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HC265 F. study guide

Health Information Technology

The term used to describe the training to familiarize a new employee with the job Orientation
A health care organization that has permanent facilities, 24-hour nursing care, and an organized medical staff Hospital
CD-9-CM is coordinated and maintained by a group of four organizations collectively called cooperating parties
The application to an insurance company for reimbursement claim
Data collected pertaining to the investigation of the patient's current health situation clinical data
The cause or source of a patient's condition or disease etiology
A hospital with an average length of stay less than 30 days, an emergency department, operating suite, and clinical departments to handle a broad range of diagnoses and treatments acute care facility
The first page in a paper record is usually admission record
A list of potentially inaccurate or problem data, usually generated by a computer error report
A paper record must be _________ before it can be analyzed assembled
The blending of the insurance and provider roles in health care delivery managed care
ICD-9-CM diagnosis and procedures codes are used to derive the DRG by following the flowchart grouper
The minimum data set for emergency services DEEDS
involves the review of a function to determine all of the tasks or components that make up an employee's job job analysis
contains patient and encounter information, often used to correlate the patient to the file identification master patient index
A physical file is used to identify an alternate location of a file in the paper-based health care record system outguide
A way to authenticate electronic data such as a password or pin number is with a digital signature
is a summary of the patient record abstract
A report of a group of patients including their age is an example aggregate data
The number of patients present in the health care facility, counted at the same time each day census
is a quality improvement technique used to elicit participation and information from an entire group Brainstorming
A method used to effectively manage patients during their hospitalization case management
If a facility meets the standards set by a licensing or accrediting body compliance
Example -A facility is reviewing its policies and procedures to ensure that they comply with JCAHO standards Accrreditation
Who administers Medicare? CMS
What amendment established Medicare to the Social Security Act? Title XVIII is the amendment to the Social Security Act
A contractor who manages health care claims for Medicare Fiscal Intermediary
The study of health trends or patterns Epidemiology
The ability of a patient to see a physician without an appointment Open-access
In a paper record, the admission record is often synonymous Face sheet
the capture of data concurrently with its observation associated with data quality characteristic Timeliness
In an electronic environment, changes to a patient’s record should be tracked Audit trail
Per a day - long-term care prospective payment is based on per diem Per diem
Ambulatory care visits measured? Encounters or visits
What patient attributes are important to grouper assignment? Gender and body system
RAI used where? The MDS is one component of a series of data collections called the RAI, Long-term care
What is color coding of a numerical identification of a file for? Prevents misfiles
How long must health records be kept? Five years
A federally mandated database collected on all inpatients discharged from a hospital UHDDS
The database mandated for collection on outpatients UACDS
What does the Medical executive committee oversee? liaison to the governing board
Who was the predecessor of JCAHO? ACS
What is an example of Prospective consent? Conditions of admission
The practice of maintaining confidentiality in health care is Physician –patient privilege
career opportunity for HIM professionals in information technology? Project Management, Design and Development, Marketing and Sales
advantages of the Electronic Health Record? Accessibility, Standardization, Improvement in quality of health
An employee, who works 16–20 hours each week, occasionally earning partial benefits part time employee
How often should policy and procedures be updated Annually and as needed due to change
Which organization orientation topics may be presented by an HIM employee? Confidentiality