MedicalNecessityPatient’sclinical/medicalinformation versusaccepted medicalreview criteria◦ Must seemreasonable andnecessaryMedicareOver 65, or thoseyounger with end-stage renaldisease (ESRD),or otherdebilitatingdiseasesSpeech/LanguageTherapistAssesses,diagnoses,treats, and helpsto preventdisorders relatedto swallowingPathologistMedical doctorwho examinestissue and bloodsamplesto determine theorigin or existenceof diseaseLicensedPracticalNursePractices withina defined scopeunder thesupervisionof a physician,dentist, or RNUnlicensedAssistivePersonnelPerforms morecomplicated tasksthan the certifiednursing assistant,including sterileprocedures, in somestatesRegisteredDietitianplans regularmenus anddevelops specialmenus tomeet the dietaryneeds of patientsRespiratoryTherapistEvaluates, treats,and cares forpatients withbreathingproblems due toheart and lungdiseasePhysicalTherapistProvides services tohelp improve orrestore functionand mobility, relievepain, and prevent orlimitpermanent physicaldisabilitiesInpatientHealthCareAcute carehospital or medicalsettingLong-term acutecare hospitalSkilled nursingfacilityCertifiedNursingAssistantPerformspatient careduties andassistsnursing staffNursePractitionerMasters-preparedregistered nursecertified in a specificarea of practice andidentified withadvanced practicelicenseHealthMaintenanceOrganization(HMO)Cost containment plan◦ Primary carephysicians (PCP) paidset amount per monthto care for members◦ Member seeks carein network, needsreferral to see aspecialistOutPatientHealthCareHealthdepartmentsMedical officeHome healthcareHospiceRegisteredNursePracticesnursing within adefined scopeunder thedirection of aphysicianPhysiciansAssistantEmployed by aphysician or hospitalto work closelywith the physicianand assist in directingpatient carePrimaryCareNursingOne nurse isresponsible forall aspects ofnursing care fortheir assignedpatientsMedicalLaboratoryTech.Examines andanalyzes body fluidsand tissues, matchesblood fortransfusions, andtests for blood levelsofmedicationsMedicaidIncome below povertylevel◦ Benefits differs bystate◦ Pregnant women,children, and thedisabled with anincome below povertylevels ClientCenteredCareAllows patients toachieve independencewithin the limits of theirdisability bypermitting them to havea voice in theirrehabilitation, schedule,goals, and method ofattaining those goalsRadiologistMedical doctorwho specializesin proceduresinvolvingx-rays andradiation therapyTeamNursingnurses andcertified nursingassistants (CNAs)or other assistivepersonnel thatprovide care for agroup of patientMedicalDoctorResponsible fordiagnosing and treatingdisease, illness,and injury; ordering diets,tests, medications,treatments, therapies,and procedures; anddirectingoverall care of patientsChaplinProvidesspiritual carefor patients inhospitals andhospicesettingsMedicalSocialWorkerplans for patients’needs afterdischarge; andarranges forneeded care suchas home healthcareOccupationalTherapistAssists patientswith disabilities todevelop, recover,ormaintain theirskills for dailyactivities and workPharmacistdistributesprescriptionmedications andadvises patientsand prescriberson the selectionSelf-payUninsured pts.may choosethis option andcan be offereda payment planManagedCareAny method offinancing andorganizing the deliveryof healthcare in which costs arecontained bycontrolling theprovision ofbenefits and servicesMedicalNecessityPatient’sclinical/medicalinformation versusaccepted medicalreview criteria◦ Must seemreasonable andnecessaryMedicareOver 65, or thoseyounger with end-stage renaldisease (ESRD),or otherdebilitatingdiseasesSpeech/LanguageTherapistAssesses,diagnoses,treats, and helpsto preventdisorders relatedto swallowingPathologistMedical doctorwho examinestissue and bloodsamplesto determine theorigin or existenceof diseaseLicensedPracticalNursePractices withina defined scopeunder thesupervisionof a physician,dentist, or RNUnlicensedAssistivePersonnelPerforms morecomplicated tasksthan the certifiednursing assistant,including sterileprocedures, in somestatesRegisteredDietitianplans regularmenus anddevelops specialmenus tomeet the dietaryneeds of patientsRespiratoryTherapistEvaluates, treats,and cares forpatients withbreathingproblems due toheart and lungdiseasePhysicalTherapistProvides services tohelp improve orrestore functionand mobility, relievepain, and prevent orlimitpermanent physicaldisabilitiesInpatientHealthCareAcute carehospital or medicalsettingLong-term acutecare hospitalSkilled nursingfacilityCertifiedNursingAssistantPerformspatient careduties andassistsnursing staffNursePractitionerMasters-preparedregistered nursecertified in a specificarea of practice andidentified withadvanced practicelicenseHealthMaintenanceOrganization(HMO)Cost containment plan◦ Primary carephysicians (PCP) paidset amount per monthto care for members◦ Member seeks carein network, needsreferral to see aspecialistOutPatientHealthCareHealthdepartmentsMedical officeHome healthcareHospiceRegisteredNursePracticesnursing within adefined scopeunder thedirection of aphysicianPhysiciansAssistantEmployed by aphysician or hospitalto work closelywith the physicianand assist in directingpatient carePrimaryCareNursingOne nurse isresponsible forall aspects ofnursing care fortheir assignedpatientsMedicalLaboratoryTech.Examines andanalyzes body fluidsand tissues, matchesblood fortransfusions, andtests for blood levelsofmedicationsMedicaidIncome below povertylevel◦ Benefits differs bystate◦ Pregnant women,children, and thedisabled with anincome below povertylevels ClientCenteredCareAllows patients toachieve independencewithin the limits of theirdisability bypermitting them to havea voice in theirrehabilitation, schedule,goals, and method ofattaining those goalsRadiologistMedical doctorwho specializesin proceduresinvolvingx-rays andradiation therapyTeamNursingnurses andcertified nursingassistants (CNAs)or other assistivepersonnel thatprovide care for agroup of patientMedicalDoctorResponsible fordiagnosing and treatingdisease, illness,and injury; ordering diets,tests, medications,treatments, therapies,and procedures; anddirectingoverall care of patientsChaplinProvidesspiritual carefor patients inhospitals andhospicesettingsMedicalSocialWorkerplans for patients’needs afterdischarge; andarranges forneeded care suchas home healthcareOccupationalTherapistAssists patientswith disabilities todevelop, recover,ormaintain theirskills for dailyactivities and workPharmacistdistributesprescriptionmedications andadvises patientsand prescriberson the selectionSelf-payUninsured pts.may choosethis option andcan be offereda payment planManagedCareAny method offinancing andorganizing the deliveryof healthcare in which costs arecontained bycontrolling theprovision ofbenefits and services

