Healthcare Terminology and Concepts, Exams of Health sciences

Download Healthcare Terminology and Concepts and more Exams Health sciences in PDF only on Docsity! Naham Exam QUESTIONS AND ANSWERS 2024/2025 AIDET acknowledge, introduce, duration, explanation, thank you Press Ganey provides patient service satisfaction surveys, used for both public relations & performance improvement KPI Key Performance Indicator KPI Example Preregistration percentage, wait times, accuracy rate, pos collections, productivity HEAT Hear them out, empathize with the customer, apologize, take responsibility for actions PPE personal protective equipment EMTALA Emergency Medical Treatment and Active Labor Act Medicaid A federal and state assistance program that pays for health care services for people who cannot afford them. Medicare A federal program of health insurance for persons 65 years of age and older Medicare Part A Hospital insurance that covers inpatient and most skilled care. Mandatory copays for hospital days 21- 150, getting higher with each period of time. Medicare Part B outpatient services Medically necessary Medical services, procedures, or supplies that are reasonable and necessary for the diagnosis or treatment of a patient's medical condition, in accordance with the standards of good medical practice, performed at the proper level, and provided in the most appropriate setting. CHAMPVA Civilian Health and Medical Program of the Department of Veterans Affairs Anti-Kickback Statute Prohibits offering, paying, soliciting or receiving anything of value to induce or reward referrals or generate federal healthcare program business. IMM important message from medicare HIPPA Health Insurance Portability and Accountability Act TRICARE U.S. government health insurance plan for all military personnel Veterans Administration (VA) A federal agency that administers benefits provided by law for veterans of the armed forces. PHI Protected Health Information PHI examples name, address, phone number, admission and discharge dates, email address Health plan information, Accreditation defined as self assessment and external peer assessment process used by healthcare organizations to access their level of performance and to implement ways to continuously improve acute care pattern of health care in which a patient is treated for an acute episode of illness, for the sequelae of an accident or other trauma, or during recovery from surgery Acute Inpatient Care A level of healthcare delivered to patients experiencing acute illness or trauma. Acute care is generally short-term (<30 days). ABN Advanced Beneficiary Notice ABN a written notice that must be issued to a fee for service for services that are usually covered by mcr Accreditation official authorization or approval for conforming to a specified standard acute care medical attention to immediate problems acute inpatient care A level of healthcare delivered to patients experiencing acute illness or trauma. Acute care is generally short-term (<30 days). Advanced Directive Legal document where a patient gives written instructions about health care decisions in the future. TCPA (Telephone Consumer Protection Act) Rule prohibiting telephone solicitation calls to a residence before 8:00 am or after 9:00 pm, regulates telemarketing calls. It also is the authority to create the National Do-Not-Call List Specialty Clinics Provide care for special specific cases and is discharged following care Server a central computer dedicated to sending and receiving data from other computers (on a network). Restricted Disclosure Defined in the HITECH Omnibus of 2013, a patient's right to restrict PHI disclosure. respite care Short-term care provided during the day or overnight to individuals in the home or institution to temporarily relieve the family home caregiver. not reimbursable through medicare or medicaid power of attorney a document authorizing another person to act as one's agent or attorney with respect to the matters stated in the document Precertification preauthorization for hospital admission or outpatient procedures Presumptive Eligibility Hospitals and qualified physicians have the option of screening patients to see if they qualify for Medicaid. Based on the patient's self-attested answers to specific questions, they may be granted this temporary coverage but must complete the application process in order to keep the coverage. Pricing Transparency In healthcare, readily available information on the price of healthcare services that, together with other information, helps define the value of those services and enables patients and other care purchasers to identify, compare and choose providers that offer the desired level of value. propensity to pay A means to evaluate payment risk, determine the most appropriate collection policy and initiate financial counseling discussions. Based on a scoring algorithm, programs can predict likelihood of payment. Those with a history of bad debt can be adjusted or forwarded to collections at the earliest point possible. HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems JD Power not a patient satisfaction survey. a survey organization for patient access departments patient satisfaction survey use: collect data, analyze data,initate education,evaluate actions the joint commission a not-for-profit organization that evaluates and accredits different types of healthcare facilities 7 levels effective compliance level has a min of this many levels what number HFAP Healthcare Facilities Accreditation Program also known as obamacare champva is always secondary medicare and other ins plans except medicaid are primary to this military insurance Birthday rule The method of determining primary coverage for a dependent child, under which the plan of the parent whose birthday occurs first in the calendar year is designated as primary. Access keys naham developed a series of guidelines that identify performance criteria,explain how to measure them and provide good/better/best benchmarks for facilities to measure. These guidekines are called... largest expense item in patient access budget is: salaries Bed Management Assign beds to patients based on service and physician