Insurance Today Ch 3

35 terms by KellieB 

Create a new folder

Advertisement Upgrade to remove ads

Review

Practice of Medicine is:

A Business

Primary goal of health insurance professional is

Complete & submit insurance claims, Conduct billing & collection procedures, to generate as much money for the practice as legally possible.

Malpractice lawsuite

A breach of medical care can result in:

The employer is ultimatley responsible for employee actions:

Loosley translated, the latin term respondeat superior means:

Negligence

Failur to excercise a reasobale degrww of care is referred to as:

Legal Contracts

Health Insurance policy & the relationship between a healthcare proveder & a patient are considered:

Making an offer

In terms of a contract law, when an individual completes an application for health insurance, he or she is:

Completing an acceptance

When the insurance company agrees to grant health insurance coverage to an inividual, this is called:

Consideration

The binding force in any contract that gives it legal status- the thing of value that each party gives to the other- is the:

Legal

For the contract to be enforceable, it must be:

Mentally competent

The parties to a legal contractual agreement must be:

Emancipated minors

Minors who are married or living separate and apart from their parents and not receiving any financial support from them:

Implied contract

The contract between a healthcare provider and a patient is referred to as:

Abondonment

Ceasing to provide care to a patient without following prudent steps is a breach of the physician/patient contract, referred to as:

Federal Privacy Act of 1974

The act that regulates disclosure of confidential information is the:

Federal Omnibus Budget Reconciliation Act of 1987 (OBRA)

The act of following current or former employees or dependants younger than age 65 to become eligible for Medicare because of end-stage renal disease is the:

Ethics

Standards of human conduct - sometimes called morals - of a particular group or culture are commonly known as:

Etiquette

Following the rules and conventions governing correct or polite behavior in society is called:

Health Record

A clinical scientific, administrative, and legal documentation of facts containing information relating to a patient's care and treatment is called a:

Written Consent

A health record is considered priviledged communication; information in it should not be disclosed without a patient's:

Appropriate addendum

If additional needs to be added to a patients record, it should be in the form of a:

Adequate and complete documentation helps to:

Determine the levels of service; Establish medical neccesity; Justify the fees charged.

Lack of proper documentation often results in:

Denied claims; reduced claim benefits.

Insurance portability

HIPPA's objective stating that employees cannot be denied health insurance coverage when moving from one group health plan to another is called:

Incidental disclosure

If two people who know each other meet inadvertently in a physician's reception area, HIPPA refers to this exposure:

Timeliness, according to the Joint Commision, is within ______ hours of the encounter.

24

Situations that do not come under the umbrella of the patient confidentiality include:

Communicable disease; The patient is being treated as a result of an on-the-job injury

Subpoena duces tectum

A legal document that requires an individual to appear in court with a piece of evidence that can be used or inspected by the court is called:

A breach of confidentially

What results when confidential information is disclosed to a third party without patient consent or court order?

Health insurance professional should be ________ in the area of the medical law and liability.

knowledgeable.

Medical laws regulating insurance are _____ the same from state to state.

not

Direct and indirect patient contact involves ethical and legal _________.

responsibility

In contract law, the promise to pay the premium is the ____________ of the individual seeking health insurance coverage

consideration

How long medical records are kept and stored and disposed of __________ from practices to practice and state to state.

varies

A written release of information is not necessary to process an __________for a patient's healthcare information they collect, maintain, use and transmit eclectronically.

insurance claim

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set