NCCT Medical Office Management – Flashcards
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ethics
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right and wrong conduct
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negligence
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failure to do something that a reasonable person would do under ordinary circumstances that ends up causing harm to another person or a persons property
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defendent
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the party being sued
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plantiff
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the party suing
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abandonment
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withdrawl of a physcian from the care of a patient without reasonable notice of such discharge from the case by the patient
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assault
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an unlawful threat or attempt to do bodily injury to another
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reasonable care
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a law protecting health care workers if they acted as reasonable as fellow workers
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malpractice
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negligence by a professional person
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crime
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an act that violates criminal law
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breach
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breaking of a law, promise or duty
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empathy
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ability to see things from another's point of view
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statue of limitations
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time established for filing a lawsuit
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subpoena
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writ that commands a witness to appear at a trial or other proceeding and to give testimony
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tort
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a wrong commited against another persons property
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false imprisionment
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holding or detaining a person against his will
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Invasion of privacy
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a violation of a person's right not to have his or her name, photograph, or private affairs exposed or made public without consent
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felony
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a major crime for which greater punishment is imposed other than a misdemeanor
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will
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legal statement of how an individual's property is to be distributed after death
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priviledged communication
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information given by a patient to medical personnel which cannot be disclosed without consent of the person who gave it
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law
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a rule of conduct made by a governing body
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most common type of medical tort
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Negligence
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consent
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permission granted by a person voluntarily and in his right mind
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defamation
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Injuring the name and reputation of another person by making false statements to a third person
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contract
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an agreement between two or more parties for the doing or not doing of some definite thing
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Incompetence
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lack of physical or mental fitness
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respondent superior
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responsibility of an employer for the acts of its employees
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non compos mentis
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latin term signifying that a person is not of sound mind
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emancipated minor
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a person who is not under the care, custody, or supervision of a parent
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medical grievence
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an impartial panel established to listen and investigate patient's complaints about medical care or excessive fees
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res gestae
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latin for "things done; deeds" the facts an circumstances attendant to the act in question
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deposition
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testimony of a witness under oath and written down before trial for possible use when the case comes to trial
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civil law
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a statue that enforces private right and liabilities, as differentiated from criminal law
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breach of duty
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violation or omission of a legel or moral duty
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battery
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A dilberate physical attack upon a person
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qui facit per alium facit per se
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latin for "he who acts through another acts for himself"
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bioethics
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study of moral issues, questions, and problems arising in the practice of medicine and in biomedical research
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expert testimony
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a statement given concerning some scientific, technical, or professional matter by an expert, such as a physcian
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contributory negligence
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a patient's failure to act prudently and reasonably, or doing that which a reasonable person would not do under the same circumstances
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assumption of risk
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consent to treatment based on a full understanding of all possible risks of unpreventable results of that treatment
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medical etiquette
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conduct, courtesy, and manners that are customarily used in a medical office by medical professionals
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fraud
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an intentional perversion of truth for the purpose of inducing another in reliance upon it to part with some valuable thing beloinging to him or to surrender a legal right
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suspension
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to interrupt or discontinue a suit temporarily with the intention or resumption at a later date, or to ask for a continuance
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res judicata
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latin for "things decided" -that is, a matter already decided by judical authority
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proximate case
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that which in natural and continuous sequence, unbroken by any new indepedent cause, produces an event, and without which the injury would not have occured
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res ipsa loquitur
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the presumption or inference of negligence when an accident is otherwise unable to be explained on terms of ordinary and known experience
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breach of contract
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failure to achieve an agreed upon result, even when the highest degree of skill has been used
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must have license to dispense, prescribe or administer controlled substances
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narcotic license
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peer review
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medical research is often published in medical journals that are evaulated by members od the medical community
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admissions review
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under the Peer Review act of 1982, Peer Review Organizations are responsible for the review for appropriateness and necessity of putting a patient into the hospital by this process
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a physcian must have the patient's permission in writing to reveal any confidential information except
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gunshot wound
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Health Insurance Portability and Accountability Act
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(HIPPA) a federal regulation that requires health care professionals to protect the privacy and confidentiality of patients' health information
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"A physcian shall respect the law" is part of
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AMA code of ethics
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also known as medical malpractice
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professional negligence
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database management
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a system whereby large quanities of data can be accessed, searched, sorted, and arranged very rapidly by computer
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coding
