Medical Terminology and Concepts, Exams of Advanced Education

Download Medical Terminology and Concepts and more Exams Advanced Education in PDF only on Docsity! NHA CCMA Exam With 100% Correct Answers 2023 Advance Beneficiary Notice (ABN) - Correct Answer-A form provided to the patient when the provider believes Medicare will probably not pay for services received Allowed Amount - Correct Answer-The maximum amount a third-party payer will pay for a particular procedure or service Copayment - Correct Answer-a small fixed fee paid by the patient at the time of an office visit Coinsurance - Correct Answer-a provision under which both the insured and the insurer share the covered losses, typically 80:20 deductible - Correct Answer-specific amount of money a patient must pay out of pocket before the insurance carrier begins paying Explanation of Benefits - Correct Answer-a form created by the insurance company to explain what charges were covered, denied, or need more documentation based on the claims submitted by the physician's office Participating provider (PAR) - Correct Answer-Providers who agree to write off the difference between the amount charged by the provider and the approved fee established by the insurer Medicare - Correct Answer-A federal program of health insurance for persons 65 years of age and older by Part A (hospitalization) or Part B (routine medical office visits) Tricare - Correct Answer-U.S. government health insurance plan for all military personnel CHAMPVA - Correct Answer-covers surviving spouses and dependent children of veterans who died as a result of service-related disabilities Medicaid - Correct Answer-provides health insurance to the medically indigent population through a cost-sharing program between federal and state governments for those who meet specific eligibility criteria Managed Care - Correct Answer-is an umbrella term for plans that provide health care in return for preset scheduled payments and coordinated care through a defined network of providers and hospitals CMS-1500 form - Correct Answer-Standard insurance form used by all government and most commercial insurance payers. - 33 blocks - divided into three section CMS-1500 Section 1 - Correct Answer-Carrier Block: contains the address of the insurance carrier and is located at the top of the form CMS-1500 Section 2 - Correct Answer-Patient/insured section: contains information about the patient or insured; includes boxes 1-13 CMS-1500 Section 3 - Correct Answer-Physician/Supplier Section: contains information about the physician or supplier: boxes 14-33 Supine Position - Correct Answer- Dorsal Recumbent Position - Correct Answer- Sims' Position - Correct Answer- Knee-elbow position - Correct Answer- Fowler's Position - Correct Answer- Lithotomy Position - Correct Answer- Epidural Injection - Correct Answer-epidural space of the spine Intra-arterial Injection - Correct Answer-injection into an artery (to break up clots) Intra-articular Injection - Correct Answer-injection into joint space Intradermal Injection - Correct Answer-Skin of the upper chest, forearms, upper pack. 5- 15º angle intramuscular injection - Correct Answer-deltoid, vastus lateralis, ventrogluteal muscles Intraosseous Injection - Correct Answer-Bone marrow Intraperitoneal Injection - Correct Answer-within the peritoneal cavity Intrapleural Injection - Correct Answer-pleural space (lungs) Intrathecal Injection - Correct Answer-Subarachnoid space (brain) Fat soluble vitamins - Correct Answer-A, D, E, K Thymus - Correct Answer-endocrine and immune Upcoding - Correct Answer-A fraudulent practice in which provider services are billed for higher procedural codes than were actually performed, resulting in a higher payment. Usual Fee - Correct Answer-Fee for a service or procedure that is charged by a provider for most patients under typical circumstances. Customary fee - Correct Answer-fee typically charged for a service in a particular geographic area Reasonable Fee - Correct Answer-The generally accepted fee a physician charges for an exceptionally difficult or complicated service. A charge is considered reasonable if it is deemed acceptable after peer review even if it does not meet the criteria for a customary fee or prevailing charges. Capitation - Correct Answer-System of payment used by managed care plans in which physicians and hospitals are paid a fixed, per capita amount for each patient enrolled over a stated period regardless