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Abandonment

Physician's leaving a case before the patient is recovered

Arbitration

Resolution of case brought about by a unbiased 3rd party

Assault

Clear threat of injury

Battery

Operating beyond the patient given consent- Body contact without consent.

Compliance

Adherence to rules and regulations

Deposition

Testimony under oath usually OUTSIDE court room

Ethics

Standards of right and wrong conduct

Etiquette

Behavior and customs that are considered good manner

Express Consent

Patients written agreement to have a procedure preformed

Fraud

Depriving others of their rights by dishonest means

Good Samaritan act

Protection for the physician from liability of a civil damage in emergency case. Emergency situations is defined by the state in which the assistant is employed.

Implied consent

Patient permission for treatment when he or she enters the DR office

Liability

Legal Responsibly

Litigation

A lawsuit

Release of information

Authorization to send the patient's information to another physician

Statute of limitations

Time limit for a lawsuit to start

Statutory Report

Confidential information that must be submitted to the state department

Summons

Written notice sent to the defendant asking for an answer to the charges.

Federal Register

Legal Paper published every business day

Qui Tam

Allows a private citizen to file a law suite in the name of US Government

Program Transmittal

Contain new and changed Medicare policies and procedures.

Medicare Administrative Contractor

MAC = Third party payer that contracts with CMS

Record Retention

Storage of documents for a established period of time

HIPAA

Health Insurance Portability and Accountability Act

Medical Integrity Program

MIP= combat fraud waste and abuse

Unique Indentifiers

National Health Plan ID
National Provider Identifier -NPI
National Individual Identifier (ON HOLD)
EIN #

EIN

Employee ID # (issued by IRS)

NPI

Assigned to health care providers

Statue

Statutory law, laws passed by legislative bodies

Security

Involves the safe keeping of patient information by controlling access to hard copy and computerized records protecting information from alteration, destruction,tampering, or loss providing employees training in confidentiality of patient information and requiring employees to sign a confidentiality statement that details the consequences of not maintaining patient confidentiality.

Clearinghouse

performs centralized claims processing for providers and health plans

National Health Plan ID

Assigned to 3rd party payer and it has 10 digit numeric position.

Medical Practice acts

set of rules for obtaining a license explains who must be licensed to give health care covers the grounds on the licenses may be revoked

Overpayment

medicare pays too much to the provider for a claim

Demand Letter

is sent when Medicare administrative contractor determines that an overpayment was made

Subpoena

is an order of the court that requires a witness to appear at particular time and place to testify

Subpoena duces tecum

requires document to be produced

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