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the process of changing words into numbers so that computers can be used in processing insurance claims
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full block style
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all lines will be at the left hand margin
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following the salutation of a business letter
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colon :
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a newsletter weighing less than one pound is considered ____
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third class mail
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business or handwritten mail that weighs less that 11 oz is known as ___
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first class mail
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fourth class mail
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(parcel post) used for bound printed matter, film, and sound recordings
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before placing a caller on hold
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ask if you may put the caller on hold, waot for caller to confirm they can wait, pbtaon a return phone number
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an incoming call should be answered by the ____
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third ring
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before answering an incoming call the medical assistant should
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smile
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when handling incoming mail the medical assistant should ___
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attach the envelope to the correspondence
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grammar
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the study of words and their relationship to other words in the sentence
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when handling a patient complaint ____
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take all complaints seriously and take thorough notes
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tecum
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midbrain
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locum tenems
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travelling physician
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inpatient
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a bed patient in a hospital
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adjuster
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a person who represents either party of an insurance claim
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claim
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a request for payment under an insurance contractor bond
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premium
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payment made periodically to keep an insurance policy in force
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provider
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a person or institution that gives medical care
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Capitation
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an insurance plan that provides a fixed payment per month to the physician, regardless of services rendered
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deductible
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the amount the insured must pay before policy benefits begin
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health maintenance organization
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an organization that offers health insurance at a fixed monthly premium with little or no deductible and works and works through a primary care provider
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catastrophic insurance
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health insurance that provides protection against the high cost of treating severe or lengthy illness or disability
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partial disability
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a disability from an illness or injury that prevents an insured person from performing one or more of the functions of his or her regular job
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subscriber
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one who belongs to an insurance policy
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benefits
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a sum of money provided in an insurance policy, payable for covered services
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coordination of benefits
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To prevent the insured from receiving a duplicate payment for losses under more than one insurance policy
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coinsurance
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the percentage of covered services that is the responsibility of the patient to pay
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major medical
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insurance that is meant to offset medical expenses resulting from a catastropnic illness
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usual, customary, and reasonable
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a doctor who agrees to accept an insurance companies pre-established fee at the maximumamount to be collected
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a notice of insurance claim or proof of loss must be filed within ___ or it can be denied
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time limit
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Medicare
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a health program for those 65 years old and older under social security
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Tri-Care
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a civilian health and medical program of the uniform services
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explanation of benefits
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a recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of benefits
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co-payment
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the insured pays a specific amount per unit of service and the insurer pays the rest of the cost
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comprehensive
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greater coverage of diseases or an accident, and greater indemnity payment in comparison eith a limited clause
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dread disease rider
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a rider added to the policy to provide additional benefits
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grace period
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an interval after a payment is due to the insurance company in which the policy holder may make psyments, and still the policy remains in effect
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assignment of benefits
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an agreement by which a patient assigns to another party the right to recieve payment from a third party for the service the patient has recieved
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hospital benefits
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payments for hospital charges incurred by an insured person because of injury or illness
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insurance agent
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an agent of an insurance company who solicits or initiates contracts for insurance coverage and services, and is the policyholder for the insured
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fee-for-service
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a method of charging whereby a physician presents a bill for each service rendered
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Tri-Care fiscal year
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October 1 to September 30
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W-4
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the number on the Eployees Withholding Exemption Certificate
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FICA provides benefits for ___
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social security
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as part of office bookkeeping procedures, the physician's bank statements should be reconciled with the ___
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checkbook
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ledger
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a record of patient's debits, credits, and balances
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deposit slip
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a form to itemize deposits made to savings or checking accounts
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to correct a handwritten error in a patient's chart, it is only acceptable to ___
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draw a line through the error, insert the correct information, date and initial it
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current procedural terminology
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a reference procedural code book that uses a numbering system developed by the AMA
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precertification
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a method used for determining whether a particular service or covered under patient's policy
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Internal Classification of Disease, 9th Revision, Clinical Modification
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used to code diagnosises
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"E" code designates ___
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classification of enviromental events, such as poisoning
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E/M codes are located in the ___ manual.
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CPT
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Which codes can modifiers ve added to, to indicate a procedure or service has bee altered in some way?
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CPT
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CMS-1500
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a form used by n-ninstitutional providers and suppliers to bill Medicare, Part B covered services