Discussion 8 Assignment Project
Discussion 8 Assignment Project
1st page- Cover page
2nd page- Abstract (include what is the purpose of this project)
3rd page- Answering the following questions:
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Describe the differences among a sole proprietorship, partnership, and corporation.
1. Identify the major disadvantage of a sole proprietorship or a partnership.
2. How does a corporation differ from a partnership?
3. What conflicts exist when a MCO provides bonuses to physicians for providing fewer tests?
4th page- References
APA citation is required.
Chapter Overview
Chapter 1 covers a lot of ground and sets the stage for the rest of the text. The premise of this text is that the health care industry is a big business and what medical office professionals do on the frontline matters. Students’ understanding of the laws and issues related to working in a medical office will help them protect patients, their employers, and themselves from unnecessary risks. Discussion 8 Assignment Project
The scope of practice is a foundational issue discussed in Chapter 1. Because both state and federal law regulate the practice of medicine, it is necessary for students to be aware that there is an assortment of statutes and regulations that define the procedures they will be permitted to perform. This chapter also features discussion of the standard of care for medical professionals and laypersons and what it means to be a medical assistant.
Technical aspects of the law are useful for medical office professionals so they can understand the business aspects of working in a medical office. That is why this chapter includes discussion of the several types of legal entities, such as corporations, limited liability companies, and sole proprietorships, among others.
Another foundational issue is managed care organizations (MCOs), including HMOs, PPOs, and ACOs. It will be necessary for students to be familiar with the many facets of MCOs, including the focused objectives of reducing costs and delivering quality health care.
And, finally, this chapter features a discussion about telemedicine as an alternative health care delivery system that has become increasingly commonplace. The use of telemedicine is still in its infancy, but it has the potential to dramatically change the practice of medicine. Your students will learn that telemedicine is one more example of how health care has become big business.
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Flight_Ch01.pptx
Law, Liability, & Ethics For Medical Office Professionals
Sixth Edition
Chapter 1
The Big Business of Health Care and You
Copyright © 2018 Cengage. All Rights Reserved.
Copyright © 2018 Cengage. All Rights Reserved.
Objectives
Recognize importance of business aspect of health care industry
Recognize importance of your role on frontlines of health care industry
Identify different types of legal entities
Identify types of managed care delivery systems
Explain benefits of telemedicine
Copyright © 2018 Cengage. All Rights Reserved.
Introduction to the Business of Health Care (1 of 2)
In 2015, the health care industry accounted for almost 18 percent of all U.S. goods and services.
Know risks that can result in lawsuit or other unwanted action
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Introduction to the Business of Health Care (2 of 2)
Industry controls health care costs with competition and regulation
Competition has:
Led employers, governments, and health insurance companies to control escalating costs through regulation
Given rise to managed care organizations
Copyright © 2018 Cengage. All Rights Reserved.
The Frontline Is You
Frontline professionals communicate most frequently with patients
What you know and how you conduct yourself can influence patient’s experience
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The Importance of Legal Knowledge (1 of 3 )
Understand legal issues to avoid lawsuits and other risks
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The Importance of Legal Knowledge (2 of 3)
Medical office professionals held to higher standard of care than laypersons
Physicians and nurses held to standard of care established by:
State law
State licensing organizations
Registration boards at national or state level
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The Importance of Legal Knowledge (3 of 3)
Know the scope within which you can practice
Most medical office employees:
Are not licensed to practice medicine
Must carry out responsibilities without making medical decisions or acting outside area of expertise
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Personal Protection (1 of 3)
Ignorance of a law/regulation does not excuse violation
Know laws and regulations that govern profession
Understand basic principles of law to protect from:
Needless litigation
Loss of reputation, personal wealth, or earning power
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Personal Protection (2 of 3)
Reasonable standard of care is conducting ourselves in a responsible manner that will not cause harm
Physicians, nurses, and other health care professionals held to higher standard of care
Violations can lead to:
Medical malpractice lawsuits
Certificate or license revocations
Criminal charges (extreme cases)
For medical assistants, required standard of care is difficult to predict
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Personal Protection (3 of 3)
Medical office professionals are link between patient and physician
Positive patient interactions minimize nonmedical and nonlegal variables
May prevent legitimate complaint from developing into lawsuit
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Patient Protection (1 of 2)
Patients trust they are being treated by qualified health care professionals
State licensure laws define education and experience required to perform certain procedures
A license indicates that holder has basic minimum qualifications required by state for the occupation
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Patient Protection (2 of 2)
Privacy and confidentiality have ethical and legal bases
Requirements of privacy and respect for confidentiality must be met
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HIPAA
Federal law
Requires every health plan and provider maintain “reasonable and appropriate” safeguards to ensure health information confidentiality
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Patient Bill of Rights (1 of 2)
Patient Bill of Rights:
Conveys patients’ legal and ethical rights
Includes acknowledgment of patient’s right to choose treatment, to consent to treatment, and to refuse treatment
Not always required by law
Establishes standards, including ethical standards, for patient care
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Patient Bill of Rights (2 of 2)
Some rights that may be included:
To be treated with courtesy and respect in an environment free from discrimination
To be treated confidentially, with access to your records limited to those involved in your care or otherwise authorized by you
To be informed by your health care provider about your diagnosis, scheduled course of treatment, alternative treatment, risks, and prognosis
To refuse medical treatment, even if your physician recommends it
To be informed about the outcomes of care, treatment, and services that have been provided, including unanticipated outcomes
To be informed if medical treatment is for experimental research and to give your consent or refusal to participate
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Respondeat Superior
Physicians and corporate employers are liable for their own conduct
Physicians and corporate employers are vicariously liable for their employees’ conduct while working within scope of employment
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The Business Structure: Legal Entities
A business is a commercial/industrial establishment
Sole Proprietorship: Single physician, therapist, other licensed health care professional
Partnership: Two or more people who combine their work, money, and talents
Corporation: Group of people band together and create an artificial being/entity
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Health Care Delivery and Compensation Systems
Health Maintenance Organization (HMO)
With prepaid group practice (PGP) and individual practice association (IPA)
Preferred Provider Organization (PPO)
Associations of physicians and hospitals (providers) that contract with employers, insurance companies, or third-party administrators to provide comprehensive medical services on a fee-for-service basis to subscribers
Copyright © 2018 Cengage. All Rights Reserved.
Managed Care
Term describes system of integration of financing and delivery of health care to provide comprehensive services to an identified segment of the population. Discussion 8 Assignment Project
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Types of Managed Care Organizations
HMO
POS
EPO
PPO
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Telemedicine
Patient is in one location and the treating physician is in another
Use of video and transmission of data to the remote physician from the patient
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