Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

30 Cards in this Set

  • Front
  • Back
State Laws written for the purpose of governing the practice of medicine in all 50 states & originally enacted for quakery?
Medical Practice acts.
A valid out-of-state license is accepted as the basis for issuing a license in second state, without a re-exam is called?
This is when madatory credentialing process established by law at the state level that gives a right to practice?
This is voluntary credentialing process whereby applicants who meet specific requirements & receive a certificate?
Official authorization/approval for conforming to a specified standard?
Name 7 criterias that physician must meet to be granted a license?
1. Age 21 or older
2. Good moral Character
3. Grad. from medical school.
4. completed approved residency.
5. U.S. citizen of filed.
6. State resident
7. Passed all state board exams.
A system in which financing, admin and delivery of health care are combined to provide medical services to subscriber for a prepaid fee?
Managed care.
A health plan that combines coverage of health care costs/deliver of health care for prepaid premium?
HMO-Health maintenance org.
Remote consultation by patients w/physicians & health care professionals by tel., television or Internet?
A form of telemedicine that involves direct contact between patients & physicians over the Internet for a fee?
The term for the use of the Internet as a source of consumer info. about health & medicine?
Steps taken to minimize danger, hazard, and liability and malpractice lawsuits?
Risk Management.
Measures taken by health care providers/practitioners to uphold the quality of patient care?
Quality improvement or quality assurance (QI).
This act help workers keep insurance when they change jobs, protects confidential medical info. and minimizes fraud and abuse.
HIPP-Health Insurance Portability and Accountability Act of 1996.
A law that allows persons to bring civil actions on behalf of the U.S. government for false claims?
Federal Falss Claims Act
A form of practice in which the physician practices alone, assuming all benefits/liabilities?
Sole Proprietorship
When two or physicians share office space & employees, but practice individually?
Associate practice.
A form of medical practice where two or more parties practice together under a written agrement stating rights,obligations & responsibilities of each partner?
A medical manag system in which 3 or more licensed physicians share the collective income,expenses,facility,equipment, records & personal?
Group practice
The primary care physician who directs the medical care of managed care health plan members?
Gatekeeper physician (PCP).
Health care plan that allows members to seek health care from nonnetwork physicians, but pays for the highest benefits for care if given by the PCP?
Point-of-servic plan (POP).
A managed care plan that features whereby subcribers may see any in network health care provider without a referral?
Open Access.
A national health care fraud/abuse data collection prog. for the reporting & disclosure of certain actions taken against health care providers & practitioners?
Healthcare Integrity and Protection Data Bank.
A network fo independen physicians,hospitals who contract w/an insurance carrier to provide medical care at a discount rate to patient who are in the insurer's plan?
Boards that protect the health,safety and welfare of health care consumers?
Medical boards.
A body formed and authorized by law to act as a single person?
Describe two fedral acts that prohibit fraud in healthcare?
1.HIPPA-Health Insurance Portability and Accountability Act of 1996.

2. The Federal False Claims Act.
Who has the authority to revokea phyician's license?
Each State's Medical board.
What can a physician to lose his/her license?
1. Felony
2. Fraud
3. Personal/profession Incapacity.
Name the "Whistleblower" statue that deals with fraud and abuse in health care?
Federal False Claims Act