Key Term's
The most efficient and effective way of accomplishing a task, process, or activity based on repeatable procedures that have proven themselves over time for large numbers of people.
Best practices
Prohibits payment in money or services to a physician in order to solicit business from that physician.
Antikickback Law
Patient's Information that is connected to their medical information
PHI
The U.S. Department of Health and Human Services
(abbreviation)
HHS
A physicians office draws samples from an average of 10 patients a day. The physician's office requests a box of 50 pairs of gloves per day from the laboratory. How would you handle this situation?
What law is this against?
This would be against the Antikickback law. The number of gloves the office is asking for is more than they would use/need in one day. Therefore, the gloves cannot be supplied to the physician's office.
Clinical Laboratory Improvement Act (CLIA)
specifications for quality control, quality assurane, patient test managment and personnel and proficiency testing.
Prohibits a physician from referring business to a laboratory in which the physician has a financial interest.
Stark Law
Provides the guidelines to keep PHI private and secure
HIPAA
The U.S. Health Insurance Portability and Accountability Act.
(abbreviation)
HIPAA
A phlebotomist is placed in a physician's office, and the phlebotomist has a large amount of extra time between draws. The phlebotomist likes to stay busy, so he helps the physician's office staff with checking in patient's and filing medical records. Is this phlebotmist putting the laboratory in a possible violation of the Antikickback Law?
the formalized monitoring of an organization's adherence to laws and regulations.
Prohibits knowingly submitting a false claim to the government for service not performed or charging for more services than were performed.
False Claims Act
Malpractice laws in civil court involve what law?
Tort Law
International Statistical Classification of Diseases Related Health Problems list of diagnosis codes for illnesses. Published by the American Medical Association.
(abbreviation)
ICD-10
The U.S. Office of the Inspector General.
(Abbreviation)
OIG
manual listing a coding of procedures and services performed by physicians. Published by the American Medical Association.
Current Procedural Terminology (CPT)
Prohibits claims for services not provided as claimed
Civil Monetary Penalties Law
intends to harm the patient. (Intentional)
Criminal Law
failure of a professional person to offer a standard of care, resulting in injury or harm to the patient.
Malpractice
Protected health information
PHI
Professional code of conduct related to treatment of patients. Ingrained in this a moral philosophy fo how a phlebotomist treats the patient.
Ethics
Includes specifications for quality control, quality assurance, patient test management, and personnel and proficiency testing.
CLIA
Injury was unintentional.
Tort Law
service that is reasonable and necessary for the treatment of the patient's illness.
Medical Necessity
Who can a phlebotomist release results too?
The ordering physician only.