Ethics Test 2

Front 1

Can be described as the process by which an agency of government grants permission to an ind. 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

1. minimum age
2. evidence of good moral character
3. US citizenship

Back 2

usual minimum requirements

Front 3

the most restrictive form of government regulation

Back 3

licensure

Front 4

the process by which a competent authority grants permission to a qualified ind to perform certain specified activities that would be illegal without a license

Back 4

licensure

Front 5

3 components:
-- a grant of right to perform certain acts& to use a given title
-- the ind satifying those requirements that are necessary to continue the eligibility of the ind to practice optometry w/in the state
-- withdrawal of the rt to practice optometry or other disciplinary action initiated by the state for the failure of the ind to adhere to certain express requirements relating to personal & professional conduct

Back 5

licensure of optometrists usually embraces 3 components

Front 6

1. procurement of a license by fraud
2. unprofessional, dishonorable, immoral, or illegal conduct
3. performance of specific action prohibited by statute & malpractice

Back 6

violations

Front 7

is a form of gov title control that prohibits ind from employing a title rather than from engaging in a regulated occupation

Back 7

registration

Front 8

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

Back 8

certification

Front 9

a voluntary form of regulation that is NOT based on state law

Back 9

Certification

Front 10

it is established by a group to formulate standards & to recognize ind satisfying those standards

Back 10

certification

Front 11

-- used not only to document chronologically the care rendered but also to plan & evaluated tx

Back 11

record

Front 12

Duty to create & maintain optometric records

Back 12

The TN optometry board says

Front 13

personal
financial
social
medical

Back 13

4 types of data

Front 14

name, birth date, sex, martial status, next of kin, occupation, identification of personal physicians, other items needed for specific pt identification

Back 14

personal info

Front 15

names of your pt 's employer & health insurance company, the type of ins & ins policy #, medicare & medicaid # , other info that is needed to bill for services

Back 15

financial data

Front 16

race & ethnic background
family relationship
community activities
lifestyle
other info related to ur pt position in society that may indicated a need for special confientiality protection

Back 16

social

Front 17

chief complaint
medical & family histories
exam results

Back 17

medical

Front 18

1.support the decisions made in the pt's care

2.support the revenue sought from payers of health care

3. document the pt's illness or injury , response to tx, & care giver decisions

Back 18

AHIMA, roles of the legal health record are to

Front 19

1. record SHOULD be legible & complete
2. reason for the pt encounter should be CLEAR
3. ALL pertinent aspects of the pt health history should be recorded, along with idenitified health risk factors
4. appropriate family health hx should be recorded
5. ALL examination data,tests, tx, & outcomes of tx should be present
6. an assessment or clinical impression should be recorded
7. the plan for further care should be documented
8. reasons for ordering diagnostic or ancillary services should be CLEAR or easily interpreted
9. the progress or response to TX, along with changes in tx or revision of diagnosis should be documented
10. medical record should support the CPT & ICD-9 codes reported on the claim form
11. the medical record should identify the provider of care

Back 19

AOA guidelines

Front 20

1. HX
2. examination
3. Medical decision making
4. counseling
5. coordination of care
6. nature of presenting problem
7. time

Back 20

7 recognized components of the DGs used to describe E/M services provided
COMPONENTS OF AOA DOCUMENTATION GUIDELINES

Front 21

HX, examination, medical decision making

Back 21

are the key components in determining the level of E/M service

Front 22

counseling, coordination of care, nature of presenting problem, & time

Back 22

only apply when the pt encounter consists primarily of counseling & coordination of care

Front 23

TIME is the key or controlling factor

Back 23

in these cases

Front 24

who owns the records

Back 24

PRACTICE OWNER/ PARTNER/ SHAREHOLDER

Front 25

you would have legal rights to the records of the pt whom you personally treated

Back 25

independent contractor

Front 26

you would have NO LEGAL ownership rights over any of the pt records , even the records of pt you had treated

Back 26

employee working for the optometric practice

Front 27

Minor errors in transcription, spelling, etc

significant errors involving test results, etc

Back 27

2 kinds of errors

Front 28

should NOT be erased, obliterated or deleted

Back 28

MISTAKES

Front 29

use a line to cross out the incorrect entry
the enter the correction
initial
date, and time

Back 29

making the correction

Front 30

buy CL
pay additional fees
sign a waiver or release in exchange for a copy of the CL Rx

Back 30

prescribers cannot require pt to

Front 31

1. pt full name & address
2. CL pwr, manufacturer, BC or other appropriate designation & diameter when appropriate
3. quantity of lenses ordered
4. date of pt order
5. date & time of verification request
6. a contact person for the seller, including name, fax, phone #
7. a clear statement of the prescriber's regular sat. busines hrs if the seller is counting those hrs as business hr under the rule

Back 31

Verification

Front 32

Rx are verified automatically if the prescriber doesnt respond to the seller's verification request within 8 business hr

Back 32

business hr

Front 33

1. the law was passed to make health ins portable so that workers would not lose their health ins when they changed jobs
2. law included provisions intended to increase the use of electronic transaction & to increase established privacy protection for health care info

Back 33

HIPPA

Front 34

1. setting standards for electronic transaction
2. setting certain security standards
3. setting standards designed to ensure privacy of healthcare info

Back 34

DHHS has published 3 types of regulation

Front 35

ind & group plans that provide or pay the cost of medical care are covered entities

Back 35

HEALTH PLANS

Front 36

entities that process nonstandard info they receive from another entity into a standard

