CCS Exam Prep. Questions section coverage, Approved.

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CCS Exam Prep. Questions section coverage, Approved. Subjective - ✔✔-Dependent on the mind or on an individual's perception for existence Objective - ✔✔-Factual or not influenced by persona... l feelings or opinions Uniform Hospital Discharge Data Set (UHDDS) - ✔✔-A series of definitions collected on all hospital inpatients. Examples include the principle diagnosis, principal procedure, discharge data, etc. Master Patient Index (MPI) - ✔✔-A list or database created and maintained by a healthcare facility to record the name and identification number of every patient who has ever been admitted or treated in the facility Enterprise Wide Master Patient Index (EMPI) - ✔✔-An index that provides access to multiple repositories of information from overlapping patient populations that are maintained in separate systems and databases. References all patients in multiple facilities Quantitative Analysis - ✔✔-Review of the medical record to determine its completeness and accuracy Qualitative analysis - ✔✔-Review of the medical record to ensure that standards are met and to determine the accuracy of record documentation Abstracting - ✔✔-When someone reviews a patient's health record and enters the appropriate pieces into the database Integrated Delivery System (IDS) - ✔✔-A network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and health status of the population serviced. Integrated network systems (IDN) - ✔✔-Systems comprised of providers, acute care hospitals, specialty clinics, home health services, and an owner insurance plan. The goal is for the patient to be able to move among the continuum of care without fragmentation. Accountable Care Organization (ACO) - ✔✔-Defined by CMS as a group of doctors, hospitals, and other healthcare providers who come together voluntarily to give coordinated high quality care to Medicare patients. Department of Health and Human Services (DHHS) - ✔✔-the federal agency tasked with governing and regulating healthcare in the United States Centers for Medicare and Medicaid Services (CMS) - ✔✔-a federal agency within the U.S. Department of Health and Human Services that is responsible for Medicare and Medicaid, among many other responsibilities. Office of the Inspector General (OIG) - ✔✔-Monitors and tracks the use of taxpayer dollars through audits, inspections, evaluations and investigations. They are under the US Department of Commerce. They publish a yearly work plan that outlines the initiatives for the upcoming year. Conditions of Participation - ✔✔-Standards developed by the Department of Health and Human Services (DHHS) that a facility must comply with in order to participate in the Medicare and Medicaid programs. Medical records must be retained for - ✔✔-5 years Medical records must be completed by - ✔✔-No more than 7 days prior to admission or within 48 hours after admission The Joint Comission - ✔✔-A private, nonprofit organization that establishes guidelines and standards for the operation and management of healthcare facilities. American Osteopathic Association (AOA) - ✔✔-The professional association of osteopathic physicians, surgeons, and graduates of approved colleges of osteopathic medicine that inspects and accredits osteopathic colleges and hospitals Accreditation Association for Ambulatory Health Care (AAAHC) - ✔✔-An organization committed to developing Standards that advance and promote patient safety, quality healthcare, and value in ambulatory healthcare settings. Comission on Accreditation of Rehabilitation Facilities (CARF) - ✔✔-An accrediting organization for rehabilitation facilities National Committee for Quality Assurance (NCQA) - ✔✔-An organization that provides an assessment of the quality of managed care plans. Developed the Health Plan Employer Data and Information Set (HEDIS) that is a tool for measuring quality of care. Example of a HEDIS measure: cancer screening and prenatal care. Registries - ✔✔-An organized system for collection, storage, retrieval, analysis, and dissemination of information on individual persons who have either a particular disease or condition. NCHS (National Center for Health Statistics) - ✔✔-The federal agency responsible for collecting and disseminating information on health services utilization and the health status of the population in the U.S. National Trauma Data Bank - ✔✔-Sponsored by the American College of Surgeons (ACS) insulin dependent diabetes mellitus registries - ✔✔-Sponsored by the National Institutes of Health (NIH) American Medical Association (AMA) - ✔✔-The national professional membership organization for physicians that distributes scientific information to its members and the public, informs members of legislation related to health and medicine, and represents the medical profession's interests in national legislative matters; maintains and publishes the Current Procedural Terminology (CPT) coding system American Hospital Association (AHA) - ✔✔-National organization that represents and serves all types of hospitals, healthcare networks, and their patients and communities; the AHA began as the accreditation agency for new prepaid hospitalization plans in 1939. They publish "Coding Clinic" and provide official coding advice for ICD and HCPCS code sets. American College of Healthcare Executives (ACHE) - ✔✔-An international professional society of healthcare executives who lead hospitals, healthcare systems, and other healthcare organizations. They publish books and textbooks on healthcare services manag [Show More]

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