Business Operations & Practice Management Flashcards

Which federal act establishes the foundation for protection against discrimination for patients with disabilities seeking O&P services?

Answer: Americans with Disabilities Act (ADA)

The ADA prohibits discrimination against individuals with disabilities in public accommodations, employment, and services, directly affecting how O&P practices must serve all patients.

The ABC (American Board for Certification in Orthotics, Prosthetics & Pedorthics) requires practitioners to earn continuing education units (CEUs) to:

Answer: Maintain board certification and ensure ongoing competency

ABC certification renewal requires CEUs to ensure practitioners stay current with evolving clinical evidence, technology, and practice standards.

Prior authorization for a prosthetic device from Medicare is required primarily to:

Answer: Verify medical necessity and ensure reimbursement eligibility before fabrication

Prior authorization confirms that the prescribed device meets Medicare's medical necessity criteria, protecting both the patient and the provider from claim denials.

Which document must be obtained from the prescribing physician before an orthosis or prosthesis can be billed to Medicare?

Answer: Written order or prescription (Certificate of Medical Necessity)

A written prescription or Certificate of Medical Necessity (CMN) from the treating physician is required by Medicare before an O&P device can be billed.

HIPAA regulations in an O&P practice primarily govern:

Answer: Protection and confidential handling of patient health information (PHI)

HIPAA establishes standards for safeguarding protected health information (PHI), requiring O&P practices to control access to and use of patient medical records.

In O&P practice, the 'ABC Scope of Practice' defines:

Answer: The range of services and devices an ABC-certified practitioner is competent to provide

The ABC Scope of Practice outlines the clinical services and device categories within the competency boundaries of certified orthotists, prosthetists, and pedorthists.