CCMA NHA Module 1
Medical Doctors (MDs) - ANS-allopathic providers , most widely recognized type of doctor, they
diagnose illness, provide treatments, perform procedures such as surgical interventions, and
write prescriptions
Osteopathic Providers (DOs) - ANS-they complete requirements similar to those of MDs to
graduate and practice medicine, in addition to using modern medicine and surgical procedures,
DOs use osteopathic manipulative therapy (OMT) in treating their patients
Nurse Practitioners - ANS-provide basic patient care services, including diagnosing and
prescribing medications for common illnesses, NPs have extensive amount of clinical
experience, generally NPs focus on preventative care and disease prevention
Physicians Assistants - ANS-practice medicine under direct supervision of licensed MD or DO,
Pas are able to make clinical decisions and be responsible for a variety of services
Medical Laboratory Technicians - ANS-perform diagnostic testing on blood, body fluids, and
other specimens under the supervision of a medical technologist
Occupational Therapist - ANS-assist patients who have developed conditions that disable them
developmentally, emotionally, mentally, or physically
Allopathic - ANS-homeopathic medicine, categorized by an effort to counteract the symptoms of
disease by administration of treatments that produce the effects opposite to the symptoms
Osteopathic - ANS-type of medicine based on the concept that disturbances in the
musculoskeletal system affect other bodily parts, causing many disorders that can be improved
by various manipulative methods in combination with conventional medical, surgical,
pharmacologic, and other therapeutic procedures
Work Ethic - ANS-a set of values based on the moral virtues of hard work and diligence
Standard of Care - ANS-the degree of care competence expected in a particular circumstance
or role
Accountable Care Organizations (ACOs) - ANS-these groups of physicians, hospitals, and
other health care providers come together voluntarily to provide coordinated high-quality care to
their Medicare patients, when an ACO succeeds in delivering high-quality care and spending
health care dollars wisely, it will share the savings it achieves for the Medicare program
, Capitation (partial of full) - ANS-in this payment model patients are assigned a per-member,
per-month payment based on their age, race, sex, lifestyle, medical history, and benefit design,
payment rates are tied to expected usage regardless of how often the patient visits, like bundled
payment models providers have an incentive to help patients avoid high-cost procedure and
tests to maximize their compensation, under partial or blended capitation models only specific
types or categories of services are paid on a basis of capitation
Global Budget - ANS-this is a fixed total dollar amount paid annually for all care, however
participating providers can determine how money is spent, global budgets limit the level and the
rate of increase of health care cost, they typically include a quality component as well
Health Maintenance Organizations(HMOs) - ANS-this plan contracts with a medical center or
group of providers to provide preventative and acute care for the insured person, HMOs
generally require referrals to specialists as well as pre certifications and preauthorization for
hospital admissions, outpatient procedures, and treatments
Patient Centered Medical Home (PCMH) - ANS-in this care delivery model, a primary care
provider (PCP) coordinates treatment to make sure patient receives the required care when and
where they need it, and in a way they can understand
Pay For Performance - ANS-this reimbursement model compensates providers only if they
meet certain measures for quality and efficiency, generating quality benchmark measures
connects provider reimbursement directly to the quality of the care they provide
Preferred Provider Organization (PPO) - ANS-these plans have more flexibility than HMO
plans, an insured person doesn't need a PCP, but can go directly to a specialist without
referrals, although patients can see providers in or our of their network an in network provider
usually cost less
General Practitioners (GPs) - ANS-medical doctors who treat acute and chronic illnesses and
provide preventative care and health education to patients, takes into factor the biological,
psychological, and social aspects relevant to the care of each patient's illness
Family Practitioners - ANS-often care for the whole family from newborn to older adults, they
are familiar with a range of disorders and diseases, preventative care is their primary concern
Internists - ANS-provide comprehensive care of adults, often diagnosing and treating chronic
long term conditions, offer treatment for common illnesses and preventative care, have a broad
understanding of the body and it's ailments to be able to diagnose conditions and provide
