the law
MCO
reimbursement
employees
chance
100
patient expectations, defensive medicine, increased level of technology, numerous procedures reimbursed
What is the cause of increased health care costs since the 1960's
100
Organization that receives fixed annual fee for each member and provide benefits at specific sites
What is an HMO
100
Incentive to get patients in and out of hospital
What is DRG's
100
authoritarian, chain of command emphsized, manager centerd
What is classical management
100
expenses > revenue
What is negative margins, loss
200
healthcare providers order more tests to rule out possiblities
What is defensive medicine
200
Reimbursement plan that pays for services rendered, but after review for UCR(usual, customary, and reasonable) treatment and can deny payment if not
What is FFS, Fee for service, with utilization review
200
medicare reimbursement utilized by SNF
What is RUGs
200
Pay increases are awarded depending upon pre-established formula
What is a good management
200
large expenditures for expensive equipment that can be amortized over several years
What is Capital expense
300
Omission of reasonable and prudent act by a person under given circumstances
What is Negligence
300
Providers receive set amount/fee per month/year for each patient which is independent of number of visits or services provided
What is Capitation DRG's = hospital providers receive pre-determined amount dependent upon diagnosis and not the services provided or length of stay
300
coding system describing diagnosis
What is ICD-9
300
Self evaluation, significant accomplishments, areas for improvement and new goals
What an employee should do/consider before Performance appraisal
300
Profits are paid out to Stockholders and re-invest in the community through paying taxes
What is For Profit Healthcare providers
400
Altering the medical record, failure to monitor patients condition, failure to notify doctor about doctor changes, failure to provide a safe environment, failure to dispense medications correctly, failure to document timely and failure to follow P&P's
What is Negligent Tort or Unintentional Tort
400
hospitals paid fixed sum annually
What is global budget/payment per institution
400
reimbursement system that puts patients at risk for under treatment and early discharge
What is capitation and per episode reimbursement
400
includes employment history, education, professional affiliations
What is included in a Resume
400
individuals that are 65 or older or permanently disabled or have end-stage renal disease
Who is eligible for Medicare
500
An act that is intentionally committed knowing it will likely result in harm like battery, false imprisonment, Defamation, Fraud, Invasion of Privacy, and Embezzlement
What is Intentional Tort
500
Coding system which determines Medicare reimbursement depending upon number of minutes of therapy received by a patient at a Skilled Nursing Facility
What is RUG's
500
patient pay fixed fee for set of specific benefits
What is HMO
500
At meeting when Arriving early, asking hire date decision, remembering interviewers name are good characteristics and trying to be funny is not
What is appropriate at a job interview
500
Medicare, Medicaid, JCAHO, CARF, CMS
What are organizations which require accountability thru audits and evaluations
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