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Discussion 8 Assignment Project

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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    The Importance of Legal Knowledge (1 of 3 )

    Understand legal issues to avoid lawsuits and other risks

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    Patient Protection (2 of 2)

    Privacy and confidentiality have ethical and legal bases

    Requirements of privacy and respect for confidentiality must be met

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    HIPAA

    Federal law

    Requires every health plan and provider maintain “reasonable and appropriate” safeguards to ensure health information confidentiality

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    Types of Managed Care Organizations

    HMO

    POS

    EPO

    PPO

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

    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

     

     

    Copyright © 2018 Cengage. All Rights Reserved.

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