RHIA Exam 309 Questions with Verified Answers,100% CORRECT

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RHIA Exam 309 Questions with Verified Answers A discharge summary must be completed within____days after discharge for most patients but within ___for patients transferred to other facilities. Di... scharge summaries are not always required for patients who were hospitalized for less than ___ - CORRECT ANSWER 30 days/24 hours/48 hours systematic random sample - CORRECT ANSWER a simple random sample that may be generated by selecting every fifth or every tenth member of the sampling frame. In order to ensure that a systematic random sample is truly random, the sample frame should not be sorted in an order that might bias the sample. Example: If an analyst is studying the wait times at a clinic and the only list of patients available is on hard copy, which sampling technique is the easiest to use. Systematic sampling Entity relationship modeling - CORRECT ANSWER is a type of conceptual modeling. Conceptual models are abstract and encourage high-level problem structing; they help establish a common ground for communication between users and developers. The entity-relationship diagram was developed to depict relational database structures. The emergency health record should include - CORRECT ANSWER time and means of arrival, treatment rendered, and instruction at discharge. Facilities are required to do a pertinent history, including the chief complaint and onset of illness or injury but not a complete medical history of the patient Minimum Data set - CORRECT ANSWER a component of the resident assessment instrument (RAI) and is used to collect information about the resident's risk factors and to plan the ongoing care and treatment of the resident in the long-term care facility. many-to-many relationship - CORRECT ANSWER occurs only in a data model developed at the conceptual level. In this case, the relationship between patients and consulting physicians is a many-to-many. For each instance of patient, there could be many instances of consulting physician because patients can be seen by more than one consulting physicians. For each instance of consulting physician, there could be many patients because the physician sees many patients. metadata - CORRECT ANSWER data about data. metadata are structured information used to increase the effective use of data. One of the most familiar types of metadata is used to describe data in databases. Data element name, data type, and field length are examples of this kind of metadata. Health Record Matrix - CORRECT ANSWER Identifies and tracks the physical location of each paper document and the source of each electronic document that constitutes the LHR. The documentation of the LHR may physically exist in separate and multiple paper-based or electronic systems. This complicates the process of pulling the entire legal record together in response to authorized requests to produce the complete patient record. The legal health record for disclosure consists of: - CORRECT ANSWER the data, documents, reports and information that comprise the formal business records of any healthcare entity that are to be utilized during legal proceedings. Understanding legal health records requires knowledge of not only what comprises business records used as legal health records, but also the processes as well as the physical and electronic systems used to manage these records. privileged communication - CORRECT ANSWER information held confidential within a protected relationship as delineated by state law. Example: Mary goes to her doctor to discuss her current medical conditions. Firewall - CORRECT ANSWER a part of a computer system or network that is designed to block unauthorized access while permitting outward communication. A firewall can limit internal users from accessing various portions of the internet The most common place to find a firewall is between the healthcare entity's internal network and the internet It supports access control policy between two networks. It cannot prevent all types of attacks How long does the privacy rule use for the period of time which privacy rule-related documents must be retained? - CORRECT ANSWER Six years. The six-year time frame refers to the date the document was created or the last effective date of the document. Such documents include policies and procedures, the notice of privacy practices, complaint dispositions, and other actions, activites, and designations that must be documented per privacy rule requirements. corporate negligence - CORRECT ANSWER a legal doctrine that was established by a judicial decision handed down in the 1965 court case Darling v Charleston Community hospital. The court in this case ruled specifically that hospital governing boards have a duty to institue a means to evaluate and council medical staff who personally perform services on a patient that results in harm due to unreasonable risk. Hospitals may be held liable when a member of the medical staff fails to meet established standards of patient care. the privacy rule requires covered entities to - CORRECT ANSWER arrange a convenient time and place for the individual to inspect his or her record. However, the covered entity also has an obligation to protect the records integrity. Therefore, it is within the covered entitiys right to provide an authorized HIM staff member to be present when the individual reviews the record. fundraising activities - CORRECT ANSWER Those that benefit the CE, the covered entity may use or disclose to a BA or an institutionally related foundation without authorization, demographic information and dates of healthcare provided to the individual. Must have an option to Opt Out from receiving the material. If a fundraising activity targets individuals based on their diagnosis, prior authorization is required The privacy rule - CORRECT ANSWER establishes a patients right to receive an accounting of disclosures of their PHI made by a covered entity. first step in conducting the security risk analysis - CORRECT ANSWER consider their own characteristics and environment and implement reasonable and appropriate measures to protect against reasonably anticipated threats and hazards to the security of PHI. The security risk analysis process provides covered entities and business associates with the structural framework up on which to bulid their securty plan Addressable Implementation Specifications - CORRECT ANSWER Addressable specifications allow a covered entity flexibility when: (1) it is determined that the specification is not reasonable or appropriate for the covered entity's environment (2) the covered entity documents why the specification is not reasonable or appropriate and implements an equivalent alternative measure as appropriate. (3) Implementing "security measures to reduce risks and vulnerabilities to a reasonable and appropriate level" is a required specification, while encryption of electronic PHI is an addressable specification The breach notification rule requires - CORRECT ANSWER covered entities and business associates to establish policies and procedures to investigate an authorized use or disclosure of PHI to determine if a breach occured to Record locator service (RLS) - CORRECT ANSWER A process that seeks information about where a patient, once identified, may have a health record available to the HIO. It manages the pointers to the information on the servers of the HIE participants. The pointers in a RLS can include a person identification number and metadata. The RLS does NOT provide information about the record, it merely points to where it might be found. Data are not stored in a centralized database and records are only provided when queried. Qualitative standards - CORRECT ANSWER specify the level of service from a function such as accuracy rate, error rate, turnaround time and response time. In this case, timely response to release of information requests can indirectly impact patient care. To properly communicate performance standards, managers need to make the distinction between quantitative and qualitative standards and identify examples of each for the health information systems functions. A possible justification for building an information system in-house rather than purchasing one from a vendor - CORRECT ANSWER the facility has development teams that they do not want to give up gross death rate - CORRECT ANSWER the proportion of all hospital discharges that ended in death. It is the basic indicator of mortality in a healthcare facility. It is calculated by dividing the total number of deaths occurring in a given time period by the total number of discharges, including deaths, for the same time period. 