HCM Vocab Ch 3, 4, 5
Terms
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- APN (Advanced Practice Nurse)
- Nurses who have education and clinical experience beyond that required of an RN
- Allied Health
- are those clinical healthcare professions distinct from the medical profession and nursing profession. As the name implies, they are all allies in the healthcare team, working together to make the healthcare system function.
- generalist
- physicians who study general medicine
- LPN (Licensed Practical Nurse)
- Overseen by RNs
- NPP (Nonphysican Practitioner)
- Clinical professionals who practice in many of the areas in which physicians practice but who do not have an MD or a DO degree.
- nurse pracitioner
- Primarly work in primary care settings
- osteopathic medicine
- Emphasize the musculoskeletal system of the body such as correction of joints or tissues
- PA (Physician's Assistant)
- NPP part of the healthcare team who work in a dependent relationship with a supervising physician to provide comprehensive care
- RN (Registered Nurse)
- Registered Nurse
- specialist
- Physicians who specialise in certain areas of medicine
- administrative information system
- Designed to assist in carrying out financial and administrative support activites such as payroll, patient accounting, staff scheduling, materials management, budgeting and cost control, and office automation
- clinical information system
- involve the organized processing, storage, and retrieval of information to support pateint care delivery
- medical practice guidelines
- systematically develpoed protocols to assist practitioners in delivering appopriate health care for specific clinical circumstances
- technology assessment
- refers to the evaltion of medical technology to determine its safety, effectiveness, feasibility and indication for use and cost effectiveness
- telemedicine
- eliminated the requirement for in-person, face-to-face contact between the examining physician and the patient
- beneficiary
- insured is also referred to as ...
- capitation
- the provider is paid a fixed monthly sum per enrollee, often called a per member, per month
- coinsurance
- 80:20 ratio of cost sharing between the insurance plan and the insured is referred to as
- copayment
- the amount that the insured has to pay out of pocket each time health services are received after the deductable amount hasw been paid
- deductable
- the amount the insured must first pay before any benefits by the plan are payable
- cost sharing
- reduces the misuse of insurance benfits
- means test program
- program jointly financed by the federal and state governments
- per diem
- daily
- prospective reimbursment
- uses certain preestablished criteria to determine in advance the amount of reimbursement
- retrospect reimbursement
- based on costs that are directly related to length of stay services rendered and the cost of providng
- third-party payers
- insurance companies, mcos, blue cross/blue shield, and the government