of the type and number of services provided; reimbursement to the hospital on a per-member/per-month basis to cover costs for the members of the plan. Phantom Billing - Correct Answer-Billing for services not performed Who do you report to for Fraud? - Correct Answer-Office of Civil Rights (OCR) Who do you report to for unsecured HPI? - Correct Answer-Secretary of Health and Human Services What is the difference between eHPI and HPI? Who governs both? - Correct Answer- HHS - Correct Answer-U.S. Department of Health and Human Services U.S. Department of Health and Human Services - Correct Answer-provide essential services, including health care for low-income families, programs for older adults, and child services CMS - Correct Answer-Centers for Medicare and Medicaid Services OSHA - Correct Answer-Occupational Safety and Health Administration Red Cross - Correct Answer-An international organization dedicated to the medical care of the sick or wounded in wars and natural disasters Legal Aid Society - Correct Answer-One of a network of community law offices that provides free or low-cost legal assistance. TJC - Correct Answer-The Joint Commission Organization, establishing standards for hospitals/health related facilities NAACLS - Correct Answer-National Accrediting Agency for Clinical Laboratory Sciences ACS - Correct Answer-American Cancer Society AHA - Correct Answer-American Hospital Association Accountable Care Organization (ACO) - Correct Answer-a network of doctors and hospitals that voluntarily share responsibility for managing the quality and cost of care provided to a group of patients Patient-Centered Medical Home (PCMH) - Correct Answer-A model of primary care that provides comprehensive and timely care to patients, while emphasizing teamwork and patient involvement. ACO vs PCMH - Correct Answer-the ACO is primarily a value-based reimbursement model that incorporates "voluntary" collaboration among providers, whereas the PCMH is primarily a care delivery model involving significant collaboration as part of the certification process Cluster Scheduling - Correct Answer-the scheduling of similar appointments together at a certain time of day or week Wave Scheduling - Correct Answer-A certain # of patients are scheduled to arrive at the same time and are seen in which the order they arrive. Open Scheduling - Correct Answer-Patients are seen on a first come first serve basis. Walk-ins Farenheit to Celsius - Correct Answer-(F-32)/1.8 Fomite - Correct Answer-A physical object that serves to transmit an infectious agent from person to person Vector (medical) - Correct Answer-an animal that is a carrier of a disease or a medication Sanitization - Correct Answer-removal of pathogens from objects to meet public health standards Sterilization - Correct Answer-The process that completely destroys all microbial life, including spores. Disinfection - Correct Answer-A process that eliminates many or all microorganisms, with the exception of bacteria spores, from inanimate objects Ishihara Book - Correct Answer-used to test color vision. If the patient misses four or more, there might be a color deficiency tympanometry - Correct Answer-the use of air pressure in the ear canal to test for infections or presence of fluid in the middle ear Yellow Stopper color - Correct Answer-Sodium Polyanethol sulfonate (SPS) Yellow Lab Use - Correct Answer-for blood culture specimen collection in microbiology Light Blue Stopper Color - Correct Answer-Sodium citrate (anticoagulant) Light Blue Lab Use - Correct Answer-Coagulation studies Red Stopper Color - Correct Answer-Plastic: clot activator Glass: no additive (plain) Red Lab Use - Correct Answer-for serum determinations and may be used for routine blood donor screening and diagnostic testing of serum for infectious diseases Gold or tiger top (red-grey) Stopper Color - Correct Answer-- Serum separator tube (SST) - Clot activator - Thixotropic gel (creates barrier) Gold or tiger top (red-grey) Lab Use - Correct Answer-for serum determinations and may be used for routine blood donor screening and diagnostic testing of serum for infectious diseases Green Stopper Color - Correct Answer-Sodium Heparin and Lithium Heparin Green Lab Use - Correct Answer-for plasma determinations in chemistry Lavender Stopper Color - Correct Answer-EDTA (anticoagulant) Lavender Lab Use - Correct Answer-WHOLE BLOOD hematology determinations, routine immunohematology testing and blood donor