Back 36

health care clearinghouses

Front 37

1. to the ind
2. tx, payment, health care operation
3. opportunity to agree or object
4. incident to an otherwise permitted use & disclosure
5. public interest & benefit activities
6. limited Data set for the purpose of research, public health or health care operation

Back 37

Permitted uses & disclosures

Front 38

is a period of time established by statute, measured in yrs, within which a party can bring a lawsuit

Back 38

statutes of limitations

Front 39

let the master answer, the employeer is going to have to answer for the action of the employee, which in turn means that the optometrist can be directly sued in court by the pt for breaching the pt confidentiality, even though the OD made no disclosure

Back 39

respondeat superior

Front 40

1. keeping the pt confidences
2. giving timely notice of dz
3. rendering care regardless of the pt's financial status
4. responding to requests for emergency care
5. referring pt to other health care providers when appropriate

Back 40

doc - pt relationship

Front 41

one not created by the explicit agreement of the parties but inferred by the law as a matter of reason & justice from their acts or conduct, the circumstances surrounded their transaction making it a resonable, or even a necessary assumption that a contract existed btw them by tacit understanding

Back 41

implied contract

Front 42

writing a note in the pt record
by having the pt signing a form that is placed in the pt' s record

Back 42

2 ways to document pt refusal

Front 43

timing
communication
record keeping

Back 43

3 keys to terminate an doc-pt relationship

Front 44

it is essential that the relationship be terminated at a normal stopping pt & NOT in the middle of TX

Back 44

TIMIING

Front 45

that a doctor always terminate a professional relationship with a pt in writing

Back 45

COMMUNICATION

Front 46

means that the doctor must record the reason for terminating the professional relationship in the pt record

Back 46

record keepiing

Front 47

can occur when the doctor fails to see the pt at necessary intervals for proper tx of pt condition

Back 47

abandonment

Front 48

1. care was unreasonalble d/c by the doctor
2. the doc failed to arrange for care by another doc
3. the d/c of care was against the pt will
4. foresight indicated that d/c might result in physical harm to the pt
5. actual harm was suffered by the pt

Back 48

abandonment

Front 49

1. to ind
2. to DHHS

Back 49

a covered entity MUST disclose protected health info in only 2 situations

Front 50

1. all consumers are created equal
2. quality comes first
3. preserve what works
4. cost matter

Back 50

guiding principles for the consumer bill of rights & responsibility

Front 51

timely
fair to all parties
administratively simple
objective & credible
accessible & understandable to consumers
cost & resource efficient
subject to quality review

Back 51

internal and external complaint & appeal processes should be

Front 52

1. info disclosure
2 choice of provider & plans
3. access to emergency services
4. particpation in tx decisions
5. respect & nondiscrimination
6. confientiality of health info
7. compliants & appeals

Back 52

consumer bill of rights topics

Front 53

is one who reveals wrong doing in the organization to a public entity or someone in authority

Back 53

whistle blower

Front 54

the use of employment power with threats, mistreatment, intimidation & retailatory discharge

Back 54

abuse of pwr

Front 55

the use of discharge as a means of oppression

Back 55

retailatory discharge

Front 56

the right to receive accurate & easily understood info about the health plan, health care professional & health care facilities

Back 56

info disclosure

Front 57

the right to a choice of health care providers

Back 57

choice of providers & plans

Front 58

the right to receive screening & stabilization emergency services whenever & wherever

Back 58

access to emergency services

Front 59

right to know ALL your tx options and to participate in decisions about your care

Back 59

participation in tx decision

Front 60

the right to considerate, respectful & nondisriminatory care from ur doc, health plan rep, & other health care providers

Back 60

respect & nondiscrimination

Front 61

the right to talk in confidence with health care providers & to have ur health care info protected
right to review & copy ur own medical record & request that your physician amend ur record if it is Not accurate,relevant, complete

Back 61

confidentiality of health info

Front 62

right to fair,fast, & objective review of any compliant you have against ur health plan, docs, hospital or other health care personnel

Back 62

complaints & appeal

Front 63

right to receive a copy of an organization's bill of rights & responsibilities

Back 63

right to know pt rights

Front 64

an organization's document of pt rights & responsibilities should be viewed as a document with legal significance whether or not the state has adopted a similar code

Back 64

right to explanation of pt rights

Front 65

pts have a right to participate in all aspects of their care & they should be encouraged to do so

Back 65

right to participate in care decisions

Front 66

pt have a right to participate in all aspects of their care & they should be encouraged to do so

Back 66

right to participate in care decisions

Front 67

pt have a rt to receive all of the info necessary to make an informed decision prior to consenting to a proposed procedure or tx

Back 67

rt to informed consent

Front 68

right to refuse tx & be told what effect such a decision could have on their health

Back 68

right to refuse tx

Front 69

pt must be informed of their right to execute advance directives

Back 69

right to execute advance directives

Front 70

pt have a right to appoint a health care decision maker to make health health care decision when the pt becomes incapacitated or is unable to make decisions on his or her behalf

Back 70

right to designate a decision maker

Front 71

pt have a rt to expect that info regarding their care & tx will be kept confidential

Back 71

right to privacy & confientiality

Front 72

any restrictions on a pt's visitors, mail, telephone, or other communication must be evaluated for their therapeutic effectiveness & fully explained to & agree upon by the pt or pt representative

Back 72

rt to know restriction on rts

Front 73

rt to an intrepreter whenever possible

Back 73

rt to have special needs addressed