AND SOLUTIONS GUARANTEE A+
✔✔Certification - ✔✔Process by which a nongovernmental agency validates, based on
predetermined standards, an individual nurse's qualifications for practice in a defined
functional or clinical area of nursing.
✔✔Standards of Practice - ✔✔Developed by the ANA, provides guidelines for nursing
performance.
They are rules or definitions of what it means to provide competent care.
✔✔State Nursing Practice Act - ✔✔Laws that define responsibilities of the nurse and
"scope of practice".
The range of activities and services as well as the qualifications for practice.
The acts are intended to protect patients from harm as a result of unsafe or incompetent
practice, or unqualified nurses.
Actual law in place.
✔✔Board of Nursing - ✔✔Protects the public's health and welfare by assuring that safe
and competent nursing care is provided by licensed nurses.
BON's achieve this mission by outlining the standards for safe nursing care and issuing
licenses to practice nursing.
✔✔HMO - ✔✔Health Maintenance Organization
Plan provides coverage for providers in their network.
A PCP is chosen from the network and this provider witll refer to you areas of need.
✔✔PPO - ✔✔Preferred Provider Organization
Selects own provider.
Does not require specific network or PCP referral for specialist.
✔✔Incident to Billing - ✔✔Are services supervised by certain non-physician
practitioners such as PA, NP, CNS, nurse midwives, or clinical psychologist.
, To qualify as "incident to" services must be part of your patient's normal course of
treatment, during which a physician personally performed an initial service and remains
active.
✔✔Medicare - ✔✔Federal health insurance program for people who are 65 and older,
certain younger people with disabilities, and people with end stage renal disease.
✔✔Medicare Part A - ✔✔Medicare plan that you receive if you are 65 or older, disabled,
or have ESRD.
✔✔Medicare Part B - ✔✔Voluntary program with monthly premiums.
Provides coverage for outpatient needs: labs, surgeries, doctor visits, wheel chairs,
walkers, etc.
✔✔Medicare Part C - ✔✔"Choice" plan that includes for additional services: vision,
dental.
Can keep Medicare Part A and pay for Medicare Part B.
✔✔Medicare Part D - ✔✔Prescription coverage
✔✔Medicaid - ✔✔Health care program that assists low-income families or individuals in
paying for long-term medical and custodial care costs.
Joint program, funded primarily by the federal government and run at the state level,
where coverage may vary.
✔✔ICD 10
(Internation Classification of Diseases) - ✔✔Used to indicate the diagnosis, including
family history disorders.
Each disease is assigned an ICD-10 code.
Global health information standard for mortality and morbidity statistics.
Increasingly used in clinical care and research to define disease and study disease
patterns, as well as manage health care, monitor outcomes and allocate resources.
✔✔CPT (Current Procedural Terminology) - ✔✔List of descriptive identifying codes that
are used to identify procedures and medical services.
It owned by by the AMA.