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27 Cards in this Set
- Front
- Back
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What is beneficence?
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The obligation of the healthcare provider to help people in need
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What is non maleficence?
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The duty of the healthcare provider to do no harm
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What is Justice?
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The responsibilty of the healthcare provider to treat all in the same fair manner.
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What is autonomy?
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The right of the competent person to choose a personal plan of life and action
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What is utilitarianism?
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Healthcare resources are allocated so that the best is done for the greastest number of people
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What is Veracity?
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The healthcare provider must be truthful and avoid deception
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What is Fidelity?
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The healthcare provider has an obligation to be faithful to commitments made to self and others
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What is malpractice?
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The failure of a healthcare professional to exercise such care as would a reasonably prudent healthcare professional under the same or similar circumstances
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What is Duty?
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-A relationship that exists between provider and patient
- A term that conveys a sense of moral commitment to someone or something. |
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What is Breach of Duty?
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Provider violates accepted standards when rendering care
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What is Proximate Cause?
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-Plaintiff establishes relationship between the breach and the injuries
-An event sufficiently related to a legally recognizable injury to be held the cause of that injury ie - giving clarithromycin to a client taking simvastatin...resulting in rhabdomyolosis |
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What is Occurrence Basis type professional liability insurance?
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Policy covers injuries that occur during the period the policy was active, regardless of whether the policy is renewed or continues to be in effect
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What is Claims-made type professional liability insurance?
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Covers the clinician only if the injury occurs within the policy period, and if the claim is filed during the period the policy is in effect - or when an uninterrupted "tail" insurance policy is in effect
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What is the Schedule I drug class?
What are some drugs included? |
Schedule i - Illegal for prescription
- Heroin, MDMA, PCP |
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What is the Schedule II drug class?
What are some drugs included? |
Schedule II - Legal to prescribe but significant abuse potential
- Morphine, Fentanyl, Methadone, Oxycodone, Methylphenidate, Anabolic steroids |
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What is the Schedule III drug class?
What are some drugs included? |
Schedule III - Includes medications with less abuse potential than the drugs or substances in scheules I or II
- Includes compounds with limtities of opioids such as hydrocodone, codeine and combinations including acetaminophen |
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What is the Schedule IV drug class?
What are some drugs included? |
Schedule IV - includes medications with low potential for abuse relative to the drugs in schedule III
- Ambien (sleep aids), benzodiazepines, phentermine |
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What is the Schedule V drug class?
What are some drugs included? |
Schedule V - includes medications or substances with low potential for abuse relative to those in schedule IV
-Anti-tussives, anti-diarrheals |
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What is medicare defined?
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Federally sponsored health insurance for the following:
- age => 65 years - age <= 65 years with certain disabilities - People of any age with ESRD |
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Medicare part A includes what?
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-Hospital Services, some post-hospital, some home health, hospice
-Religiously associated facilities |
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What is included in Medicare part B?
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Supplemental Insurance
-Outpatient services, home health -NP's can be reimbursed as long as services rendered are physican-like services, not RN services |
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What is included in Medicare Advantage (Part C/MA plans)?
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-Offered by private companies that are approved by medicare
-provide PPO or HMO services -provide part A & B coverage -usually includes a prescription drug benefit |
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What is included in Medicare part D?
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-Prescription drug coverage
-Must have part A & B to qualify for D -A premium is charged |
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What is needed for NP's to be reimbursed by Medicare?
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-NP's must be qualified and legally authorized in state services rendered
-Bill only for services deemed "medically necessary", required for symptom management, provided in accordance with accepted healthcare practice |
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Under the "Incident to" billing Medicare term, what is required for 100% reimbursement?
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-NP must be employed by MD (exceptions in rural areas)
-MD initiates treatment -Services provided by NP are under MD supervision |
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What is the purpose of HIPAA?
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To establish national standards for electronic healthcare transactions and national identifiers for providers, health plans, and employers
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What is the Administrative Simplification Compliance Act (ASCA) in regards to HIPAA?
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The ASCA amended HIPAA and requires that, since 2003, all claims be submitted to Medicare electronically except for certain circumstances
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