Ethical And Legal T#2, P2

Front 1

Can be described as the process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competency necessary to insure that the public health, safety, & welfare will be reasonably well protected.

Back 1

Licensure

Front 2

The three usual minimum requirements for licensure:

Back 2

1. Minimum age
2. Evidence of good moral character
3. US citizenship.

Front 3

__________ is the most restrictive form of government regulation.

Back 3

Licensure

Front 4

The process by which a competent authority grants permission to a qualified individual to perform
certain specified activities that would be illegal if you did not go through the process.

Back 4

Liscensure

Front 5

Two commonly stated objectives of licensing laws are to:

Back 5

1. limit & control admission to the different
health care occupations
2. to protect the public from unqualified practitioners by promulgating &
enforcing standards of practice within the profession.

Front 6

Licensure of optometrists usually embraces 3 components:

Back 6

1. A grant of the right to perform certain acts & to use a given title, conferred upon those qualified individuals who satisfy the minimum requirements established by the state for the practice of
optometry.

2. The individual satisfying those requirements that are necessary to continue the eligibility of the individual to practice optometry within the state.

3. Withdrawal of the right to practice optometry or other disciplinary action initiated by the state for the failure of he individual to adhere to certain express requirements relating to personal & professional conduct.

Front 7

Licensing boards have authority to suspend or revoke the license of a health care professional found to have violated specified norms of conduct. Such violations may include:

Back 7

1. Procurement of a license by fraud;
2. Unprofessional, dishonorable, immoral, or illegal conduct;
3. Performance of specific actions prohibited by statute & malpractice.

Front 8

______________ is a form of government title control that prohibits individuals from employing a title rather than from engaging in a regulated occupation.

Back 8

Registration

Front 9

The state establishes standards that must be met in order for individuals to use these titles.

Back 9

Registration

Front 10

While these titles do not establish a monopoly like licensure, they do set individuals apart from other in their occupations.

Back 10

Registration

Front 11

_____________ is title control conducted by professions & trades in order to recognize individuals who have attained a superior level of competence or are highly qualified to perform a specialized area of practice.

Back 11

Certification

Front 12

_______________ is a voluntary form of regulation that is not based on state law.

Back 12

Certification

Front 13

It is established by a group to formulate standards & to recognize individuals satisfying those standards.

Back 13

Certification

Front 14

The process in which American Academy of Optometry grants certificates to those optometrists who successfully fulfill all requirements to be called diplomates.

Back 14

Certification

Front 15

Legal actions are often litigated _____ to _____ years after the patient received treatment.

Back 15

2 to 5

Front 16

A patient record consists of 4 types of data:

Back 16

Personal
Financial
Social
Medical

Front 17

Personal information is usually obtained during the first visit and includes 8 things:

Back 17

1. Name
2. DOB
3. Sex
4. Marital status
5. Next of kin
6. Occupation
7. Identification of personal physician.
8. Other items needed for specific patient identification.

Front 18

Financial data include:

Back 18

1. Name of patient employer and health insurance company.
2. Types of insurance and insurance policy numbers.
3. Medicare and Medicaid numbers.
4. Other info needed for billing services.

Front 19

Social data include:

Back 19

1. Race and ethnic background.
2. Family relationships
3. Community activities
4. Lifestyle
5. Other information related to your patient's position in society that may indicate a need for special confidentiality protection.

Front 20

Medical data from your patient's clinical record that is continuously maintained:

Back 20

1. Chief complaint
2. Medical and family history
3. Exam results

Front 21

The American Health Information Management Association (AHIMA) has developed useful guidelines for establishing components of a legal record. The 3 roles of a legal record are to:

Back 21

1. Support the decisions made in patient care.
2. Support the revenues sought from payers of health care.
3. Document the patient's illness or injury, response to treatment, and caregiver decisions.

Front 22

Guidelines of a legal record were developed jointly by the:

Back 22

1. American medical association (AMA)
2. Health care financing administration (HCFA)

Front 23

The AOA has participated in the legal record documentation guidelines development process since the ________ version.

Back 23

1997

Front 24

1. What are the 7 recognized components of the AOA Documentation Guidelines (DM) used to describe evaluation and management services (E/M):

When do the last four only apply?

Back 24

1. History
2. Examination
3. Medical decision-making
4. Counseling
5. Coordination of care
6. Nature of presenting problem
7. Time

Last four only apply when the encounter consists primarily of counseling and coordination of care. (In these cases time is the key factor).

Front 25

What are the 3 components of the AOA Documentation Guidelines (DM) used to describe evaluation and management services (E/M) that are key to determining the level of E/M service.

Back 25

1. History
2. Examination
3. Medical decision making

Front 26

If an optometrists refuses to comply with copying records at a patient request, who could you report to?

Back 26

1. State disciplinary agency
2. Office of civil rights of the US DHHS for potential HIPPA violation.

Front 27

What are two types of errors that generally occur with patient records:

Back 27

1. minor errors in transcription, spelling, etc.
2. significant errors involving test results, inadvertently omitted information, etc.

Front 28

What does the Federal and State freedom of information act require:

Back 28

Release of copies of patient records on demand of the patient.

Front 29

All optometrists must comply with the RX requirements of the ____________________.

Back 29

FTC Eyeglasses Rule

Front 30

When was HIPAA (Health Insurance Portability and Accountability Act) passed.

Back 30

1996

Front 31

What HIPAA provisions were not passed by congress and are left up to the DHHS to provide regulation?

Back 31

1. Setting standards for electronic transactions.
2. Setting certain security standards.
3. Setting standards to ensure privacy of healthcare information.

Front 32

DHHS issued the ________ ______ to implement the requirement of the HIPAA.

Back 32

Privacy Rule

Front 33

Organizations subject to the privacy rule are called ________________.

Back 33

covered entities

Front 34

Who is covered by the privacy rule?

Back 34

1. Health plans
2. Health care providers
3. Health care clearing houses.

Front 35

What information is protected under HIPAA.

Back 35

1. PHI (protected health information)
2. all "individual identifiable health information"
3. Demographic data that relates to the individual's past, present or future physical mental health or condition, the provision of health care to the individual, past, present or payment for providing health care to the individual.

Front 36

What are some examples of individually identifiable health information?

Back 36

1. Name
2. Address
3. Birth date
4. SS #