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39 terms

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

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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