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HCA 460 Midterm Exam Study Guide Solutions
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HCA 460 Midterm Exam Study Guide Solutions Contract - ANSWER-An agreement between two or more parties to perform specific services or duties First party - ANSWER-the person designated in the contract to receive a contracted service Second party - ANSWER-the person or organization providing the...

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  • November 4, 2024
  • 6
  • 2024/2025
  • Exam (elaborations)
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  • hca 460 midterm exam study guide solutions

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Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024




HCA 460 Midterm Exam Study Guide

Solutions


Contract - ANSWER✔✔-An agreement between two or more parties to perform specific services or

duties


First party - ANSWER✔✔-the person designated in the contract to receive a contracted service


Second party - ANSWER✔✔-the person or organization providing the service


Third party - ANSWER✔✔-the one who has no binding interest in a specific contract


Guardian - ANSWER✔✔-the person who is legally designated to be in charge of the patient's affairs. The

patient is a minor or an incompetent adult.


Breach of Confidentiality - ANSWER✔✔-the unauthorized release of confidential patient information to a

third party.


Reason behind breach of confidentiality - ANSWER✔✔-For providers to properly treat patients, the

patients must be willing to be examined and be touched by the medical professionals, thus revealing to

the providers not only why they sought medical advice, but also how the problem has affected them and

at times revealing their inner thoughts and feelings. If the patients are to open up to the health care




Copyright © Stuvia International BV 2010-2024 Page 1/6

, Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024




providers, they must be assured that they can control the release of the information given to the hc

providers.


Authorized release of information - ANSWER✔✔-a written permission to release necessary medical

information to an insurance company or other third party


Coordination of benefits clause - ANSWER✔✔-Restrict payment by insurance companies to more than

100 percent of the covered benefits.


The second insurer requires a statement of benefits paid by the primary insurer before paying its share

of the procedures performed.


Fraud - ANSWER✔✔-An intentional deception or misrepresentation that an individual makes, knowing it

to be false which could result in some unauthorized benefit.


Abuse - ANSWER✔✔-Incidents or practices while not considered fraudulent, are not consistent with

accepted sound medical, business or fiscal practices.


Fraudulent Claim's - ANSWER✔✔-Billing for services not rendered.


Different diagnosis (DRG)


Additional treatment


An increase in the charges.


Change the date of treatment.



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