25/500=0.05x100=5% work distribution chart - CORRECT ANSWER A matrix that depicts the work being done in a particular workgroup in terms of specific tasks and activities, time spent on tasks, and the employees performing the tasks is initially completed by each employee and includes all responsible task content. Can help when problems have been identified with work proceses such as too much time spent on unimportant tasks. pie chart - CORRECT ANSWER a chart that shows the relationship of a part to a whole. pie charts can be used to show the component parts of a single group or variable. incidence rate - CORRECT ANSWER a computation that compares the number of new cases of a specific disease for a given time period to the population at risk for the disease during the same period. a hospital is looking to cut cost on a vendors proposal for health IT should consider - CORRECT ANSWER acquiring it's own hardware Boolean Search - CORRECT ANSWER A Boolean operator is a computer-programming term for conjunctions like, AND, OR, and NOT which can be used to construct more complex search conditions. Usually found under the advanced options. Structured Query Language (SQL) - CORRECT ANSWER A language used to create and manipulate databases. Truncation - CORRECT ANSWER In metric verse, the omission of an unaccented syllable at either end of a line Wildcard search - CORRECT ANSWER search that uses characters such as * or ? to replace letters in a search term Monitoring Results - CORRECT ANSWER enables a hospital to understand if the present system is currently supporting the needs of the organization and whether the next step, identify needs will set in motion new or further development or acquisition of health IT Discrete Data (Quantitative) - CORRECT ANSWER Numerical data values that can be COUNTED. whole numbers that may or may not be related. A bar graph is the best data display tool to use Application Service Provider (ASP) - CORRECT ANSWER A company that provides the software, support, and computer hardware on which to run the software from the user's facilities over a network. There is much less upfront captial outlay and fewer IT staff required in house. The ASP acquisition strategy may be considered essentially a financing model Case Mix Index - CORRECT ANSWER The average relative weight of all cases treated at a given facility or by a given physician, which reflects the resource intensity or clinical severity of a specific group in relation to the other groups in the classification system The weight of each ms-drg is multiplied by the number of discharges for that ms-drg. Total weights are summed and divided by the number of toal discharges to arrive at the case-mix index Data provenance - CORRECT ANSWER Record of where data originated and have moved refers to the ablitiy to track the source of data super users - CORRECT ANSWER individuals with normal jobs who happen to be skilled at learning new information technology and can help others master new technology; they are not intended to replace scribes, trainers, or technicians Pareto Chart - CORRECT ANSWER a bar graph whose bars are drawn in decreasing order of frequency or relative frequency a type of bar graph that uses data to determine priorities in problem solving. Best way to ensure that elements of a HIS work together is to - CORRECT ANSWER ensure standards are applied to software development that support interoperability Haldol - CORRECT ANSWER Haloperidol (antipsychotic) used for behavior or mental conditions division - CORRECT ANSWER Cutting into a body part without draining fluids and/or gases from the body part in order to separate or transect a body part Clustering - CORRECT ANSWER the practice of coding or charging one or two middle levels of service codes exclusively under the philosophy that, although some will be higher and some lower, the charges will average out over an extended period. Capitated rate - CORRECT ANSWER a method of payment for health services in which the third-party payer reimburses providers a fixed, per capita amount for a period. Per capita means per head or per person. A common phrase in capitated contracts is per member per month. The PMPM is the amount of money paid each month for each individual enrolled in the health insurance plan. Capitation is characteristic of HMOs. Workers Compensation - CORRECT ANSWER is a payer that pays for healthcare services due to work-related incidents. Because workers compensation is paying the bill, they are the third-party. Allowing patterns of retrospective documentation, hiding or ignoring negative quality review outcomes, and hiding incomplete health records from accreditation surveyors are unethical behaviors for which of the following Code of Ethics principle? A. Advocate and uphold the right to privacy B. Put service before self-interest C. Represent the profession accurately to the public D. Respect the inherent dignity and worth of every person - CORRECT ANSWER put service before self-interest What is the payment reduction for facilities that fail to successfully meet the requirements of medicare's quality reporting programs - CORRECT ANSWER 2 percent reduction Integrated Delivery System (IDS) - CORRECT ANSWER 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. collaboration integration of healthcare providers. The goal of the IDS isa seamless delivery of care along the continuum of care, so one bill would be generated. (even if the care provided is over a 10 month period) Value-based care - CORRECT ANSWER includes 4 domains: safety, clinical care, efficiency and cost reduction, and person and community engagement. Each domain has measures that must be reported to CMS HCAHPS - CORRECT ANSWER Hospital Consumer Assessment of Healthcare Providers and Systems part of the person/community engagement domain strategy - CORRECT ANSWER a plan of action or policy designed to achieve a major or overall aim. characteristics of strategy: an action or set of actions, a description of how one intends to achieve the goals, a plan to improve the organizations fit within the external environment implementation plan is critical to the successful execution, it is not a characteristic of strategy. tracer methodology - CORRECT ANSWER A process the Joint Commission surveyors use during the on-site survey to analyze an organization's systems, with particular attention to identified priority focus areas, by following individual patients through the organization's healthcare process in the sequence experienced by the patients; an evaluation that follows (traces) the hospital experiences of specific patients to assess the quality of patient care; part of the new Joint Commission survey processes (LaTour 953-954) Profitability Index - CORRECT ANSWER Net Present Value / Investment Required divide the present value of the cash inflows by the present value of the cash outflows. data steward - CORRECT ANSWER An individual responsible for the management of critical data elements, including identifying and acquiring new data sources; creating and maintaining consistent reference data and master data definitions; and analyzing data for quality and reconciling data issues. are embedded within an organizations business unit and responsible for monitoring the data quality of the unit Accession number - CORRECT ANSWER A number assigned to each case as it is entered in a cancer registry consists of the first digits of the year the patient was first seen in the facility, with the remaining digits assigned sequentially throughout the year. Healthcare Effectiveness Data and Information Set (HEDIS) - CORRECT ANSWER a set of standard performance measures designed to provide purchasers and consumers of healthcare with the information they need to for comparing the performance of managed healthcare plans. breach notification laws - CORRECT ANSWER do not exist in numerous states, but they often are not tailored to medical information Context-based access control (CBAC) - CORRECT ANSWER The most stringent type of access control, which takes into account the person attempting to access the data, the type of data being accessed, and the context of the transaction in which the access attempt is made. Omnibus Rule - CORRECT ANSWER Set of regulations enhancing patients' privacy protections and rights to information and the government's ability to enforce HIPAA created a new fine structure for civil monetary penalities based on a four tier system for HIPAA violations. Tiers 3 and 4 are based on violations that have been determined to be due to willful neglect. If a breach is corrected within 30 days from the date of discovery it would fall into Tier 3. If it wasn't corrected it would be a tier 4. a patient requests that disclosures made from her medical record be limited to specific clinical notes and reports. Given HIPAA requirements, how must the hospital respond - CORRECT ANSWER common practice for covered entities is to accept the request, but not to agree to the restriction because of legal implications to the covered entity should the restriction be violated the privacy rule lists two circumstances where phi can be used or disclosed without the individuals authorization - CORRECT ANSWER 1.disclosing PHI to a family member or close friend that is directly relevant to his or her involvement with the patients care or payment. Facility access controls - CORRECT ANSWER A visitor walks through the computer department and picks up a CD from an employee's desk. What security controls should have been implemented to prevent this security breach? technical safeguards - CORRECT ANSWER identification and authorization, encryption, firewalls, malware protection, application design includes automatic log-off, which ensures electronic processes that terminate an electronic session after a predetermined time of inactiviy Covered entities are responsible for their workforce, which consists not only of employees, but also volunteers, student interns and trainees. Workforce members are not limited to those who receive wages from the CE - CORRECT ANSWER a volunteer is a workforce member in relation to the hospital employees are not covered by - CORRECT ANSWER privacy rule the privacy rule permits individuals to request that a covered entity amend a PHI record about the individual in a designated record set unless - CORRECT ANSWER the report was erroneously placed in the record. It is not part of the designated record set. One of the medical staff committees at st vincent hospital is responsible for reviewing cases of patients readmitted within 14 days after discharge. This review of patients' medical records is considered healthcare - CORRECT ANSWER operations there is the least amount of interoperability between - CORRECT ANSWER EHR in a