Chapter 2&3 Insurance Handbook/Chapter 4&5 Medical Terminology

39 terms by ellemireles

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HIPAA

Health Insurance Portability and Accountability Act of 1996

respiration rate

number of breaths per minute

sign

term for objective evidence of a disease

symptom

subjective evidence as perceived by the patient

percussion

term for tapping the body with the fingertips or fist to evaluate internal organs or to evaluate fluid in a body cavity

neoplasm

a tumor

remission

disappearance of the characteristics of malignant tissue

therapeutic

pertaining to therapy

prognosis

predicted outcome of a disease

connective epithelial muscular nervous

four main types of tissue

they are ductless

what is true of endocrine glands

superior

term that means uppermost or situated above

cranial

what body cavity contains the brain

antibodies

immunoglobulins that are formed to act against foreign cells or substances

ambulant

able to walk

anterosuperior

in front and above

spinal

pertaining to the spine

true

if the physician no longer wishes to treat a HMO or a PPO patient, termination is handled according to the same method that is used when discharging patients who are insured under private insurance

true

state laws may bar the use of a signature stamp

civil law

most legal issues of private health insurance claims fall under what law

policy holder subscriber member

in health insurance the insured is known as what

the health plan of the person whose birthday falls earlier in the calender year will pay first

if a child has health insurance coverage from two parents, according to birthday law

preexisting

conditions that existed and were treated before the health insurance policy was issued are called what

contract

insurance policy is a legally enforceable agreement called what

deductible

the amount that must be paid each year by the insured before policy benefits begin

co-insurance

when the insured is required to pay a percentage of the covered services' costs

tickler file

duplicates of all insurance claim forms are retained in the office pending file, also called a suspense, follow-up or

true

notes, papers, and memos regarding patient information should be disposed of using a shredding device

true

confidentiality between the physician and the patient is automatically waived when the patient is being treated in a workers' compensation case

true

the patient has the right to obtain a copy of his or her confidential health information

true

the correct coding initiative (CCI) detects improperly coded claims through the use of computer edits

confidential information

everything that is head, read and seen about or regarding a patient.

gunshot wounds child abuse extremely contagious diseases

confidentiality is automatically waived in cases of

the employee and employer could be brought into litigation by the state or federal government

what action could happen if an employee knowingly submits a fraudulent Medicare or Medicaid claim at the direction of the employer and subsequently the medical practice is audited

facts

nonpriviledged information consists of ordinary_____unrelated to the treatment of the patient

embezzlement

stealing money that has been entrusted to one's care is known as

theft false statement fraud obstruction

HIPAA amendments to the Criminal False Claims Act cover what four areas

verbal warning written warning suspension probation demotion termination criminal prosecution

list five of the disciplinary standards resulting from misconduct

privacy glass wait to dictate avoid phone conversations

list three things that can be done to avoid having patients hear confidential information regarding other patients

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