Deck 3: Legal Concerns and Insurance Issues

Question 1

Please check all of the following things that an athletic trainer can do in order to reduce the risk of litigation.

A) Create an emergency action plan that will be reviewed every 3-5 years
B) Keep factually accurate and timely records that at minimum documents the patient's injury
C) Follow the express orders of a physician at all times
D) Permit an injured player to participate once they look better
E) Use common sense when making a decision about a patient's health and safety
F) Document efforts to create a safe training environment
G) Work to establish good working relationships with the athletes, parents, patients, clients, and coworkers
H) Obtain written consent from the team doctor to treat minors
I)Be aware of the limitations of their personal liability insurance
J) Only use modalities that state law permits
K) Have a written detailed job description

Answer 1

Follow the express orders of a physician at all times
Use common sense when making a decision about a patient's health and safety
Document efforts to create a safe training environment
Work to establish good working relationships with the athletes, parents, patients, clients, and coworkers
Be aware of the limitations of their personal liability insurance
Only use modalities that state law permits
Have a written detailed job description

Question 2

Please check all of the items that an Athletic Trainer can bill for based on procedure codes.

A) Aquatic therapeutic exercise
B) Ultrasound
C) Suturing
D) Prosthetic training
E) Nutritional consultation
F) Counseling
G) Massage
H) Spinal manipulations
I) Dry needling

Answer 2

Aquatic therapeutic exercise
Ultrasound
Prosthetic training
Massage

Question 3

When submitting documentation for billing what needs to be included? Please check all that apply:

A) An impression or diagnosis
B) Monthly progress notes
C) Patient updated medical history form
D) Copies of weekly treatment records
E) Copies of their physical
F) Diagnostic test results

Answer 3

An impression or diagnosis
Patient updated medical history form
Diagnostic test results

Question 4

An athletic trainer decides to suture an athlete's head wound which is against the state practice act. What type of legal concern is this?

A) Act of omission
B) Act of commission
C) Misfeasance
D) Duty of care
E) Liability

Question 5

Which of the following legal terms is synonymous with malfeasance?

A) Act of omission
B) Act of commission
C) Tort
D) Negligence
E) Liability

Question 6

An athletic trainer is performing ultrasound on a patient and accidentally burns the patient by failing to moving the ultrasound head. What type of legal concern is this?

A) Misfeasance
B) Act of omission
C) Act of commission
D) Sovereign immunity
E) Good Samaritan law

Question 7

What is the full meaning for the NOCSAE abbreviation?

A) National Operating Commission on Safety of Athletic Equipment
B) National Operating Committee on Standards for Athletic Equipment
C) National Organization on Safety of Athletic Equipment
D) Newly Organized Committee on Standards for Athletic Equipment
E) Nations Operating Commission on Safety of Athletic Equipment

Question 8

Which of the following is NOT a goal of the Affordable Care Act?

A) Improving the quality of healthcare
B) Establishing legal protections for consumers
C) Providing mechanisms for consumers to choose the insurance that is the best fit for them individually
D) Giving free healthcare to all of the people whose employer does not offer health insurance.
E) Making health insurance coverage more accessible and affordable

Question 9

What type of insurance should an athletic trainer possess in order to cover the act of negligence in a civil case?

A) Catastrophic insurance
B) Accident insurance
C) Professional liability insurance
D) General health insurance
E) Health Maintenance Organization Insurance

Question 10

Which of the following is an incorrect statement about catastrophic insurance?

A) The medical plan benefits the NCAA offers to athletes who require a lifetime of extensive medical care because of a permanent disability.
B) Errors and omissions liability insurance evolved to offset the shotgun approach of lawsuits and to cover what is not covered by a general liability policy.
C) The National Federation of State High School Associations (NFSHSA) offers a plan that provides for costs in excess of $10,000 not covered by other insurance benefits.
D) The existence of these plans eliminates the need for the professional to carry personal liability insurance.
E) Costs for catastrophic insurance are based on the number of sports and the number of hazardous sports offered by the institution.

Question 11

Which third-party payer usually involves a major hospital or hospital chain and its physicians?

A) HMO
B) PPO
C) PHO
D) Medicare
E) Indemnity plans

Question 12

Which third-party payer is a combination of the HMO and PPO plan, yet allows members to go outside the HMO to obtain services?

A) PPO
B) POS
C) EPO
D) PHO
E) TPA

Question 13

Which third-party payer would provide financial medical assistance to an athlete who comes from a low-income family?

A) HMO
B) Medicare
C) Indemnity plan
D) Worker compensation
E) Medicaid

Question 14

When were athletic trainers able to bill third-party payers for services rendered?

A) 1990s
B) 1995
C) 1996
D) Early 2000s
E) Athletic trainers have always been able to bill.

Question 15

What needs to be stressed to parents if the host institution offers a secondary insurance policy for athletes?

A) Save all receipts so they can be filed with the individual's tax records.
B) Submit all bills to the primary insurance company before submitting the remainder to the host institution.
C) All insurance filing will be taken care of by the host institution.
D) Pay all bills up front; the host institution will reimburse the family.
E) Keep all the bills until the end, then collectively file them together.

Question 16

What action by the Centers for Medicare and Medicaid Services (CMS) in 2005, created a job-loss for athletic trainers working in clinics and hospitals or as physician extenders?

A) Individual state licensure acts were revoked; Board of Certification was the only honoring professional credentialing body.
B) Insurance billing codes for athletic training rehabilitation services were deleted.
C) A mandate was set forth that only outcomes research practices/treatments could be eligible for reimbursement.
D) Athletic trainers were no longer recognized as a qualified professional to provide therapy incident to a physician's service.
E) Reimbursement could only be offered if the patient had primary insurance coverage.

Question 17

What type of code identifies specific medical procedures used in treating a patient?

A) HCFA-1500
B) HCFA-1450
C) UB-92
D) ICD-9-CM
E) CPT

Question 18

What does the Sports Medicine Licensure Clarity Act protect?

A) The athlete's ability to choose a healthcare provider
B) The right to practice athletic training
C) Ensuring that athletic trainers and other sports medicine professionals are properly covered by malpractice insurance while traveling
D) Insuring that athletic trainers can bill for service
E) HIPPA and FERPA must be protected for all athletes

Question 19

Any healthcare provider who uses standard electronic transactions, such as electronic claims, eligibility verifications, claims status inquiries, and claim attachments is required to have one of these:

A) Licensure
B) Certification
C) NPI number
D) CPT code
E) Billing code

Question 20

You are hosting a flag football tournament and your coach comes to you asking what type of insurance coverage you need to cover the students at this event. What would be the most appropriate insurance?

A) Catastrophic insurance
B) Accident insurance
C) Professional liability insurance
D) Workers compensation
E) Capitation