MASTER STUDY GUIDE — HIGH-YIELD Q&A
◉Morbidity. Answer: The incidence and severity of illness and
accidents in a population
◉Medigap. Answer: Health insurance sold by private insurance
companies to fill the "gaps" in original Medicare plan coverage
◉Medicare recovery audit program. Answer: A program to identify
and correct improper payments from Medicare to providers, with
the aim of preventing future improper payments by Medicare; a
common improper payment is for surgical services provided in the
wrong setting (inpatient instead of outpatient).
◉Magnet Recognition Program. Answer: A program developed by
the American Nurses Credentialing Center that recognizes
healthcare organizations for quality patient care, nursing excellence
and innovations in professional nursing practice; Magnet
designation is the ultimate credential for high-quality nursing
, ◉Long-term care. Answer: A continuum of maintenance, custodial,
and health services provided to the chronically ill, disabled or
mentally handicapped.
◉Joint Commission. Answer: The independent, not-for-profit
organization that evaluiates and monitors the quality of care
provided in hospitals
◉Interdisciplinary plan of care. Answer: A documented process that
includes the patient, the family, and all clinical disciplines involved in
planning and providing care to a patient from system point of entry,
throuhgout the entire acute care episode, and to the next level of
care
◉Independent Practice Association. Answer: A legal entity that
contracts with a group of independent physicians to provide
services to managed care organizations at a negotiated per capita
rate; the arrangement is usually not exclusive, so the physicians may
sign contracts with other managed care companies
◉Indemnity Plans. Answer: Traditional fee-for-service health plans
◉Hospitalist. Answer: A physician who manages broad categories of
hospitalized patients