physician office and revenue cycle management MPI: Master Patient Index manager - CORRECT ANSWER is responsible for ensuring that registration interfaces are properly built and tested line/plot graph - CORRECT ANSWER displays trends over time Normal Bell Curve - CORRECT ANSWER the normal distribution is actually a theoretical family of distributions that may have any mean or any standard deviation. It is bell shaped and symmetrical about the mean. because it is symmetrical, 50% of the observations fall above the mean and 50% fall below it. In a normal distribution, the mean, median and mode are equal. Histogram - CORRECT ANSWER A graph of vertical bars representing the frequency distribution of a set of data. (nominal or ordinal data) Levels of interoperability - CORRECT ANSWER basic--functional--semantic basic relates to the ability to successfully transmit and receive data from one computer to another functional refers to sending messages between computers with a shared understanding of the structure and format of the message. The use of clinical terminologies in EHRs to provide standardized data is essential to achieving semantic interoperability. the ICU bed count in the state has relaized a decrease of 20% bed count is a component needed to calculate occupancy rates for any facility. - CORRECT ANSWER reduction of ICU beds at any healthcare facility in the state has the potential to increase the volume of patients in this hospitals ICU Federated inconsistent databases - CORRECT ANSWER Model for HIE includes multiple enterprises agreeing to connect and share specific info in a point to point manner information warehouse - CORRECT ANSWER Allows organizations to store reports, presentations, profiles, and graphics interpreted and developed from stores of data for reuse in subsequent organizational activities. the master patient index - CORRECT ANSWER Permanent database including every patient ever admitted to or treated by the facility. the MPI must be kept permanently it is the key to an effective retention and retrieval system of health records in a facility. results management application - CORRECT ANSWER enables results of a diagnostic study to be compared and displayed with other data. character and symbol recognition technologies - CORRECT ANSWER include bar coding, optical character recognitions and gesture recognition technologies. clinician web portal - CORRECT ANSWER used by physiciaans to access multiple sources of patient information within the healthcare organizations network. predictive modeling - CORRECT ANSWER applies statistical techniques to determine the likelihood of certain events occurring together. Statistical methods are applied to historical data to learn the patterns in the data. These patterns are used to create models of what is most likely to occur. contingency table - CORRECT ANSWER displays the relationship between two categorical variables. They are often referred to by the number of rows and columns. Discharged Not Final Billed (DNFB) - - CORRECT ANSWER A report that includes all patients who have been discharged from the facility but for whom, for one reason or another, the billing process is not complete. a bill cannot be generated until the coding is complete, so organizations routinely monitor the DNFB days. Hospital Compare - CORRECT ANSWER A website created by CMS and the Hospital Quality Alliance to promote reporting on hospital quality of care. Reports on 139 measures of hospital quality of care for heart attack, heart failure, pneumonia and the prevention of surgical infections. The data available on Hospital Compare is reported by hospitals to meet the requirements of the medicare value based purchasing program. how do providers benefit from the health insurance exchanges created under the ACA - CORRECT ANSWER Providers should see an increase in reimbursement both from newly insured patients and from patients who are now eligible for medicaid under the expanded programs Aging of accounts standard incrememnt - CORRECT ANSWER 30 days what benefit of comparing the coding assigned by coders to the coding that appears on the claim - CORRECT ANSWER may find claim generation issues that cannot be found in other ways Medicare participating physicians - CORRECT ANSWER payments are 80% of medicare fee schedule. noPAR payments are 95% of the 80%. Focused reviews on lower weighted MS-DRGs from triples and pairs - CORRECT ANSWER indicats areas of risk related to lower weighted MS-DRGs from triple and pair combinations which may be the result of a coder missing secondary diagnosis. A focused audit based on this specific potential problem area could help to identify these cases. Optimization seeks the most accurate documentation, coded data, and resulting payment in the amount the provider is rightly and legally entitled to receive Dr. Smith, a surgeon at Community Hospital, is trying to understand how she can help the hospital improve reimbursement from Medicare. The HIM manager explains to Dr. Smith that reducing catheter-associated UTIs and surgical site infections would improve the hospital's scores in which of the following domains of the Medicare Value-Based Purchasing program? - CORRECT ANSWER safety Most facilities begin counting days in accounts receivable at which of the following times? - CORRECT ANSWER date the claim drops three competencies common to all successful change - CORRECT ANSWER Leadership, change management and strategic development state licensure agencies - CORRECT ANSWER What type of organization works under contract with the CMS to conduct Medicare/Medicaid certification surveys for hospitals? Three ways to address conflict - CORRECT ANSWER compromise, control and constructive confrontation constructive confrontation - CORRECT ANSWER a method of conflict resolution in which both parties meet with an objective third party to explore their perceptions and feelings. The desired outcome is to produce a mutual understanding of the issues and to create a win-win situation Hay Guide Chart-profile Method (Hay plan) - CORRECT ANSWER Refined version of the point method used by approx. 8000 public and private sector organizations worldwide to evaluate clerical, trade, technical, professional, managerial, and/or executive-level jobs. used as a job evalutaion tool Contract Elements - CORRECT ANSWER agreement, offer, acceptance, consideration DURSA - CORRECT ANSWER data use and reciprocal support agreement, legal binding contract that draws from federal and local laws and defines requirements for participation in eHealth exchange national network, agreement also addresses sanctions for violations of contract Net Income Equation - CORRECT ANSWER Net Income = Revenues - Expenses Net assets - CORRECT ANSWER Non current assets + net current assets - long term liabilities work sampling technique - CORRECT ANSWER a statistical method that reviews a select portion of tasks performed and provides baseline data for further job performance assessment. work distribution chart - CORRECT ANSWER is initially completed by each employee and includes all responsible task content. (LaTour 801) the him manager tasked the coding manager to development a dashboard that shows the discharges pending final billing so that she can plan staffing. Because this data changes throughout the day, what analysis technique is needed. - CORRECT ANSWER real time analysis a physician on your staff asked you to help her collect information about the effects of smoking during pregnancy on the birth weight of the babies. You were asked to collect the following information: whether or not the mothers smoke during pregnancy, birth weight of the babies, apgar scores at one minute and apgar scores at 5 minutes. The scales of these variables would be: - CORRECT ANSWER nominal (yes or no question), ordinal (apgar--because the order of the numbers is meaningful), interval, ratio (birth weight--scaled data--unit of measure) a pattern used in computer based patient records to capture data in a structured manner is a called a _______. One benefit of using a ______ is to ensure data integrity upon data entry. - CORRECT ANSWER template ____ is a statistic that is used to describe the association or relationship between 2 variables. - CORRECT ANSWER correlation quantitative analysis - CORRECT ANSWER is conducted to determine whether documentation is complete and accounted for in the medical record. If information is missing or incomplete, it is flagged for the provider to review and complete. It is generally conducted retrospectively. when an entity relational diagram is implemented as a relational database, the entity will become a ____ - CORRECT ANSWER table. It becomes a table because it is the person, place or thing about which you are collecting the data in your database. alternative hypothesis - CORRECT ANSWER the compliment of the null hypothesis and typically requires some action to be taken. In this scenario, the analyst is comparing emergency department wait times between weekends and weekdays. The alternative hypothesis would be that the average wait time is longer on weekends. Metadata - CORRECT ANSWER data contained in the data dictionary. Metadata are descriptive data that characterize other data to create a clearer understanding of their meaning and to achieve greater reliability and quality of information. source systems - CORRECT ANSWER Systems that provide a source of organizational data. information systems that capture and feed data into the EHR. Source systems include the electronic medication administration record, laboratory information system radiology information systems, hospital information system, nursing information systems, and more. biomedical research - CORRECT ANSWER basic and applied research