1.allied health services: phlebotomy and PT
2.before: the role of an MA is to assess the pt _____________ the provider visits
3.admin duties: - greet pt
- handle correspondence
- answer phone
4. clinical duties: - obtain history
- explain treatment
- draw labs
- imms
5.MD role: allopathic providers who diagnose, treat, perform procedures, and write
prescriptions
6.DO role (osteopathic): use osteopathic manipulative therapy (OMT) to treat
7.NP role: basic pt care services:
- diagnose
- prescribe
- preventative care
8. medical laboratory technicians: perform diagnostic tests on blood, body fluids, and
specimens
9. medical receptionist: check people in and out, answer phones, and perform filing and
faxing
10. occupational therapist: assist pts who have disabling conditions mentally, physically,
emotionally
11. pharmacy tech: assist pharmacist with duties that do not require expertise or a
license
12. physical therapist: assist patients in regaining mobility and improving strength and
ROM
13. radiology tech: use various types of imaging to assist provider in diagnosing disease
14. professionalism: the skills, behavior, and appropriate judgement that represent the
best qualities of a person in a specific profession
15. work ethic: a set of values based in the moral virtues of hard work and diligence
16. integrity: the quality of being honest and having strong moral principles
, .
17. scope of practice: the duties that can be delegated to MAs based on their
qualifications
18. standard of care: the degree of care or competence expected in a particular role
19. exam: in order to become licensed, a DO, MD, or PT must pass an ______
20. health care delivery: an organization of individuals and resources to deliver health
care services and meet health needs of populations
21. payment model: issues a single bundled payment to providers for all services
rendered to treat a condition 22 affordable care act: promoted new payment models
by testing new methods of health care delivery and creating a reimbursement
structure
23. accountable care organizations (ACOs): groups of care providers come together
voluntarily to provide high-quality care and shares saved money with Medicare
24. capitation: pts assigned a per-month payment based on age, sex, race, lifestyle, and
usage is predicted to calculate payments
25. global budget: a fixed total dollar amount paid annually for all care that limits the
rate of increase of health care cost
26. health maintenance organization (HMO): a plan that contracts with an organization
to provide preventative and acute care
27. patient centered medical home (PCMH): a PCP coordinates treatment to ensure pts
get required care
28. pay for performance: providers are compensated only if they meet measures for
quality and efficiency 29. preferred provider organization (PPO): have more flexibility and
pt can go directly to specialist without referral
30. internist: provide care for adults and treat long term conditions
31. ancillary services: services that meet a specific medical need for a specific
population
32. advance beneficiary notice (ABN): a form provided to a pt when medicare will likely
not pay for
their service
33. allowed amount: the max amount a third-party payer will pay for a service
34. coinsurance: the policyholder and insurance company share the cost of loss in a
ratio
, .
35. deductible: a specific amount of money a pt must pay before the insurance
company pays anything
36. explanation of benefits: a statement from carrier detailing what was paid, denied, or
reduced
37. participating provider (PAR): providers who agree to write off difference between
amount charged and approved fee
38. medicare: covers pts over age 65 by hospitalization (part A) or routine office visits
(Part B)
39. CHAMPVA: covers surviving spouses and dependents of military personnel
40. medicaid: provides health insurance to medically indigent (poor) pop. through cost
sharing
41. managed care: plans that provide health care in return for preset scheduled
payments
42. workers compensation: protects wage earners against cost of care resulting from
accident
43 private insurance plans: - blue cross blue shield
- aetna
- united healthcare
44. administrative simplification compliance act (ASCA): requires that claims to
medicare be submitted electronically
45. direct billing: an insurance carrier allows a provider to submit claims directly to
carrier electronically
46. clearinghouse submission: a provider submits all claims using software that audits
and sorts claims and sends them to insurance companies
47. computerized provider order entry (CPOE): provider can send orders electronically
and make referrals
48. abd: abdomen
49. ac: before meals
50. ACLS: advanced cardiac life support
51. AKA: above the knee amputation
52. ASA: aspirin
53. BE: barium enema