Nursing 102 Module 2

Front 1

Third Party Payer

Back 1

The source that's responsible for a persons medical services. Medicaid, Medicare, Private Insurance, Veterans Administration

Front 2

Free for Service

Back 2

Patients were billed for actual services provided to them, which varied a lot depending on the provider fees, tests conducted, procedures needed, medications used. The more services provided, the more money the hospital would make.

Front 3

Prospective Payment System (PPS)

Back 3

PPS provides reimbursement for most hospital services on the patient's diagnosis at the time of hospital admission, not the actual services used by the patient. These are attempts to limit the money spent on healthcare.

Front 4

Health Maintenance Organization (HMO)

Back 4

A form of health care coverage in the US. You see doctors who have a contract with your HMO provider.

Front 5

Medicare

Back 5

Provides healthcare insruance to those who are 65 and older.

Front 6

Medicaid

Back 6

Federal Health Insurance for those who have low income and resources.

Front 7

Cost Shifting

Back 7

When services were increased to paying patients to absorb the cost for non paying patients who were treated for free or discounted services.

Front 8

Diagnosis Related Groups (DRG)

Back 8

The provider says we will give this amount of money to cover a certain condition based on the ICD-9 diagnosis code.

Front 9

Patient Dumping

Back 9

When a facility transfers a patient to another facility when they are able to provide necessary care. Now hospitals must stabalize the patient before they can be transferred. Providing care regardless of how they will receive payment.

Front 10

Length of Stay (LOS)

Back 10

Patients are no longer kept for longer than needed. Long term care hospitals are now available for long periods of stay.

Front 11

JCAHO (Joint Commission)

Back 11

Accredits hospitals to regulate care for medicare and medicaid.

Front 12

ICD-9

Back 12

International Classification of Diseases, Ninth Revision. Numbers assigned to medical diagnoses, used for billing purposes by PCP. Reimbursement varies based on the code.

Front 13

Magnet Status

Back 13

Award given by the American Nurses Crediting Center (ANCC) to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. Nursing service makes up the largest part of any hospital's budget and personnel.

Front 14

AHRQ (Agency for Health Care REsearch and Quality)

Back 14

Research to determine the best practices (evidence based practice) and tries to get Health care providers to follow.

Front 15

QA (Quality Assurance)

Back 15

Measures the quality of care within a hospital by standards the hospitals set. EX: the hospital may have a goal for every elevated ST, MI to be in CCL within 60 minutes of entry into the hospital.

Front 16

Nursing Diagnoses

Back 16

Standardized Statement about a patients health. Nursing diagnosis are based on data obtained after a nursing assessment.

Front 17

NIC (Nursing Interventions Classification)

Back 17

The Nursing Interventions Classification (NIC) is a comprehensive, research-based, standardized classification of interventions that nurses perform.

Front 18

NOC (Nursing Outcomes Classification)

Back 18

he Nursing Outcomes Classification (NOC) is a comprehensive, standardized classification of patient/client outcomes developed to evaluate the effects of nursing interventions.

Front 19

Health Care Financing Administration (HCFA)

Back 19

administers the Medicare program and works in partnership with state governments to administer Medicaid

Front 20

Phasmatodea

Back 20

walking sticks The walkingsticks resemble sticks, with long twig-like abdomens, and slender legs. The leaf insects, of the Timemidae family, are green or brown, and have broad flat abdomens that mimic leaves and stems. Some can change colors depending on temperature, light or humidity. Some Phasmids have wings, but most are wingless. In the tropics, walkingsticks can reach a length of up to 12 inches. All Phasmids are plant eaters and most are slow-moving, relying on their camouflage for protection. They can drop legs when attacked by a predator, and in some cases can regenerate them when they molt.

Front 21

Nursing Theory

Back 21

is the term given to the body of knowledge that is used to support nursing practice. In their professional education nurses will study a range of interconnected subjects which can be applied to the practice setting. This knowledge may be derived from experiential learning, from formal sources such as nursing research or from non-nursing sources.