aimed at increasing medical knowledge and understanding is considered the ancillary function of the health record. Uniform Hospital Discharge Data Set (UHDDS) - CORRECT ANSWER Used for reporting inpatient data in acute care, short-term care, and long-term care hospitals. Minimum set of items based on standard definitions to provide consistent data for multiple users. Required for reporting Medicare and Medicaid patients. name of element, definition, application in which the data element is found, locater key, ownership, entity relationships, date first entered system, date terminated from system and system of orgin - CORRECT ANSWER examples of metadata scatter diagram - CORRECT ANSWER A correlation chart that uses a regression line to explain or to predict how the change in an independent variable will change a dependent variable. whenever a scatter diagram indicates that the points are moving together in one direction or another, conclusions about the variables relationship, either positive or negative become evident. a data analysis tool used to plot points of two variable suspected of being related to each other in some way. Resident Assessment Instrument (RAI) - CORRECT ANSWER a federally mandated standard assessment used to collect demographic and clinical data on residents in a Medicare- or Medicaid-certified long-term care facility. It consists of three components: the Minimum Data Set (MDS) Version 3.0, the Care Area Assessment (CAA) process, and the RAI utilization guidelines (LaTour 199) How do healthcare providers use the administrative data they collect? - CORRECT ANSWER for regulatory, operational and financial purposes what is the most secure signature type - CORRECT ANSWER the digital signature is similar to the electronic signature except that is uses encryption to provide nonrepudiation to prove the authenticators identity, who is responsible for the quality of documentation of the record - CORRECT ANSWER The provider identify the level in the data model that describes how the data is being stored in the database - CORRECT ANSWER physical data model. The users are not involved with this level of the database because of its technical complexity Entity Relationship Diagram (ERD) - CORRECT ANSWER A diagram that depicts an entity relationship model's entities, attributes, and relations. describes how the tables work together. The diagram is a graphic representation of the entities, attributes and relationships that are part of a database and is a data modeling tool. Disaster Recovery Plan (DRP) - CORRECT ANSWER a plan to restore an organization's IT capability in the event that its data center is destroyed The technological aspect of business continuity planning. HIM professionals assist in designing disaster recovery plans that address documenting information in the health record during down time or a disaster. Skewness - CORRECT ANSWER A measure of the shape of a data distribution. Data skewed to the left result in negative skewness; a symmetric data distribution results in zero skewness; and data skewed to the right result in positive skewness. If the longer tail is on the right, the curve is skewed to the right. If the longer tail is on the left, the curve is skewed to the left. Hybrid health records - CORRECT ANSWER mixture of paper and electronic, or multiple electronic systems that do not communicate or are not logically architected for record management. these records are increasingly seen as the most common transition points between fully paper and completely electronic records Uniform discharge data set (UDDS) - CORRECT ANSWER adopted in 1974 by the federal government as the standard for collecting data for the medicare and medicaid programs. When the prospective payment act was enacted in 1983, UHDDS definitions were incorporated into the rules and regulations for implementing drgs. A key component was the incorporation of the definitions of principal dx, principal procedure and other significant procedures, into the DRG algorithm. minimum data set for long term care - CORRECT ANSWER is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. an assessment form used to collect demographic and clinical data on nursing home residents. it consists of a core set of screening and assessment elements based on common definitions. To meet federal requirements, long-terms facilites must complete an MDS for every resident at the time of admission and at designated reassessment points throughout the residents stay. physician index - CORRECT ANSWER categorizes patients by primary physician. It guides the retrieval of cases treated by a particular physician. This index is created simply by sorting patients by physician object-oriented database - CORRECT ANSWER is derived from object-oriented programing and has no single inherent structure. The structure for any given class or type of object can be anything a programmer finds useful--a linked list, a set, an array, ect. An object may contain different degrees of complexity, making use of multiple types and multiple structures Stakeholder team - CORRECT ANSWER This should be first step in the LHR definition process. This team will drive the creation of the legal health record documentation, undertake the LHR definition project, and be responsible for its continued maintenance. national committee on vital and health statistics (NCVHS) - CORRECT ANSWER has developed the initial efforts toward creating standardized data sets for use in different types of healthcare settings including acute care, ambulatory care, long term care and home care which of the following data sets would be most useful in developing a matrix for the identification of components of the legal health record? a. document name, media type, source system, electronic storage start date, stop printing start date b. document name, media type c. document name, medical record number, source system d. document name, source system - CORRECT ANSWER A. document name, media type, source system, electronic storage start date, stop printing start date LHR (legal health record) concept - CORRECT ANSWER was created to describe the data, documents, reports and information that comprise the formal business records of any healthcare organization that are to be utilized during legal proceedings. health record must be maintained - CORRECT ANSWER for every individual evaluated or treated in the hospital. Health records must be retained in their original or legally reporduced form for a period of at least 5 years. Data breech of less than 500 - CORRECT ANSWER the covered entity or business associate must notify the secretary of the HHS annually; however, the notification must occur no later than 60 days after end of the calendar year in which the data breach occurred. HITECH - CORRECT ANSWER makes it easier for schools to receive student immunization records where state or other law requires it prior to student admission. HITECH permits CEs to disclose a childs immunization records to a school with the oral consent of the parent or guardian. This contrasts with the previous written authorization requirement Electronic data can be destroyed - CORRECT ANSWER with magnetic degaussing as this is an acceptable form of destruction for that medium. Burning, shredding and pulverizing are acceptable destruction methods for paper based records HIPAA Privacy Rule - CORRECT ANSWER Law that regulates the use and disclosure of patients' protected health information (PHI). states that the covered entity must provide individuals with their information in the form that is requested by the individuals, if it is readily producible in the requested format. The covered entity can certainly decide, along with the individual, the easiest and least expensive way to provide the copies they request. Per the request of an individual, a covered entitiy must provide an electronic copy of any and all health information that the covered entity maintains electronically in a designated record set. If a covered entity does not maintain the entire designated record set electronically, there is not a requirement that the covered entity scan paper documents so the documents can be delivered electronically. Retention and Destruction - CORRECT ANSWER The process of storing and health information and destroying it when it is no longer needed Firewalls - CORRECT ANSWER hardware, software, or both designed to prevent unauthorized persons from accessing electronic information situated between the routers of a private and public network a patient has access to their records for how long? - CORRECT ANSWER as long as it's MAINTAINED HIPAA Security Rule - CORRECT ANSWER law requiring covered entities to establish safeguards to protect health information required CEs to ensure confidentiality, integrity, and availability of ePHI. The rule contains provisions that require CEs to adopt administrative, physical and technical safeguards. HITECH Act - CORRECT ANSWER shortened the time frame for an accounting of disclosures made during the previous six years. This has been shortened to disclosures made during the previous three years. HIPAA Privacy Rule facility directory - CORRECT ANSWER individuals can decide whether they want to be listed in a facility directory, the patient should be informed that only callers who know his or her name will be given any of this limited information. CE generally do not, however, have to provide screening of visitors or calls for patients because such an activity is too difficult to manage with the number of employees and volunteers involved in the process of forwarding calls and directing visitors. If the CE agreed to the screening and could not meet the agreement, it could be considered a violation of this standard of the