Bri goes to the optometrist wanting her prescription updated with no symptoms or indications for anything other than a routine exam. The doctor orders a CT scan, an x-ray, and refers her to an ophthalmologist. What principle is this?
Overtreatment
100
Fixed payment that patients pay for services
What is copay?
100
a program designed to cover uninsured children in families with incomes that do not meet the Medicaid requirement
What is S-CHIPS?
100
Employer sponsored, public programs, marketplace
What are methods to obtaining health insurance?
100
Discussing patient protected health information with an individual not involved in treatment
What is a HIPPA violation?
200
A patient is allergic to a drug that he is prescribed. What principle is this an example of?
Misuse of services
200
fixed amount that a beneficiary must pay out of pocket on a yearly basis
What is a deductible?
200
Federally funded program to ensure coverage to the elderly and some disabled individuals
What is Medicare?
200
Reimbursement based on quality improvement and cost control
What is pay for performance?
200
A part of a federally funded program that allows beneficiaries to enroll in an outside private plan
What is Medicare Part C?
300
A doctor, while in a rush, misdiagnoses a patient. This is an example of a...
Medical error
300
Beneficiaries can only receive care from in-network physicians. Emphasis is on primary care and usually requires referral to see a specialist.
What is an HMO?
300
a committee established to review and approve research involving human subjects
What is the IRB?
300
Uses prospective payment model and reimburses hospitals at a flat rate for inpatient hospital care
The insurance company is the payer and assumes risk for future medical cost for the beneficiary
What is fully insured?
400
Beneficiaries can receive care from out-of-network providers for a higher deductible
What is a PPO?
400
Non-government regulatory body that accredits hospitals and health care facilities
What is the Joint Commission?
400
Considers work of the physician, expense to the practice, cost of malpractice
What is a Relative Value Unit?
400
Goal is to communicate illness severity, medical problems, treatments, and potential issues to a new medical provider. Occurs when patients are passed to new providers.
What is patient handoff?
500
Primary care, maternity, prescription drug coverage, prevention and wellness
What is minimal coverage?
500
Federal agency responsible for improving access to healthcare by strengthening the health care workforce and health equity
What is the Health Resources and Services Administration?
500
Primary government agency responsible for health systems and outcomes research
What is the Agency for Healthcare Research and Quality (AHRQ)?
500
Considers changes in physician fees, GDP, and expenditures due to new laws and regulations
What is Medicare Sustainable Growth Rate?
500
Lack of transparency, lack of standardization, lack of coordination, overtreatment