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NHA CCMA Certification study guide
Negligence - \Most common type of medical tort liability Defendant - \A person being sued Abandonment - \The person of a physician from the care of a patient with out reasonable notice of such discharge from the case by the patient is Assault - \An unlawful threat or attempt to do bodily injury to another is Reasonable care - \The healthcare worker is protected by law if it can be determined that he or she acted reasonable as compared with the fellow workers. Brcach - \The breaking of a law, promise,or duty Statute of limitations - \The time established for filling law suit Tort - \A wrong committed against another person or the person's property Plaintiff - \One who institutes a lawsuit Privileged communication - \Information given by a patient to medical personnel which cannot be disclosed without consent of the person who gave it Negligence - \Failure to do something that is reasonable person would do under ordinary circumstances that ends up causing harm to another person Defamation - \Injuring the name and reputation of another person by making false statements to a third person Contract -
\An agreement between two or more parties for the doing or not doing of some definite Incompetence - \Lack of physical or mental fitness Judgement - \The final decision of a court in an action or suit Respondeate superior - \Responsibility of an employer for the acts of an employee Non compos mentis - \A Latin term signifying that a person is not of sound of mind Emancipated minor - \A person who is no longer under the care,custody,or supervision of a parent Medical Grievance - \An impartial panel established to listen to and investigate patient's complaints about medical care or excessive feees is called a committee. Res gestae - \Latin for "things done;deeds",the facts and circumstances attendant to the act in question Deposition - \Testimony of a witness under oath and writtern down before trial for possible use when the case comes to trial Civil law - \A statute that enforces private right and liabilities,as differentiated from criminal law Breach of duty - \Violation or omission of a legal or moral duty Battery - \A deliberate physical attack upon a person qui facit per alium facit per se - \Latin for "he who acts through another acts for himself" Bioethics - \The branch of study of moral issues,questions,and problems arising in the practice of medicine and in biomedical research Expert testimony -
\Medical research is often published in medical journals that are evaluated by members of the medical community through a process Admissions - \Under peer review Improvement Act of 1982, Peer Review Organizations are responsible for the review for appropriateness and necessity of putting a patient into the hospital by a process is known as review. Forgery - \A fraudulent signature Ethics - \Are defined as what are right and wrong Bioethics decision - \The use of fetal tissue transplantation for research Gunshot wound - \A physician must have the patient's permission in writing to reveal any confidential information except for Unethical - \It is to deny treatment to an HIV infected patients. HIPPA - \A federal regulation that requires healthcare professionals to protect the privacy and confidentiality of patient's health information Health Insurance Portability And Accountability Act - \In health care field the acronym HIPPA stands for AMA codes of ethics - \The statement "A physician shall respect the law" is part of the Breach of confidentiality - \Which of these generally results from an act of carelessness, without an intent to harm Database management - \A system whereby large quantities of data can be accessed, searched, sorted, and arranged very rapidly by computer Software - \Technology that tells a computer what to do Hardware - \A computer monitor, hard drive, and printer
Delete - \The computer DEL command means Move the cursor right,left, up and down - \The computers directional arrow keys how easy the system is to operate - \Referring to computers, the term "user friendly" refers to Coding - \The process of changing words into numbers so that computers can be used in processing insurance claims At the left hand margin - \A business letter written in full block style will have all lines Backup - \Making a duplicate file to protect computer information from being lost Colon - \When writing a business letter, the salutations of a letter should be followed by which punctuation mark Third class mails - \A newsletter that weighs less than 1 lb would be considered Fax machine - \What office instrument is designed to receive and send printed documents via the telephone First class mail - \Business or handwritten mail that weighs less than 11 ounces Fourth class mail - \Parcel post used for bound printed matter, film & sound recordings Before placing a telephone caller on hold - \Ask that it is ok to put caller on hold, wait for caller to confirm they can wait, get a return phone number By the third ring - \An incoming call should be answered Caller name, return phone number, and date - \Is needed when taking a routine phone message