privacy rule. job shadowing - CORRECT ANSWER should be limited to areas where the likelihood of exposure to PHI is very limited, such as in administrative areas. There is a provision in the privacy rule that permits students and trainees to practive and improve their skills in the healthcare environment; however, the context of this provision appears to imply that the students are already enrolled in a healthcare field of study and that they are under the supervision of the CE. Most CE require students to be trained on confidentiality and other requirements of the privacy rule, and job shadowing activities do not appear to apply in this exception. quality management studies outcomes - CORRECT ANSWER may be used to evaluate a physicians application for continued medical staff membership and privileges to practice. These studies are usually conducted as part of the hospitals QI activities. These review activites are considered confidential and protected from disclosures. The maintenance of policies and procedures implemented to comply with the security rule must be retained for how long? - CORRECT ANSWER Six years from the date of its creation or the date when it was last in effect, whichever is later. AHIMA recommends that documents of health record destruction include all of the following except __________. - CORRECT ANSWER the reason for destruction. (items recommended to be included: data and method of destruction, statement that records were destroyed is the normal course of business and description of the disposed record series of numbers or items.) Where does the minimum necessary requirement not apply - CORRECT ANSWER healthcare providers for treatment, to the indivdual or his or her personal representative pursuant to the individuals authorization to the secretary of the HHS for investigations, compliance review, or enforcement, as required by law or to meet other privacy rule compliance requirements. No authorization is needed to use or disclose PHI for - CORRECT ANSWER public health activities. Some health records contain information that is important to the public welfare. Such information must be reported to the states public health service to ensure public safety The key to defining PHI is that - CORRECT ANSWER it requires the information to either identify an individual or provide a reasonable basis to believe the person could be identified from the information given. Pursuant to the privacy rule, the hospital may disclose health information to law enforcement officials without authorization for law enforcement purposes for certain situations including, - CORRECT ANSWER situations involving a crime victim. Disclosure is made in response to law enforcement officials request for such information about an individual who is, or suspected to be a victim of a crime. the privacy rule requires ______to be included in a patient accounting of disclosures - CORRECT ANSWER state-mandated public health reporting such as sexually transmitted disease business associate - CORRECT ANSWER A person, who on behalf of the covered entity, performs or assists in the performance of a function or activity involving the use or disclosure of individually identifiable health information. The privacy rule allows (but does not REQUIRE) a CE to request amendments to an individuals health record - CORRECT ANSWER to be in writing when would a breech not need to be reported - CORRECT ANSWER if the recipient of the unauthorized information would have no reason to retain it (no hard copy) accounting of disclosures is not required for which disclosures - CORRECT ANSWER to the individual to whom the information pertains, incidental to an otherwise permitted or required use or disclosure, and pursuant to an authorization. A disclosure WOULD be required to patient information faxes to an erroneous fax number. Device and Media Controls (physical safeguard) - CORRECT ANSWER a standard within the security rule that provides guidance for covered entities to secure laptops and other small portable mobile technologies used within the healthcare facility access to phi can be denied if - CORRECT ANSWER it would be reasonably likely to endanger the life or physical safety of the individual or another person system customization - CORRECT ANSWER the process of modifying a commercial application to reflect an organization's needs. This is where decision support rules can be adjusted data stewardship - CORRECT ANSWER The responsibilities and accountabilities associated with managing, collecting, viewing, storing, sharing, disclosing, or otherwise making use of personal health information Data governance (DG) - CORRECT ANSWER agreeing on standards and how they are to be implemented for successful mapping between systems qualitative standards - CORRECT ANSWER Specify a level of service quality expected Accuracy rate Error rate Turnaround time Response time interater reliability - CORRECT ANSWER the degree to which multiple testers can obtain measurements that agree a way to assess the quality of data in the EHR - CORRECT ANSWER Audit structured data entries clinical pathways (critical pathways, CareMaps) - CORRECT ANSWER case management tools used to communicate that standardized, interdisciplinary plan of care for a particular group of patients, care guidelines and outcome are specified for each day of the patient's stay Dashboards (digital dashboards) - CORRECT ANSWER reports of process measures to help leaders follow progress to assist with strategic planning. The dashboard provides the status of key measures. control charts - CORRECT ANSWER graphic presentations of process data over time, with predetermined control limits Association rule learning - CORRECT ANSWER Examining data to discover new and interesting relationships among attributes that can be stated as business rules. Syntactic interoperability - CORRECT ANSWER If two or more systems are capable of communicating with each other, when using specified data formats, communication protocols. XML or SQL standards are among the tools addresses the medical words, phrases and terms used in healthcare and their definitions so that there is clear and consistent usage among all EHR systems. Identity matching - CORRECT ANSWER Also known as patient matching, the process in which the HIO identifies the right person within the database to exchange information between HCOs The process examines different demographic elements from different health information technology systems to determine if they refer to the same patient auditing _______ of ehr documentation would be the best approach for avoiding selection bias and in determine how the copy function is being used - CORRECT ANSWER a random sample scheduling systems - CORRECT ANSWER are used to control the use of resources throughout the healthcare facility. These resources can include staff, equipment, rooms, and more. Scheduling systems may be centralized or independent. health information blocking - CORRECT ANSWER when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. blocking stems from healthcare providers or HIT vendors protecting their own proprietary and business interests above the interests of the patient and healthcare improvement. These efforts actively impede the progress sought by the concept of EHRs and health information exchange. line plot - CORRECT ANSWER is used for two main purposes. (1) to present trends or patterns in the number of occurrences between groups or (2) to present trends or patterns in the mean of a variable between groups. Typically, the change of a variable over time is compared. Structural Metadata - CORRECT ANSWER Describes how the data for each data element are captured, processed, stored, and displayed. Data models, such as entity-relationship diagrams (ERD) and dataflow diagrams (DFD) are diagrammatical or graphic tools used to help program the system and to identify areas of inefficiency. Decision Support System (DSS) - CORRECT ANSWER information system that gathers data from a variety of sources and assists in providing structure to the data by using various analytical models and visual tools in order to facilitate and improve the ultimate outcome in decision making tasks associated with the nonroutine and nonreceptive problems which of the following basic services provided by a health information exchange (HIE) entity matches identifying information to an individual. a. consent management b. person identification c. record locator d. identity management - CORRECT ANSWER b. person identification Providing a process's policy and procedure guide to a user who has never used the IS and asking the user to perform the process could be used in what type of testing? - CORRECT ANSWER Documenation Boxplot - CORRECT ANSWER A plot of data that incorporates the maximum observation, the minimum observation, the first quartile, the second quartile (median), and the third quartile. which of the following basic services provided by an HIE entity identifies participating users and systems. a. identity management b. person identification c. registry and directory d. secure data transport - CORRECT ANSWER c. registry and directory histograms / bar graph - CORRECT ANSWER are used to present the distribution of numeric data. the numeric variable is broken down into groups based on specific ranges of values to establish the widths of each bar in a histogram. The height of each bar represents the frequency or destiny of each of the binned groups. The distribution can be described as normally distributed when the pattern follows a bell-shaped pattern Data Silos - CORRECT ANSWER stand-alone data stores. Their data are not accessible by other ISs that need it or outside that department. consumer health informatics - CORRECT ANSWER