treatment
Medical Doctors (MDs) - ANS-allopathic providers , most widely recognized type of doctor, they
diagnose illness, provide treatments, perform procedures such as surgical interventions, and
write prescriptions
Osteopathic Providers (DOs) - ANS-they complete requirements similar to those of MDs to
graduate and practice medicine, in addition to using modern medicine and surgical procedures,
DOs use osteopathic manipulative therapy (OMT) in treating their patients
Nurse Practitioners - ANS-provide basic patient care services, including diagnosing and
prescribing medications for common illnesses, NPs have extensive amount of clinical
experience, generally NPs focus on preventative care and disease prevention
Physicians Assistants - ANS-practice medicine under direct supervision of licensed MD or DO,
Pas are able to make clinical decisions and be responsible for a variety of services
Medical Laboratory Technicians - ANS-perform diagnostic testing on blood, body fluids, and
other specimens under the supervision of a medical technologist
Occupational Therapist - ANS-assist patients who have developed conditions that disable them
developmentally, emotionally, mentally, or physically
Allopathic - ANS-homeopathic medicine, categorized by an effort to counteract the symptoms of
disease by administration of treatments that produce the effects opposite to the symptoms
Osteopathic - ANS-type of medicine based on the concept that disturbances in the
musculoskeletal system affect other bodily parts, causing many disorders that can be improved
by various manipulative methods in combination with conventional medical, surgical,
pharmacologic, and other therapeutic procedures
Work Ethic - ANS-a set of values based on the moral virtues of hard work and diligence
Standard of Care - ANS-the degree of care competence expected in a particular circumstance
or role
Accountable Care Organizations (ACOs) - ANS-these groups of physicians, hospitals, and
other health care providers come together voluntarily to provide coordinated high-quality care to
their Medicare patients, when an ACO succeeds in delivering high-quality care and spending
health care dollars wisely, it will share the savings it achieves for the Medicare program
, Capitation (partial of full) - ANS-in this payment model patients are assigned a per-member,
per-month payment based on their age, race, sex, lifestyle, medical history, and benefit design,
payment rates are tied to expected usage regardless of how often the patient visits, like bundled
payment models providers have an incentive to help patients avoid high-cost procedure and
tests to maximize their compensation, under partial or blended capitation models only specific
types or categories of services are paid on a basis of capitation
Global Budget - ANS-this is a fixed total dollar amount paid annually for all care, however
participating providers can determine how money is spent, global budgets limit the level and the
rate of increase of health care cost, they typically include a quality component as well
Health Maintenance Organizations(HMOs) - ANS-this plan contracts with a medical center or
group of providers to provide preventative and acute care for the insured person, HMOs
generally require referrals to specialists as well as pre certifications and preauthorization for
hospital admissions, outpatient procedures, and treatments
Patient Centered Medical Home (PCMH) - ANS-in this care delivery model, a primary care
provider (PCP) coordinates treatment to make sure patient receives the required care when and
where they need it, and in a way they can understand
Pay For Performance - ANS-this reimbursement model compensates providers only if they
meet certain measures for quality and efficiency, generating quality benchmark measures
connects provider reimbursement directly to the quality of the care they provide
Preferred Provider Organization (PPO) - ANS-these plans have more flexibility than HMO
plans, an insured person doesn't need a PCP, but can go directly to a specialist without
referrals, although patients can see providers in or our of their network an in network provider
usually cost less
General Practitioners (GPs) - ANS-medical doctors who treat acute and chronic illnesses and
provide preventative care and health education to patients, takes into factor the biological,
psychological, and social aspects relevant to the care of each patient's illness
Family Practitioners - ANS-often care for the whole family from newborn to older adults, they
are familiar with a range of disorders and diseases, preventative care is their primary concern
Internists - ANS-provide comprehensive care of adults, often diagnosing and treating chronic
long term conditions, offer treatment for common illnesses and preventative care, have a broad
understanding of the body and it's ailments to be able to diagnose conditions and provide
treatment
