”
POMR
Helps track treatments in medical records
Infection Timeline
Incubation, Itching/chills phase, peak stage with vomiting/aches/chills, recovery stage
Jurisprudent
Knowledgable on the law
CPT-4
Codes for treatments
NPI
8-20 digit number for Medicare providers
Patient Bill of Rights
Access to closest ER, choice of doctor, pediatrician, etc