a field devoted to informatics from multiple consumer or patient views and includes patient-focused informatics, health literacy, and consumer education with a focus on information structures and presents that empower consumers to manage their own health. what must be in place to enhance the retrieval process for scanned documents - CORRECT ANSWER indexing system when describing the typical length of stay for patients admitted for chf, which is the most appropriate measure of central tendency where there are a number of long stay outliers - CORRECT ANSWER Median. if the sample has extreme values on either the high or low end of the scale, then the median may be the better choice for describing the center of the distribution. The median is less affected by outliers Optical Character Recognition (OCR) - CORRECT ANSWER enhances the accuracy of indexing features in addition to barcoding. Messaging Standards - CORRECT ANSWER Protocols that help ensure that data transmitted from one system to another remain comparable aka interoperability standards or data exchange standards. provide the tools to map proprietary formats to one another and more easily accomplish the exchange of data Enterprise master patient index (EMPI) - CORRECT ANSWER An index that provides access to multiple repositories of information from overlapping patient populations that are maintained in separate systems and databases Preventive Controls - CORRECT ANSWER front end processes that guide work in such a way that input and process variations are minimized. Simple things such as standard operating procedures, edits on data entered into computer-based systems, and training processes are ways to reduce the potential for error by using preventive controls. Extranets - CORRECT ANSWER are networks that connect a given organization to its customers and business partners or suppliers. Although extranets send information over public networks, requiring a greater level of security, access to them in still restricted to the services and persons authorized. a patient was admitted for removal of the left lobe of the liver via laporatomy - CORRECT ANSWER The root operation was resection--cutting out of off, without replacement all of the following are considered the most common types of registration errors affecting the revenue cycle except: a. patient registered with more than one medical record number b. inpatient registered with observation stay type c. missing guarantor or employer information d. insurance eligibility verification failure - CORRECT ANSWER b. inpatient registered with observation stay type local managed contracts - CORRECT ANSWER independent contracts are independent of Medicare NCDs and LCDs the insurance verification process involves confirming the patient is a member of the insurance plan communicated to the provider. Which of the following describes the most common time when insurance verification occurs for an unscheduled patient. a. prior to medical screening b. during or directly after preregistration c. after the patient is released from care d. after medical screening - CORRECT ANSWER d. after medical screening nonparticpating providers (nonPARs) do not sign a particpation agreement with Medicare but may or may not accept assignment. If the nonPAR physician elects to accept assignment, he or she is paid 95 percent (5 percent less than participating physicians) of the Medicare fee schedule (MFS). - CORRECT ANSWER if the MFS amount is $200, the PAR provider receives $160 (80 percent of $200) but the nonPAR provider receives only $152 (95% of 160). In this case the physician is nonparticipating so he or she will receive 95 % of the 80% of the MFS or 80% of 300, which is 240. 95% of 240 is 228. HNN Hospital-issued notice of noncoverage - CORRECT ANSWER may not be issued to a patient after service is rendered Transparency Approach - CORRECT ANSWER involoves providing financial information in a user-friendly format along with all relevant past and current patient obligations which of the following is not a reason to deliver a hospital-issued notice of noncoverage to a Medicare beneficiary? a. service is not medically necessary b. service was not preauthorized c. service was not delivered in the most appropriate setting d. service is custodial in nature - CORRECT ANSWER b. service was not preauthorized conversion factor - CORRECT ANSWER an across-the-board multiplier that sets the allowance for the relative values--a constant ABNs (advanced beneficiary notice of noncoverage) primary purpose - CORRECT ANSWER is to inform the patient of financial responsibility for outpatient services when it is not likely Medicare will cover due to NCD or LCD requirements. In the HHPPS system, which home healthcare services are consolidated into a single payment to home health agencies? - CORRECT ANSWER nonroutine medical supplies, home health aide visits, medical social services, and nursing and therapy services Accounts Receivable collection cycle involves the time from - CORRECT ANSWER admission to deposit in the bank MS-LTC-DRGs and MS-DRGs are based on - CORRECT ANSWER principal diagnosis in terms of grouping and reimbursement in a typical acute-care setting, the explanation of benefits, Medicare summary notice and remittance advice documents (provided by the payer) are monitored in which revenue cycle area? - CORRECT ANSWER Claims reconciliation and collections A payer has advised your hospital that it is auditing records from 2010 due to a suspected payment error. Your hospital's first action should be to _____. - CORRECT ANSWER Review the contract to determine whether this is a violation of the look-back period Exploding charges - CORRECT ANSWER Charges for items that must be reported separately but are used together, such as interventional radiology imaging and injection procedures identity theft is primarily a federal crime. However ____can impact an individuals ability to obtain health care and health insurance coverage - CORRECT ANSWER medical identity theft Patient Access - CORRECT ANSWER admissions (patient registration, insurance, authorization, cash collection, scheduling) is responsible for posting admitting diagnosis. Federal Trade Commission (FTC) - CORRECT ANSWER has oversight responsibility for identity theft regulations and requires financial institutions and creditors to develop and implement written identity theft prevention programs. a federal agency empowered to prevent persons or corporations from using unfair methods of competition in commerce financial counselor - CORRECT ANSWER staff dedicated to helping patients and physicians determine sources of reimbursement for services; responsible for identifying and verifying the method of payment and debt resolution for services rendered to patients Outlier payment - CORRECT ANSWER The cost of the service is greater than the APC payment by a fixed ratio and exceeds the APC payment plus a threshold amount the facility's Medicare case-mix index has dropped, although other statistical measures appear constant. The CFO suspects coding errors. What type of coding quality review should be performed. - CORRECT ANSWER focused audit urethral suspension without mesh - CORRECT ANSWER reposition What is the principal goal of internal auditing programs for billing and coding? - CORRECT ANSWER Protect providers from sanctions or fines. One of the most common issues that healthcare organizations fail to do well in the strategic process is - CORRECT ANSWER Execute the implementation plan The percent of antibiotics administered immediately prior to open reduction and internal fixation (ORIF) surgeries or the percent of deliveries accomplished by cesarean section are examples of what type of performance measure - CORRECT ANSWER process measure when implementing health information management training, determining who needs to be trained, who should do the training, how much training is required, and how the training will be accomplished is the responsibility of - CORRECT ANSWER the implementation team during her new employee orientation, katie is paired with another coder who shows katie to her workstation, explains the organizations coding guidelines, takes her to lunch, and explains the online encoder. This orientation is taking place at what level? - CORRECT ANSWER individual Serial work division - CORRECT ANSWER consecutive handling of tasks or products by individuals who perform a specific function in sequence. Often referred to as production line work division, serial-work division tends to create task specialists. Kinesthetic learners - CORRECT ANSWER People who learn best through a hands-on approach; also called tactile learners. Before the on-site survey team leaves the healthcare facility they meet with the organization's leadership team and provide a report of their findings. This meeting is called _____. - CORRECT ANSWER exit conference Zero-Based Budget - CORRECT ANSWER allocates resources as if each budget was brand new apply to organizations for which each budget cycle poses the opportunity to continue or discontinue services based on the availability of resources. Every department or activity must be justified and prioritized annually in order to effectively allocate the organizations resources. Professional associations and charitable foundations routinely use zero-based budgeting. opening conference - CORRECT ANSWER a meeting conducted at the beginning of the accreditation site visit during which the surveyors outline the schedule of activities and list any individuals whom they would like to interview Licensure - CORRECT ANSWER a state act of granting a healthcare organization or an individual healthcare practitioner permission to provide services of a defined scope in a limited