screening Gray Stopper Color - Correct Answer-Potassium oxalate and sodium fluoride remittance advice (RA) - Correct Answer-a document that lists the amount that has been paid on each claim as well as the reasons for nonpayment or partial payment. used to pot payments to patient accounts ICD-10-CM - Correct Answer-3-7 characters used CPT Codes - Correct Answer-billing codes for medical, surgical and diagnostic services What to include in a referral - Correct Answer-- demographic - insurance information - provider's ID info - diagnosis - planned procedure or treatment Accounts receivable - Correct Answer-amount owed to the provider for the services rendered Accounts payable - Correct Answer-debt incurred but not yet paid Assets - Correct Answer-property of an individual or organization LIABILITIES + CAPITAL = ASSETS Liabilities - Correct Answer-items that are outstanding (debts) Capital - Correct Answer-what has been paid Malfeasance - Correct Answer-performance of an unlawful, wrongful act (EX: performing a procedure on the wrong patient) Misfeasance - Correct Answer-performance of a lawful action in an illegal or improper manner (EX: performing on the correct pt but doing it incorrectly) Nonfeasance - Correct Answer-failure to perform a task, duty, or undertaking that one has agreed to perform or has a legal duty to perform Living will - Correct Answer-A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes and under what conditions Durable power of attorney for health care - Correct Answer-A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decision-making capacity. MOLST - Correct Answer-Medical document that specifies which treatments will be allowed during end of life care. these orders move with the patient if they move facilities, and is bright pink Bundled Coding - Correct Answer-combining two or more codes into one. Doing so allows them to replace two codes with one overarching code and pay the provider only for the amount allowed under the more dominant code Electronic Health Record (EHR) - Correct Answer-An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across MORE THAN ONE healthcare organization Electronic Medical Record (EMR) - Correct Answer-An electronic record of health- related information about an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within a SINGLE healthcare organization. Order of Cleaning Instruments - Correct Answer-- Sanitization - Disinfection - Sterilization (chemical or autoclave) Isopropyl Alcohol - Correct Answer-used for phlebotomy procedures other than blood cultures Chlorhexidine - Correct Answer-used to clean skin before a blood culture draw Benzoin Tincture - Correct Answer-used to clean skin before applying an adhesive dressing Manifestation of Congestive Heart Failure - Correct Answer-shortness of breath, fatigue, and edema AC interference - Correct Answer-uniform spikes on an EKG caused by electrical interference Somatic Tremor - Correct Answer-artifact caused by voluntary or involuntary muscle movement Subcutaneous Injection - Correct Answer-- pinch the skin at the injection site to make sure the medication goes into the subcutaneous tissue - inject at a 45-90 degree ankle, bevel up - slowly inject the medication Weber ear test - Correct Answer-- used to determine if one ear is better than the other -ask the pateient if they hear the vibration louder in one ear than the other. Rinne test - Correct Answer-hearing acuity test performed with a vibrating tuning fork that is first placed on the mastoid process and then in front of the external auditory canal to test bone and air conduction CPT Code - Correct Answer-Procedural description with a five-digit identifying code number (can add 2 more digits that adds more information about it) Chain of Custody Guidelines - Correct Answer-- Drug screens - Forensic studies - blood alcohol levels - Parentage testing (paternity test) RACE (fire safety) - Correct Answer-rescue, alarm, confine, extinguish Cardiac event monitor - Correct Answer-A RECORDING DEVICE THAT CAN RECORD CARDIAC ACTIVITY FOR AT LEAST 30 DAYS - change the electrodes daily - continue with normal daily exercise Papule - Correct Answer-small, solid, raised lesion on surface of the skin Macule - Correct Answer-flat, colored spot on the skin (freckle) vesicle skin lesion - Correct Answer-blister Pustules - Correct Answer-Variously sized circumscribed elevations containing pus inches to centimeters - Correct Answer-1 in = 2.54 cm