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76 terms

Chapter 2: Overview of the healthcare today

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Accepting assignment
Providers of medical services agreeing that the receipt of payment from Medicare for a professional service will constitute full payment for that service
Accreditation
Recognition that a health care organization has met an official standard
Acute care
Level of health care, generally provided in hospitals or emergency departments,for sudden, serious illnesses or trauma
Attending physician
Term applied to a physician who admits and is responsible for a hospital patient
Capitation
Payment method whereby the provider of care receives a set dollar amount per patient,regardless of services rendered
Case manager
Health care professional and expert in managed care who assists patients in assessing health and social service systems to ensure that all required services are obtained;coordinates care with doctor and insurance companies
Catastrophic coverage
Coverage at Medicare beneficiary has after reaching a certain amount of "out of pocket" monies paid for their medications during the temporary coverage gap. The beneficiary will pay a coinsurance amount.
Chief executive officer
Individual in direct charge of a hospital who is responsible to the governing board
Chiropractic medicine
Complimentary and alternative health care profession with the purpose of diagnosing and treating mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health
Chronic care
Care for illnesses of long duration, such as diabetes or emphysema
Community health
Concerned with the members of a community with emphasis on orienting and early detection of disease
Coverage gap
Sometimes called a "donut hole"; a temporary coverage gap in Medicare that occurs after the beneficiary has accumulated a certain amount of money in total prescription drug expenses.
Custodial care
Unskilled care given for the primary purpose of meeting personal needs, such as bathing and dressing
Diagnosis-related groups
Classsification system used to determine payments from Medicare by assigning a standard flat rate to major diagnostic categories. This flat rate is paid to hospitals regardless of the full cost of the services provided
Governing board
Group of community citizens at the head of the hospital organizational structure
Health maintenance organization
Organization that has management responsibility for providing comprehensive health care services on a prepayment basis to voluntarily enrolled persons within a designated population
Home health
Equipment and services provided to patient in-home to ensure comfort and care
Homeopathic medicine
Alternative medical system. A belief that "like cures like", meaning that small, highly dwiluted quantities of medicinal substances are given at higher or more concentrated doses would actually cause those symptoms.
Hospice
Supportive care for terminally I'll patients and their families
Hospitalist
Full-time, acute care specialist who focuses exclusively on hospitalized patients
Inpatient
Patient who has been admitted to a health care facility for at least 24 hours for treatment and care
Integrated delivery networks
Health care organizations merged into systems that can provide all needed health care services under one corporate umbrella
International statistical classification of diseases and related health problems
Detailed description of known diseases and injuries. Each disease(or group of related diseases) is described with its diagnosis and is given a unique code, up to six characters long. Published by the world health organization
Magnet status
Award given by the American nurses credentialing center to the hospitals that satisfy a set of criteria designed to measure their strength and quality of nursing
Managed care
The useof panned and systematic approach to providing health care, with the goal of offering quality care at the lowest possible cost
Medicaid
Federal and state program that provides medical assistance to the indigent
Medical savings accounts (MSAs)
Tax exempt bank accounts that are owned by an individual and managed by a financial institution.
Medicare
Government insurance; enacted in 1965 for individuals older than the age of 65 and any person with a disability who has recieved who has recieved social security benefits for 2 years (some disabilites are covered immediately)
Medicare supplement
Private insurance plan available to medicare-eligible persons to cover the costs of medical care not covered by medicare.
Merger
The combining of individual physician practices and small, stand-alone hospitals into larger networks
Naturopathc Medicine
Alternative medical system that proposes that there is a healing power in the body that establsihes,maintains, and restores health. Treatments include nutrition and lifestyle counseling, nutrional supplements, medicinal plants, exercise, homeopathy, and treatments from traditional chinese medicine.
Outpatient
Patient who receives care at a health care facility but is not admitted to the facility for 24 hours
Primary care physician
Sometimes referred to as "gate keepers," these general practitioners are the first physicians to see a patient for illness
Propietary
For profit
Resident
A graduate of a medical school who is gaining experience in a hospital
Robotic Surgery
The use of robots in performing surgery
Surfing the web
Using different websites on the internet to locate information
Triage
Nursing interventions. Classification defined as the establishing priorities of patient care, usually according to a three-level model: emergent, urgent, and nonurgent
Voluntary
Not for profit
Web Address (URL, or uniform resorce locator)
Keywords that when entered after "http;//www..." on the Interet will take the user to a specified location, referred to as a website.
ANA
American Nurses Association
ANCC
American Nurses Credentialing Center
CCM
certified case manager
CEO
chief executive officer
CFO
chief operating officer
COO
chief operating officer
DO
doctor of osteopathy
DRG
diagnosis-related group
DSU
day surgery unit
ECF
extended care facility
ED
emergency department
ER
emergency room
HIMS
health information management system
HMO
health maintenence organization
HO
house officer
ICD
International Classification of diseases and related health problems
LTC
Long-term care
MD
medical doctor
Neuro
neurology
OB
obstetrics
OR
operating room
Ortho
orthopedics
PACU
postanesthesia care unit
PCP
primary care physician
Peds
pediatrics
PPO
preferred provider organization
Psych
psychiatry
RR
recovery room
SAD
save a day (patient admitted the day of surgery)
SDS
same-day surgery (patient admitted on the day of surgery)
SNF
skilled nursing facility
Surg
surgical
TJC
The joint commission (formerly the Joint commission on accreditation of health care organizations [JCAHO])
UCR
usual, customary, and reasonable
WHO
World health organization
www
World Wide Web