geographical area. State governments issue licenses based on regulations specific to healthcare practices Stacy is the nursing manager for the cardiology services at a local hospital. The hospital has recently emphasized a policy requiring all managers to track and report their employees' absences from work. Stacy feels that this requirement is time consuming and unnecessary. Why would the hospital require their managers to complete this process? - CORRECT ANSWER Reports of absences are tabulated and examined for a possible HAI (hospital acquired infection) connection strategic managers must be skilled in - CORRECT ANSWER the ability to envision relationships between trends and opportunities needs analysis - CORRECT ANSWER Determining a customer's needs by acquiring information, processing and evaluating the information, then creating a plan of action to address the needs. critical to the design of the training plan. the approach typically focuses on three levels: the specific job tasks, the organization and the individual employee warranty - CORRECT ANSWER a statement made by one party to induce another party to enter into a contract strategy map - CORRECT ANSWER Provides a visual framework for integrating strategies Dr. Smith, a surgeon at Community Hospital, is trying to understand how she can help the hospital improve reimbursement from Medicare. The HIM manager explains to Dr. Smith that reducing catheter-associated UTIs and surgical site infections would improve the hospital's scores in which of the following domains of the Medicare Value-Based Purchasing program? - CORRECT ANSWER SAFETY At a recent medical staff committee meeting, a committee member asked what the state laws are for breach notification and how these laws will impact facility policy. The HIM director explained to the committee member that the state laws for breach notification are ________ and therefore may not guide facility policies related to breach notification for medical information. - CORRECT ANSWER generally not tailored to medical information The Hay method is used to measure the three levels of major compensable factors: the know-how, problem-solving, and accountability requirements of each position. This system is used for: - CORRECT ANSWER job evaulation Caroline is interviewing candidates for a supervisor of release of information position. She asks each candidate to explain how they would prepare a record in answer to a subpoena. This is what type of interview question? - CORRECT ANSWER job knowledge A core data set developed by the American Society for Testing and Materials (ASTM) to communicate a patient's past and current health information as the patient transitions from one care setting to another is: - CORRECT ANSWER continuity of care The HIM director hired an HIM data integrity analyst. This is a new position with a newly created job description. The director needs to develop performance standards for this job and will review a random selection of the job tasks performed in order to develop baseline data for future job performance assessments. This method is called: - CORRECT ANSWER work sampling In figuring a drug dosage, it is unacceptable to round up to the nearest gram if the drug is to be dosed in milligrams. Which dimension of data quality is being applied in this situation? --often relates to numerical data. It denotes how close to an actual size, weight, or other standard a particular measurement is - CORRECT ANSWER precision If a data breach caused by willful neglect is corrected within 30 days from the date of the covered entity or business associate becoming aware of it, what level of violation of the HIPAA Omnibus Rule is this breach? - CORRECT ANSWER Tier 3 The Omnibus Rule created a new fine structure for civil monetary penalties based on a four-tier system for HIPAA violations. Tiers 3 and 4 are based on violations that have been determined to be due to willful neglect. In this situation, because the breach was corrected within 30 days from the date of discovery it would fall into Tier 3. If it wasn't corrected, it would be a Tier 4 violation ________are often referred to as data about data. Metadata are structured information used to increase the effective use of data. By describing data, metadata makes it easier to locate, retrieve, use, and manage - CORRECT ANSWER metadata A potential employee was required to undergo a physical exam prior to becoming employed by San Fernando Hospital. This employee's medical information is: - CORRECT ANSWER Not protected by the Privacy Rule because it is part of a personnel record The computer-based process of extracting, quantifying, and filtering data that reside in a database is called: - CORRECT ANSWER data mining Which data collection program is the basis for the CMS value-based purchasing program? - CORRECT ANSWER hospital compare The health record of Kathy Smith, the plaintiff, has been subpoenaed for a deposition. The plaintiff's attorney wants to use the records as evidence to prove his client's case. In this situation, although the record constitutes hearsay, it may be used as evidence based on the: - CORRECT ANSWER business record exception The Business Record Exception is the rule under which a record is determined to not be hearsay if it was made at or near the time by, or from information transmitted by, a person with knowledge; it was kept in the course of a regularly conducted business activity; and it was the regular practice of that business activity to make the recor Physicians use the ________ to access multiple sources of patient information within the healthcare organization's network. - CORRECT ANSWER clinician web portal model for HIE includes multiple enterprises agreeing to connect and share specific information in a point-to-point manner - CORRECT ANSWER The Federated—inconsistent databases is based only on the arithmetic difference between total revenue and total expenses of the current fiscal year - CORRECT ANSWER net income The relationship between patient gender and readmission to the hospital is best displayed using a: - CORRECT ANSWER Contingency tables are a useful method for displaying the relationship between two categorical variables. Contingency tables are often referred to by the number of rows and columns The elements of a contract must be stated clearly and specifically. A contract cannot exist unless all the following elements exist: - CORRECT ANSWER there must be an agreement between two or more persons or entities and the agreement must include a valid offer, acceptance, and exchange of consideration Susan is completing her required high school community service hours by serving as a volunteer at the local hospital. Relative to the hospital, Susan is a(n - CORRECT ANSWER workforce member An encrypted laptop was stolen from your organization. Based on the Breach Notification Rule, how should you respond? - CORRECT ANSWER do nothing, a breech did not occur Under what access security mechanism would an individual be allowed access to ePHI if he or she has a proper login and password, belongs to a specified group, and his or her workstation is located in a specific place within the facility? - CORRECT ANSWER context-based Between which two health information system applications is there the least interoperability at the present time? - CORRECT ANSWER EHR in a physician office and revenue cycle management When adopting value-based care, what technology helps healthcare professionals appropriately use financial information that may impact their choice of drugs, referrals, need for care coordination, and other factors for their patients? - CORRECT ANSWER Integration of EHR and RCM (revenue cycle management) In the Hospital Value-Based Purchasing Program, a facility's total performance score (TPS) is used to determine the amount of holdback dollars the facility has earned. In regard to the TPS, which is better? - CORRECT ANSWER A higher TPS is better The hospital value-based purchasing (VBP) will measure hospital performance using four domains. The domain scores are combined resulting in a total performance score (TPS). A facility's TPS determines what portion of the hold back amount the facility will earn back. For every point increase in the TPS, the provider will increase payment by a portion of the hold back dollars, so in this VBP, the higher TPS score is desired Working with the healthcare entity's integration team to ensure that registration interfaces are properly built and tested is the responsibility of the: - CORRECT ANSWER MPI manager Monitoring and managing a master patient index (MPI) also requires constant vigilance from the organization, including oversight, evaluation, and correction of errors. The overall responsibility of maintaining the MPI should be centralized and given to an individual who is detail oriented, is properly trained, has access to adequate tools, and is well versed in the organization's policies and procedures for MPI maintenance. Working with the organization's integration team to ensure registration interfaces are properly built and tested is a key responsibility of the MPI manager Which of the following is a conflict management method in which both parties meet with an objective third party to explore their perceptions and feelings? - CORRECT ANSWER Conflict management focuses on working with the individuals involved to find a mutually acceptable solution. There are three ways to address conflict: compromise, control, and constructive confrontation. Constructive confrontation is a method in which both parties meet with an objective third party to explore their perceptions and feelings. The desired outcome is to produce a mutual understanding of the issues and to create a win-win situation