AOTA NBCOT Prep

Define management

a process of how one works with other in order to achieve desired goals or stated outcomes

budget

a specific way to allocate where the org's money is spend, how much money is allotted to various expenses, and the money that comes into the org

National Provider Identifier

a ten digit number that each health care provider/practitioner must have who bills for service

Altruism

ability to place needs of individuals over their own

medicare part B coverst __ % if medically necessary OP therapy

80

POS

Sometimes allows pple to refer themselves to physicians who do not belong to the network

NBCOT requires certicifed ot practitioners to get __ of continuing ed every ____ to maintain certification

36 credit hours; 3 years

Resident Assessment Instrument

- classifies patients into untilization groups based on the number of minutes of therapy per week required by the client

4 keys to transitional changes

- recognize when changes need to occur -take step to plan for needed change -begin to implement change -spend time evaluating the change and results of the change

Name some general eligibility requirements for medicare:

-65yrs+ -(some pple under 65 w. disabilities) -People who have end stage renal disease

FOCUS PDCA

-Find out what type or process in org needs improvement -Organize a group that understance the process -Clarify issues with who hat when where -Understand why the process or procedure demonstrates inconsistency -Select a solution that may help remediate the problems -Plan for imprivng the process -Do the improvements -Check whether it was effective -Act to ensure improvement are maintained and improce the team perforamnace during the focus PDCA cycle

transactional leadership

-leader clarify roles and task requirments -provide followers +/- rewards contingent on successful performance

transformational leadership

-moticate other to reach highest potential -providing insipration to others towork effectively together to meet the goal of the group

what does entrepreneurship entail for OT

-opening a private practice -assumes risk associated with business

General reimbursment requirements under medicare

-referral from physician - services follow written care plan approved by physician -Services must be performed by qualified OTR and COTA w/ supervision -Services must be skilled and require OT expertise -Amount, duration, and intensity of services must be reasonable and necessary for condition

6 primary components of nonverbal communication

-voice volume, pitch, tone, emphasis of certain words - use of silence - gestures -body positioning, distance, bw pple communicating -eye contact -facial gestures

11 EBP conflict resolution solutions

1 encourage active communication 2 use I statements 3 use effective listening 4 use joint problem solving 5 stay positive 6 avoid uncontrolled emotions 7 comment on the idea rather than attacking people personally 8 try to come to a resolution 9 achive a solution mutually agreeable to all 10 stay focused on the topic 11 be aware of nonverbal communication

Name 3 categories of ethical problems

1) ethical temptation: personal struggle that you want something you know you shouldnt have 2) ethical distress: want to do an ethical thing but the facility rules make it difficult 3) ethical dilemma: you cant really tell what the right thing is

Medicare par a covers up to ___ days in a SNF if the person meets requirments such as needing at least __ days of therapy/wk

100; 5

Name 5 sanctions that can be taken against you if the ethics commission finds you guilty

A) reprimand (private letter) B) Censure ( public reprimand) C Probation of membership until you meet terms D) Suspension of AOTA membership E) Permanent revocation of aota memebership

Name the 3 agencies that oversee the OT profession.

AOTA, State lisensure board, NBCOT

Coding for type of service provided

CPT codes

prudence

Clinical and ethical reasoning skills, sound judgement, and reflection to make decisions within the OT practioners scope of practice

=Reusable medical equipment such as walkers, wheelchairs or hospital beds, generally covered by medicare about 80% of the way and client usually pays the rest

Durable Medical Equipment

Codes for diagnosis

ICD 10

part of a law that covers educational services for individuals 3-21

IDEA part B

part of law mandating educational services for ages 0-2

IDEA part C

What documentation type accompanies federally mandated early intervention services?

IFSP: Individualized Family Service Plan

Part of medicare that covers inpatient hospital stays, short term SNF, hospice, some home helath.

Medicare part A

Part of medicare that covers outpaitent care such as physcian visits, OPOT, some home health and some supplies and equipement

Medicare part B

__ is offered by a private company that contracts with medicare

Medicare part C, the medicare advantage plan

HMO

Prepaid organized delivery system where the organization and the primary care physicians assume some financial risk for the care provided to its enrolled members

Progressive, usually chronic conditons resulting from damage to the PNS, CNS, or both are classified as..

Neurodegenerative disorder

Clients on Medicare and Medicaid must have an _______ completed to receive home health services.

OASIS Outcome assessment information set

truth

OT must provide accurate info both in oral and written form

Procedural justice

OT shall comply with insitiutional rules and locale, state, federal, and international laws, AOTA documents applicable to the procession

Beneficience

OT shall demonstrate concern for the wellbeing and safety of the client

veracity

OT shall provide comprehensive, accurate, and objective information when respresent the profession

autonomy/ confidentiality

OT shall respect the right of pt to self determination

Fidelity

OT shall treat colleags and other professionals with respect, fairness, discretion, and integrity

False Claims act:

Protects the government from being overcharged or sold substandards goods and services; may result in fines or imprisonment

What defines a treatment as "medically necessary"?