Fat soluble vitamins - Correct Answer-Vitamins A, D, E, K FLATPIG hormones (anterior pituitary) - Correct Answer-F- Follicle stimulating hormone L- luteinizing hormone (LH) A- Adrenocorticotropic hormone (ACTH) T- Thyroid stimulating hormone (TSH) Pi- Prolactin G- growth hormone Scratch test rules - Correct Answer-- at least 2 cm apart - 15 min wait after pricks Cc - Correct Answer-chief complaint Pc - Correct Answer-after meals Ac - Correct Answer-before meals Hordeolum - Correct Answer-sty; an acute infection of a sebaceous gland of the eyelid Hemoptysis - Correct Answer-coughing up blood Melena - Correct Answer-coffee ground appearance stool (from blood) hemotemesis - Correct Answer-vomiting blood Otalgia - Correct Answer-pain in the ear Tinnitus - Correct Answer-ringing in the ears Presbycusis - Correct Answer-age related hearing loss How far away does the patient stand for a Snellen chart vision test? - Correct Answer- 20 feet Curette - Correct Answer-spoon-shaped instrument used to scrape tissue from body cavities CHF manifestations - Correct Answer-shortness of breath, fatigue, and edema Abandonment - Correct Answer-provider lets a patient go without notice, short staffed Slander - Correct Answer-the action or crime of making a false spoken statement damaging to a person's reputation Assault - Correct Answer-threat or attempt to injure Battery - Correct Answer-unlawful touching of another person without consent defamation - Correct Answer-either slander or libel and damaged a person's reputation - slander: false spoken claim - libel: published false statement diaphoretic - Correct Answer-profuse sweating eupnea - Correct Answer-normal breathing dyspnea - Correct Answer-difficulty breathing fecal occult test - Correct Answer-test of stool specimen for the presence of minute amounts of blood - smear small layer onto stool test card - add developer onto the test card NOT the stool speciment - read the results after 1 min - blue color is positive Probe - Correct Answer-used to explore and navigate through tissue, cannot actually cut and remove stuff ( aka cannot dissect) Forceps - Correct Answer-grasping and clamping tissues Scissors - Correct Answer-used for dissecting Metformin - Correct Answer-Type 2 diabetes Zolpidem - Correct Answer-ambien. used to treat insomnia Clonazepam - Correct Answer-Klonopin, anticonvulsant Lisinopril - Correct Answer-propranolol. antihypertensive Heprin - Correct Answer-warphrin. anticoagulant Diphenhydramine - Correct Answer-Benadryl. Antihistamine Dextromethorphan - Correct Answer-Delsym. Antitussive Statins - Correct Answer-drugs used to lower cholesterol in the bloodstream Acyclovir - Correct Answer-Antiviral Nystatin - Correct Answer-Antifungal Esomeprazole - Correct Answer-TUMS. Antacid (PPI) Albuterol - Correct Answer-Bronchodilator Sumatriptan - Correct Answer-Imitrex. Migraine Syphilis Bacteria - Correct Answer-Treponema pallidum Remittent Fever - Correct Answer-Fluctuating, remains elevated and does not return to baseline Intermittent Fever - Correct Answer-Fluctuating fever that returns to or below baseline then rises again DKA Symptom - Correct Answer-Breath that smells like Acetone Immunity from breast milk - Correct Answer-passive Maslow's Hierarchy of needs- spontaneity - Correct Answer-self actualization, level 5 immunoglobin - Correct Answer-protein in the blood associated with antibodies is tardive condition - Correct Answer-slow onset 2-15 mL - Correct Answer-volume range for blood collection tubes Bacillus - Correct Answer-Rod shaped bacteria (causes tuberculosis) Purchase Order - Correct Answer-before buying supplies you should fill out this Thrush - Correct Answer-a fungal infection in the mouth and/or throat caused by Candida albicans and manifesting as white patches and ulcers Capillary Collection from an infant - Correct Answer-... Heart Rate from EKG - Correct Answer-1500/ # of boxes between 2 successive R waves Block Letter Format - Correct Answer-the commonly used format in which all letter parts begin at the left margin Modified Block Letter Format - Correct Answer-- Date sign off and signature start at the center of the page - paragraphs and subject line are indented Semi- block format - Correct Answer-All elements are left-aligned, except for the beginning of each paragraph, which is indented five spaces Simplified Block Letter - Correct Answer-- no salutation or closing - every paragraph is indented and has a blank line in between