Health maintenance organization - \An organization that offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider Catastrophic - \Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities Outpatient - \A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient Partial disability - \An injury that prevents a worker from performing one or more of the regular functions of his job Preexisting condition - \A previous injury , disease or physical condition that existed before the health insurance policy was issued Subscriber - \One who belongs to a group insurance plan Benefits - \A sum of money provided in an insurance policy, payable for covered services Coordination of benefits - \To prevent the insured from receiving a duplicate payment for losses under more than one insurance policy Coinsurance - \When a patient has health insurance, the percentage of covered services that is the responsibility of the patient to pay Major medical - \Insurance that is meant to offset medical expenses resulting from a catastrophic illness Accident - \An unexpected event which may cause injury called Participating physician - \A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected Usual, customary and reasonable -
\Insurance plans that pay a physician's full charge if it does no exceed his normal charge or does not exceed the amount normally charged for the service Time limit or it can be denied - \A notice of insurance claim or proof of loss must be filed within a designated or Medicare - \A health program for people age 65 and under social security Tri-care - \A civilian health and medical program of the uniform services Workers's compensation - \A form of insurance paide by the employer providing cash benefits to workers injured or disabled in the course of employment is called Explanation of benefits - \A recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of payment on a claim is called Co-payment - \A type of insurance whereby the insured pays a specific amount per unit of service and the insurer pays the rest of the cost Comprehensive - \In insurance, greater coverage of diseases or an accident, and greater indemnity payment in comparison with a limited clause Dread disease rider - \A rider added to a policy to provide additional benefits for certain conditions is called Grace period - \An interval after a payment is due to the insurance company in which the policy holder may make payments, and still the policy remains in effect Assignment of benefits - \An agreement by which a patient assigns to another party the right to receive payment from a third party for the service the patient has received Extended care facility - \A skilled nursing facility for patients receiving specialized care after discharge from a hospital Hospital benefits - \Payment for hospital charges incurred by an insured person because of illness
Classification of environmental events, such as poisoning - \In insurance coding using and "E" code designates CPT Manuel - \E/M codes are located in the CPT - \Which codes can modifiers be added to, to indicate that procedure or service has been altered in some way? The CMS-1500 - \Form is used by non-institutional providers and suppliers to bill Medicare, Part B covered services. Emia - \Suffix for blood Dilate - \Medical term for opening wider or expanding UA - \Abbreviation for urinalysis Blood pressure - \Often omitted in pediatric examination Vastus Lateralis - \Preferred site for IM injection on infants to 2 years Erythrocyte sediment rate - \What is not included in the complete blood count? Coagulation - \Platelets or thrombocytes are involved in doing what in the blood? Chlamydia - \What STD coexists with gonorrhea? Orchidectomy - \A surgery to remove the testicle Cholecystogram - \Diagnostic procedure useful in determining the presence of gallstones Spirometry -
\Tool used to diagnose a respiratory disease Pulmonary function test - \A breathing test that measures airflow, volume, and capacity? Snellen - \Test used to measure distance of visual activity Earwax - \Cerumen is also known as? Invasion - \A procedure that involves creating an opening in the skin such as a surgical incision, or inserting a urinary catheter Electrolyte - \A panel of tests for carbon dioxide, potassium, chloride, and sodium Group A, beta-hemolytic streptococcus - \The organism that causes strep throat Height - \What is a factor that does not determine the dosage of medications? Lower leg - \Where can't a SQ injection be given? Adverse reactions - \Lists the effects of the drug Precautions - \States the possible unfavorable effects that the drug may have on a patient Complete, Clear, Concise, & Cohesive - \What are the Cs of communication? 7% - \What percentage of a message is actually communicated by the spoken word? Enunciation - \Speaking your words clearly and articulating them carefully Discharge summary - \Patients history of hospital admissions report Consultation -
Ather/o - \Plaque, Fatty substance Angi/o - \Vessel (blood or lymph) Arrhythmia - \Abnormal heart rhythm Fibrillation - \Abnormal muscle contraction in the heart Hyperventilation - \Excessive rate of breathing Atherosclerosis - \Hardening of the arteries cause by fatty deposits Cardiomyopathy - \Disease process of the heart muscle Consultation - \Elements of an H & P