Community Hospital uses barcoding technology as part of its medication management processes. Barcoding is an example of - CORRECT ANSWER Character and symbol recognition technology What is the benefit of comparing the coding assigned by coders to the coding that appears on the claim? - CORRECT ANSWER May find claim generation issues that cannot be found in other ways atlas severity of illness - CORRECT ANSWER presents ordinal data Terminal-digit filing system - CORRECT ANSWER records are filed according to a 3-part number made up of two-digit pairs; basic filing system contains 10,000 divisions made of 100 sections ranging 00 to 99 with 100 divisions within each section ranging from 00 to 99 ANSI (American National Standards Institute) - CORRECT ANSWER establishes standards for healthcare transactions healthcare financing administration - CORRECT ANSWER responsible for level two national codes Straight numeric filing system - CORRECT ANSWER In this type of medical record filing system, the records are arranged consecutively in ascending numeric order. records that not being used are pulled from one area Test sensitivity - CORRECT ANSWER the ability of a test to correctly identify those with the disease (true positive rate) # of true positives/# of total positives HIPAA (Health Insurance Portability and Accountability Act) - CORRECT ANSWER detects fraudulent health plans This type of data display tool is used to illustrate frequency distributions of continuous variables, such as age or length of stay (LOS - CORRECT ANSWER histogram Which of the following is a mechanism that records and examines activity in information systems? - CORRECT ANSWER audit controls Line graphs are used for - CORRECT ANSWER showing change over time used to compare the relationship between 2 things if both variables increasing--positive relationship if both variables decreasing--negative relationship FOIA (Freedom of Information Act) - CORRECT ANSWER requires federal agencies to release files to the public, unless the material falls into certain exceptions for national security or other confidential information the average number of days between the discharge date and the receipt of payment for services rendered is identified as - CORRECT ANSWER a/r days ACO - CORRECT ANSWER accountable care organization: groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. OCR (Optical Character Recognition) - CORRECT ANSWER When you scan a document, it's like taking a picture that results in an image. The letters and sentences in that image can't be changed or manipulated. ______ is software that attempts to recognize the individual characters and transform the image back into a document that can be edited. ICR - CORRECT ANSWER Intelligent Character Recognition or Image Copy Recognition is a more specific OCR. ICR learns different fonts and styles of handwriting. According to industry best practices, password changes should occur ever ____ to ____ days - CORRECT ANSWER 120-180 Theory Z (Ouchi) - CORRECT ANSWER Japanese Model People are more loyal to a company if they have part in the decision making ____ technology is a digital, distributed ledger of transactions that use an 'append only' data structure, which are recorded and stored in blocks of data on every node of the network - CORRECT ANSWER blockchain fetal death rate calculation - CORRECT ANSWER fetal deaths/(live births + fetal deaths) inductive reasoning - CORRECT ANSWER specific to general--top down process that involves drawing conclusions based on generalizations, rules, or principles Swimlane - CORRECT ANSWER an activity diagram component that divides the workflow activities into groups showing which agent performs which activity business process A new Health Information Department has purchased 200 units of 6-shelf files and plans to implement a terminal digit filing system. How many shelves should be allocated to each primary number? - CORRECT ANSWER 600 unitsx6 shelves per unit=3600 shelves total 3600shelves/100 primary numbers=36 shelves per primary number POMR (problem oriented medical record) - CORRECT ANSWER Organized by problem number Database: history and physical Problem List: titles, numbers, dates of problems..."Table of Contents" of the record Initial Plan: describes diagnostic, therapeutic, and patient education plans Progress Note: documents the progress of a patient throughout the episode of care Discharge Note/ Transfer Note: summarizes episode of care and current status of patient how many inches are recommended for aisles between file units - CORRECT ANSWER 32 A data repository would include which of the following information? - CORRECT ANSWER clinical, administrative and financial patient data integrated progress notes - CORRECT ANSWER all progress notes documented by physician , nurses and other professionals are organized in the same section of the record advanced directives - CORRECT ANSWER are not required to be included in the patient chart PQRS (Physician Quality Reporting System) - CORRECT ANSWER a health care quality improvement incentive program initiated by the centers for medicare and medicaid services in the united states in 2006 ONC - CORRECT ANSWER created the guide to privacy and security of health information to guide healthcare organizations through the establishment/creation of a privacy and security compliance program within their organizaion triangulation - CORRECT ANSWER the use of multiple sources to investigate the same phenomenon MAC auditor - CORRECT ANSWER performs prepayment reviews for medicare topography - CORRECT ANSWER the source of origin of a neoplasm WARN - CORRECT ANSWER requires that organizations employing more than 100 people give the employees and the community 60 day notice of its intent to close the business or to lay off 50 or more members of its workforce physician index - CORRECT ANSWER A list of patients and their physicians that is usually arranged according to the physician code numbers assigned by the healthcare facility ____ is the sequence of processes to progress a patient account from creation to closing - CORRECT ANSWER revenue cycle CHAP (Community Health Accreditation program) - CORRECT ANSWER it accredit home health and hospice programs Temperature is classified as what type of data - CORRECT ANSWER interval Hawthorne effect - CORRECT ANSWER A change in a subject's behavior caused simply by the awareness of being studied Most large facilities use a ____ system - CORRECT ANSWER unit numbering within an ERD, entities are represented with _____, attributes are represented with ____, and relationships are represented with ______ - CORRECT ANSWER rectangle, circle, diamond location of care is an example of which type of data - CORRECT ANSWER administrative data IRB (Institutional Review Board) - CORRECT ANSWER any academic research needs to be proposed to their IRB, review for ethical violations and/or procedural errors protects the rights and welfare of human research subjects involved in research activites All of the following are elements supported by the OIG as essential components of an overall compliance plan except: a. longitudinal studies b. benchmarking c. nominal group technique d. regular reporting - CORRECT ANSWER nominal group technique is another type of statistical inference that not only measures the strength of the relationship between two variables, but also estimates a functional relationship between them. SLR may be used when one of the two variables of interest is dependent on the other - CORRECT ANSWER Simple linear regression (SLR) Once the budget preparation period is over and budget reports are issued, the budget becomes a controlling tool. - CORRECT ANSWER Responding to a monthly budget variance report is a statistic that is used to describe the association or relationship between two variables - CORRECT ANSWER correlation A clinic that is expanding its service offerings and needs an individual to help design a new database will be searching for a: - CORRECT ANSWER A data administrator focuses on understanding interrelationships among data in order to prepare a logical design for a database. A database administrator is an information technology specialist in database implementation and maintenance. Data governance managers are, typically, users of databases. Data technologist is not a commonly used job title, but it may be one who manages metadata In which type of health information exchange architectural model does the entity operate much like an application service provider (ASP) or bank vault? - CORRECT ANSWER The federated architectural type has become more prevalent for health information organizations. There are two forms of this architecture. The consistent federated form is very similar to the consolidated architecture in which the data repository is partitioned but centrally managed. The consistent federated form, however, takes this one step further and physically separates the data but still offers centralized management. Essentially, this is much like an application service provider (ASP) or software as a service (SaaS) model of acquiring software a tool designed to coordinate multidisciplinary care planning for specific diagnoses and treatments - CORRECT ANSWER Clinical pathways describes how data will be processed - CORRECT ANSWER data model probability of making a Type I error based on a particular set of data is called - CORRECT ANSWER p-value The Administrative Simplification portion of Title II of HIPAA addresses - CORRECT ANSWER Uniform standards for transactions and code sets The process of integrating healthcare facility systems requires the creation of - CORRECT ANSWER Enterprise master patient indexes [Show More]

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