Ch. 5 Key Terms
Criminal Law
all criminal offenses in the Health Care Sector
Negligence
Medical negligence occurs when medical care providers fail to fulfill their professional obligations.
Slander
a false statement of fact, published to a third party
Consent Form
a process of communication between you and your health care provider that often leads to agreement or permission for care, treatment, or services
Denial of Services
a payer's decision to not pay for services rendered to a patient
Malpractice
occurs when a professional deviates from the standard of care as he or she is treating a patient.
Invasion of Privacy
Sharing the results of a test in front of family members or other patients without your permission
Defamation
a false statement of fact, published to a third party.
Contract
agreements between healthcare providers and insurance companies to furnish medical services to a specific patient population
Omnibus Budget Reconciliation Act (OBRA)
amended the Public Health Service and Social Security Acts to create the Agency for HealthCare Policy and Research.
Battery
occurs when someone inflicts physical harm on another in a medical setting
False Imprisonment
an allegation that a healthcare professional or someone employed by the provider acted intentionally to restrict a patient's movement unlawfully.
Libel
a defamatory statement in writing or other visible forms
Scope of Practice
Scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license.
Assault
a crime or attempting to cause immediate offensive physical contact or bodily harm that someone has the actual ability to cause and put the victim in fear of such harm or contact
Torts
when a medical professional acts in a negligent manner and injures someone in their care
Abuse
occurs when someone gives false information about illness in a child that requires medical attention, putting the child at risk of injury and unnecessary medical care.
Breach of Contract
damages may be given to place the patient back in the financial position that he or she would have been in had the physician performed the agreement.
Ethics
concerned with the obligations of the doctors and the hospital to the patient along with other health professionals and society
Pre Existing Condition
a health condition that exists before someone applies for or enrolls in a new health insurance policy.
Civil Law
he victim's compensation is being fought for, often without regard for punishing the defendant.
Power of Attorney
A medical power of attorney (or healthcare power of attorney) is a legal document that lets you give someone legal authority to make important decisions about your medical care
Living Will
Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself
Denial of Payment
the rejection by the alternative payment provider host due to the customer making a payment request having insufficient funds in the customer account to meet the value of the payment request
Termination of Coverage
when the consumer has chosen a plan and effectuated coverage by paying the first premium payment and ends the coverage effective after the date the coverage was effectuated