Services are consistent with accepted standards of tx for that dx/condition

Medicare requires occupational therapy services to be ______ and ________ to be reimbursed

Skilled and Medically necessary

True or False: Third party payers may review and audit OT documentation

True

mission

an organizations core, underlying purpose or basis for its existence, focus, and actions

Dynaicm systems theory of management

analysis of systems or organizations that change; based upon chaos, complexity, and dynamical systems

according to the principle of ________ when a client refuses services, we should respect hat

autonomy

maintaining up to date assessment tools and providing evidence based care to ensure well being of client is and example of..

beneficence

provides helathcare to nearly 8 million children whose income qualifies for medicaid

childrens health insurance program

the lifestyle management programs are designed to assist clients over an extended period of time and provided meaningful occupational engagement as tolerated for clients with more chronic mental health conditions

consumer based nonprofit or health system based day treatment programs

dysmetria

decreased coordination of movement

Equality

desire to promote faireness in interaction w/ others

Medicare Abuse

directly or indirectly result in unnecessary costs to the medicare program

program evaluation

examines the therapeutic process and forms the basis for program improvements

justice

fair and impartial manner to individuals with whom they interact and respect and adhere to the applicable laws and standards regarding their area of practice

t/f ot is covered under CHIP in all states

false

t/f must be a military healthcare provider to bill tricare

false, just have to be a militry related services user

Not gossiping about your coworkers is an example of exercising...

fidelity

Federal employees health benefits program

health insurance for federal workers -coverage varies based on private plans with which the government contracts to administer health care services

Hierarchical vs heterarchical

hierarchical is top down, heterarchical is botton up; heterarchical process uses resources and inpute from everyone in the organization

akinesia

impariment in voluntary and spontaneous movement initiation leading to freezing especially during gait activities

Nonmalficience

intentionally refrain from causing harm

consultation

interactive process of helping others solve existing or potential problems by identifying and analyzing issues, developing strategies to address problems and preventing more problems from occurring

Anti- kickback statute

it is a criminal offense to knowingly or willingly offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by federal health care program

complexity theory

knowledge and understanding transcend linear systems to includ a multifaceted world view

continuing competence standard ( 5 categories)

knowledge, critical reasoning, interpersonal skills, performance, ethical practive

Medicare Fraud

making false statements or representing facts in a way to benefit payment

general eligibility for ___ is income under a certian level, pple with disabilities are elibible in all states. also covers early, periodic, screening, dx, tx for pple under 21

medicaid

The ____ act allows related services in school to bill medicaid if medically neccessary

medicaid catastrophic coverage act

OT standards of practice define the _______ for practicing OT

minimum standards

Chaos theory

minute changes lead to larger outcomes/effects

rigidity

muscle stiffness that impairs movement

Not showing up to workunder the influence and not being careless of safety precautions is one way to practice...

nonmaleficence

Perscription durs coverage , some medicare cost plans, some medicare private fee for service, and some medicare medical savings account plans are under part __ of medicare

part D

By following reimbursment guidelines and staying aware of how laws affect OT services you are exercising...

procedural justice

leadership

process of motivating pple to perform at their full potential w a focus on effectiveness

kinesics

related to body language

dyad

related to interpersonal communication w 2nd person

as a manager, hiring excellent employees is as important as ___ them

retaining

Bradykinesia

slowed motor movements

Volunteering at a health fair to promote health across all populations is an example of adhering to the principle of ....

social justice

we should reat clients fairlt no matter what their barground is in order to be ....

socially just

proxemic

study of spance, including personal spaces used during communication

Define advocacy

the act of speaking up or pleading the case of another

start up costs

the costs associated with opening a business

Freedom

the desire of clients must guide interventions

vision

the ideal state or ultimate level of achievement to which an organization aspires

continuous quality improvements

the management process that evaluates the arrangement of pple, equipment, and procedures in a series of tasks intended to repeatedly produce a desired end result

cash flow

the monetary flow of an org

operational costs

the ongoing costs of operating a business

PPO

the people who belong to it are able to go directly to a specialists without going through their pcp

strategic planning

the process of ensuring that an organizations current purpose/goals, contect to the plan and supports its mission

define marketing

the process of identifying and communicating w/ consumers through a set of strategies and techniques intended to attract, persuade, maintain, the consumers as purchaser of services and products

paralinguisitcs

the study of nonverbal communication

dignity

treating each client respectfully and as an individual by enablin client to engage in occupations that are meaningful, regardless of ability level

type of health insurance to cover active duty, service members, retireees, their families, survivors, and former spouses

tricare

T/F: if a compain about you is submitted to NBCOT, the you can face similiar consequence tiers to those of the AOTA ethics commission can take but in regards to your certification

true

T/F: the ethics commission does not have jurisdiction over you if you weren't an AOTA member at the time of the incident

true

t/f receiving ss automatically qualifies you for medicaid

true

By ensuring documentation is accuarate and truthful and that you dont plagarize you are exercising

veracity