Ancillary Services
College of American Pathologist (CAP)
What is one the Medicare approved accrediting organizations (AO) for clinical laboratories
The records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance use disorder education, prevention, training, treatment, rehabilitation, or research requires consent to disclosure patient identifying information or records outside the program, but don't forget the Part
What is Part 2 (42 CFR 2)
American Association for Ambulatory Healthcare (AAAHC),
What is AAAHC, an accreditation organization for ambulatory health care through nationally recognized quality improvement standards and a survey experience founded on a peer-based, educational approach to onsite review. (ASC)
Licensed clinicians must be licensed in the state where the patient is located unless the licensing board for that state expressly allows or an interstate compact is established between the states where the clinician is licensed and patient is located. The individual licensee is responsible for compliance with that state/jurisdiction’s laws
Can a licensed clinician provide treatment services to a patient located out of state?
Willamette University
Where did Bill receive his BS and MBA?
American College of Radiologist (ACR)
A plan or issuer may not impose limits on MH/SUD benefits unless, under the terms of the plan or coverage as written and in operation, any processes, strategies, evidentiary standards, or other factors used in applying the NQTL to MH/SUD benefits in a classification are comparable to, and are applied no more stringently than, those used in applying the limitation with respect to med/surg benefits in the same classification (e.g., medical management standards, network design, formulary design).
How are Mental Health Parity Non-Quantitative Treatment Limits (NQTLs) evaluated
ESRD Conditions for Coverage, but it's got to be isolation
What Medicare Conditions for Coverage/Participation require an isolation of HBsAg (Hepatitis B surface antigen) positive or reactive patients?
Situation, Background, Assessment, Recommendation
What is an SBAR
Evergreen State College, UC Berkeley, and Cal State San Bernardino
Where did Jon receive his degrees
1.) Clear Error (Cast on left leg, but order says right leg)
2.)Test Design (number of views, contrast or no contrast)
3.)Patient condition (patient cannot tolerate contrast)
4.) Radiologist is the treating physician (radiation therapy)
5.) Radiologist determines that an additional exam is needed due to an abnormal result, but the treating physician is not available (Diagnostic mammography)
Clue: Change is hard
Under what conditions can a radiologist change an imaging order?
Whether a voluntary or involuntary patient, in California mental health records are confidential. This means all information obtained in the course of mental health services or treatment is not to be shared by anyone without written patient authorization, with few exceptions.
What is CA MH Confidentiality Law
A free-standing medical facility does not require a state license in the KP Mid-Atlantic region, but its got to be urgent
What are Urgent Cares (UC)?
The Darrin was the first mass-produced fiberglass-bodied sports car in the world, meaning of course that it was also the first composite-bodied production car. But getting one was not a covered benefit.
What is the name of the car produced by Henry J Kaiser?
1.) Nike Inc.
2.) Boulder Hospital
3.) Alameda County Mental Health
1.) Where was Bills first job upon completing graduate school (Although he did have a summer job as a camp counselor for the Portland Trailblazers)
2.) Where was Chaise's first nursing job?
3.) Where was Jons first job after graduate school?
The testing of unknown samples. Samples are sent to participating laboratories on a scheduled basis (usually three times per year). After testing, the laboratory reports its sample results back. Grades are based on the results using the CLIA grading criteria and sends the laboratory their scores. CMS and accreditation organizations routinely monitor their laboratories’ performance
What is Laboratory Proficiency Testing?
It's complicated. The age of consent for substance use disorder (SUD) services varies by state, but in all KP Markets, a minor is able to independently consent to some SUD services. These laws do not specifically require a minor to consent to SUD services, the parent/legal guardian’s consent is sufficient (though this does not guarantee or require the minor to meaningfully participate in treatment unless involuntary treatment criteria are met, providers must exercise judgment to recommend clinically appropriate treatment the minor will be likely to participate in or complete).
Can a minor independently consent to or refuse SUD services?
Four, were additional for 2023. This is specific to ASC procedures. But don't forget your blanket.
How many procedures were added to the ASC covered procedures list for CY 2023?
Policies and Procedures
Chief Compliance Officer
Education and Training
Reporting
Monitoring and Auditing
Enforcement
Responding to Issues
What are the 7 elements of an effective compliance program?
Front Range Community College, Grand Canyon University, and Loyola Chicago
Where did Chaise receive her associates then BSN, and then Masters degree?
Nuclear Regulatory Commission (NRC) provides assistance to States expressing interest in establishing programs to assume NRC regulatory authority under the Atomic Energy Act of 1954, as amended. Section 274 of the Act provides a statutory basis under which NRC relinquishes to the States portions of its regulatory authority to license and regulate byproduct materials (radioisotopes); source materials (uranium and thorium); and certain quantities of special nuclear materials. The mechanism for the transfer of NRC's authority to a State is an agreement signed by the Governor of the State and the Chairman of the Commission, in accordance with section 274b of the
What are agreement states?
It depends. Masters Level therapists, including MFTs, LPCs, and LCSWs can independently deliver and bill patients for treatment services, including private pay, and commercial and Medicaid insurance plans. However, for Medicare only LCSWs are qualified master level licensed mental health providers. The others can provide treatment to Medicare members but only Incident To a physician or qualified non-physician provider (NPP)
Effective January 2024, all state licensed masters level therapists will be able to treat Medicare members without supervision. They will be recognized by Medicare as qualified providers.
Can all masters level licensed therapists independently treat and bill all insurance plans, including Medicare
Groups of Medicare-approved dialysis clinics in geographic areas designated by CMS to support patient care and engage in QI activities to protect ESRD beneficiaries, and its not a disorganization with a net
What are ESRD Networks?
1.) Owns and manages risk
2.) Oversees risks and compliance
3.) Provides independent assurance
What are the 3 lines of defense?
Cardiac: I am running after it, and its right next to the bed.
What was Chaise’s specialty as a bedside nurse?