Healthcare systems - Call List

(Print) Use this randomly generated list as your call list when playing the game. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


1
I I
2
N N
3
O O
4
B B
5
N N
6
O O
7
I I
8
I I
9
O O
10
O O
11
G G
12
G G
13
B B
14
B B
15
B B
16
O O
17
O O
18
N N
19
B B
20
G G
21
I I
22
N N
23
G G
24
I I
25
G G
26
I I
27
G G
28
N N
29
B B
  1. I-Patient’s clinical/medical information versus accepted medical review criteria ◦ Must seem reasonable and necessary
    I-Medical Necessity
  2. N-Over 65, or those younger with end-stage renal disease (ESRD), or other debilitating diseases
    N-Medicare
  3. O-Assesses, diagnoses, treats, and helps to prevent disorders related to swallowing
    O-Speech/ Language Therapist
  4. B-Medical doctor who examines tissue and blood samples to determine the origin or existence of disease
    B-Pathologist
  5. N-Practices within a defined scope under the supervision of a physician, dentist, or RN
    N-Licensed Practical Nurse
  6. O-Performs more complicated tasks than the certified nursing assistant, including sterile procedures, in some states
    O-Unlicensed Assistive Personnel
  7. I-plans regular menus and develops special menus to meet the dietary needs of patients
    I-Registered Dietitian
  8. I-Evaluates, treats, and cares for patients with breathing problems due to heart and lung disease
    I-Respiratory Therapist
  9. O-Provides services to help improve or restore function and mobility, relieve pain, and prevent or limit permanent physical disabilities
    O-Physical Therapist
  10. O-Acute care hospital or medical setting Long-term acute care hospital Skilled nursing facility
    O-Inpatient Health Care
  11. G-Performs patient care duties and assists nursing staff
    G-Certified Nursing Assistant
  12. G-Masters-prepared registered nurse certified in a specific area of practice and identified with advanced practice license
    G-Nurse Practitioner
  13. B-Cost containment plan ◦ Primary care physicians (PCP) paid set amount per month to care for members ◦ Member seeks care in network, needs referral to see a specialist
    B-Health Maintenance Organization (HMO)
  14. B-Health departments Medical office Home health care Hospice
    B-Out Patient Health Care
  15. B-Practices nursing within a defined scope under the direction of a physician
    B-Registered Nurse
  16. O-Employed by a physician or hospital to work closely with the physician and assist in directing patient care
    O-Physicians Assistant
  17. O-One nurse is responsible for all aspects of nursing care for their assigned patients
    O-Primary Care Nursing
  18. N-Examines and analyzes body fluids and tissues, matches blood for transfusions, and tests for blood levels of medications
    N-Medical Laboratory Tech.
  19. B-Income below poverty level ◦ Benefits differs by state ◦ Pregnant women, children, and the disabled with an income below poverty levels
    B-Medicaid
  20. G-Allows patients to achieve independence within the limits of their disability by permitting them to have a voice in their rehabilitation, schedule, goals, and method of attaining those goals
    G-Client Centered Care
  21. I-Medical doctor who specializes in procedures involving x-rays and radiation therapy
    I-Radiologist
  22. N-nurses and certified nursing assistants (CNAs) or other assistive personnel that provide care for a group of patient
    N-Team Nursing
  23. G-Responsible for diagnosing and treating disease, illness, and injury; ordering diets, tests, medications, treatments, therapies, and procedures; and directing overall care of patients
    G-Medical Doctor
  24. I-Provides spiritual care for patients in hospitals and hospice settings
    I-Chaplin
  25. G-plans for patients’ needs after discharge; and arranges for needed care such as home health care
    G-Medical Social Worker
  26. I-Assists patients with disabilities to develop, recover, or maintain their skills for daily activities and work
    I-Occupational Therapist
  27. G-distributes prescription medications and advises patients and prescribers on the selection
    G-Pharmacist
  28. N-Uninsured pts. may choose this option and can be offered a payment plan
    N-Self-pay
  29. B-Any method of financing and organizing the delivery of health care in which costs are contained by controlling the provision of benefits and services
    B-Managed Care