Define and describe CLIA

Stand for Clinical Laboratory Improvement Amendment

*proliferation of "black box" technology

*regulates all testing on humans for health purposes using minumin quality standards

*ensures accurate testing refardless of location

*Labs MUST enroll and meet all CLIA requirments

(personel, pt, quality controlm patient test management pre & post analytic, faculity administration, quality assessment)

*provide biannual surveys

What is HIPAA?

Health Insurance Portability and Accountability Act

*federal law passed  to protect individuals rights to privacy and confidentiality and assure the security of electronic transfer of personal information

 Why HIPAA?

*genetic advancements- patients cant be denied bc of known disease

*prevent marketing of unsolicited products or servises based on harvested marketing data

*hold violaters accountable for accidental or intentional interception of protected health info (PHI)

What are the objectives to the HIPAA privacy regulations for patients?

*give patients more control of thier health info

*set boundaries on use and disclosure of health records

*establish safegaurds for ppl who participate with healthcare to make sure they honor patients rights

*hold violaters accountable through civil and criminal penalities

*strike a balance when public responsibilities requires disclosure of some forms of data

What is OSHA?

occupational safety and health administration

*saves lives, prevents injuries , and protect health of americans workers 

*develop job safety and health standards and enforcing them through workers inpections

*maintaining and reporting and record keeping to keep track of job related injuries 

*provide training programs to increase knowlege about occupationsal safetly and health

What is JCAHO

Joint Commission on Accreditation of Health Care Organizations

*made of individuals from private medical sector to develop and maintian standards of quantity in medical facility

*no connection to US government & no legal enforcement power

*acceditation procedure to indidacte to the public that thier particular institution meets quality standards and its policies has taken on a real importance in the medical fiels despite the lack of offical government sanction

What is NCCLS (CLSI)

 National Committee for Clinical Lab Standards 

now called clinical lab standards institute

*used the FDA

*Global nonprofit, standards developing organizations that promotes the development  and use of voluntary consensus standards and guidelines within health care community

What is ADA?

Americans with Disabilities Act

*wide rangeing civil rights prohibits under certain circumstances discrimination based on disability

* employers must be sure disabled workers and accomidated 

What are CPT codes?

*current procedural terminology

*#'s assignened to every task and services a medical practioner may provide to a patient including medical, surgical, and diagnostic services

*the used by insurers to determine the amount of reimbursement that a practioner will recieve by an insurer

*enures uniformity

*thousands of codes updated annually 

*overseen by AMA

What is ICD Code?

International Classifcation of Disease Insurances code

*describes a clients medical condition or diagnosis

What is Indemnity?

*type of health insurance

*flexibility and oppurtunity to choose your own physician or hospital when you need healthcare without dealing with healthcare provider network

*prefered bc of traveling, prefered phsyicain who doesnt belong to mangaged healthcare network, if have serious illness, or if  u can afford the freedom of choice

What is POCT?

Point Of Care Testing

*poct lab testing preformed in the clinical setting non-lab healthcare professionals

Advantages: results available quickly instead of transporting to lab

Disadvantages: expensive not preformed by trained professionals

What is DRG?

Diagnosis Related Group

*system to classify hospital cases into one of approximately 500 groups

*developed for medicare as part of the payment system

*assigned by "grouper" system based on ICD, diagnosis, procedure, age , sex, discharge, status

*determine how mcuh medicare pays the hospital, since patients within each category are similar clincally and are expected to use same level of hospital resource

What is HCFA/CMS

previously Healthcare Financing Administration (HCFA)

now- Center for Medicare and Medicaid Services

*federal agency within the US department of Health and human sercvices (DHHS) that administers the medicare program

*contracting agencys for HMOS who seek direct contractors providers  for provsions of medicare benefit package

What is ASCLS ?

American Society for Clinical Lab Science

-preeminent organization for clincal lab science practitionersm provies leadershiip and promotes all aspects of clincal lab science practice, education, and management to ensure excellent, accessible cose-effective lab services for the consumers of healthcare