Body of law derived from judicial decisions and opinions
What is Common Law or Case Law?
100
Has contractual responsibility for payment of medical expenses of others
What are Insurance companies? / What are third-party payers?
100
Assessment of the medical necessity for hospital level services
What is admission certification?
200
Health care business that includes multiple levels of care
What is an integrated delivery system?
200
Protect the public interest by providing guidance to the profession's members on what constitutes ethical conduct and on the level of conduct required from the profession's members
What are Codes of Ethics
200
Monetary compensation for loss or injury to person or property
What are damages?
200
A pre-determined amount that is the patient’s responsibility for medical expenses
What is co-pay?
200
Type of medical records analysis that takes place after services have been provided
What is retrospective review?
300
Intensity of services or resources required to diagnose and treat patient problems
What is level of care?
300
Acting on behalf of those who are not able to speak for or represent themselves
What is Advocacy?
300
Negligence or incompetence on the part of a professional
What is malpractice?
300
Actions related to ability to safely live independently
What are Instrumental Activities of Daily Living (IADL)?
300
Health care services guided by nationally recognized treatment protocols
What is evidence based practice (EBP)?
400
Group of health care providers contracted with a health insurance company
What is a network?
400
A form of personal liberty whereby an individual possesses sufficient mental ability to determine his or her behavior in accordance with a plan chosen and developed by himself or herself (CCMC, 2004)
What is Autonomy?
400
The party that brings a lawsuit in a civil action
What is a plaintiff
400
Assessment tool used in skilled nursing facilities to determine patient acuity and reimbursement rates
What is the Minimum Data Set (MDS)?
400
Clinical outcomes that must be met before client is ready for discharge
What is discharge criteria?
500
A different care setting that will safely provide needed services
What is an Alternative Level of Care?
500
Autonomy (self-determination), Beneficence (to do good), Justice (treat fairly) and ____________
What is Nonmaleficence (to do no harm)?
500
Court order commanding the appearance of a witness.
What is a subpoena?
500
These responses begin with the Letter C:
role of the case manager