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Midterm test
| Question | Answer |
|---|---|
| Cancer registrars collect cancer data from variety of sources and reports cancer statistics to who and the purpose | To insure timely accurate and complete collection and maintenance of cancer data (government and health agencies |
| A coding specialist ensures that all diagnosis, services, and procedures documented in patients records are | Coded accurately to ensure reimbursement and for research and statistical |
| Patient data is organized, analyzed, and maintained by health information managers to do what | To ensure the delivery of quality health |
| Health insurance specialists verify health claims against third-party payer guidelines for what reason | To authorize appropriate payment or refer claim to an investigator for more review |
| Health services managers plan, direct, coordinate, and supervise the delivery of health care. They include specialists who | Direct clinical department or services and generalist who manage an entire facility or system |
| Medical assistants perform routine administrative and clinical tasks, which include | Answer telephones, greet patients, update and file patient records, insurance claims, lab tests |
| Medical staff coordinators usually report directly to the health care facility's administrator, and they are responsible for managing the medical staff office and complying with medical staff by laws, which means they manage what | The physician credentialing and recredentialing process |
| A privacy officer oversees the development, implementation, and maintenance of, and adherence to, an organization's policies and procedures covering privacy of and access to patient health information in compliance with | Federal and state laws |
| A quality manager coordinates a health care facility's quality improvement program to | Improve patient outcomes |
| A risk manager investigates incident reports to | Recommend appropriate corrective action |
| 10% of the medical staff is non compliant regarding documentation issues related to appropriate assignment of diagnosis and procedure codes. Which professional would be best to provide in- service training in this area | Coding specialist |
| Which professional initially greets Mrs. Petrie and updates her registration information in the computer system | Medical assistant |
| Which professional would review M. Lambert' claim to verify it against third-payer guidelines to determine if payment is authorized | Health insurance specialist |
| Diagnosis-related groups (DRGs) classify inpatient hospital cases into groups that are expected to consume similar hospital resources. Which is characteristic of inpatient care received under DRGs | Inpatients remain in the hospital until they are well enough to be discharged home |
| An acute care facility (ACF) is a hospital that provides health care services to patients who have serious, sudden, on acute illnesses or injuries and who need certain surgeries. Which is an accurate statement about an ACF? | Government and health care agencies ( state cancer registries.. |
| Hospitals have an organized medical and professional staff, and inpatient beds are available 24 hours per day. The primary function of hospitals is to provide inpatient medical and nursing services.. | Coded accurately to ensure reimbursement and for research and statistical |
| To calculate an inpatient length of stay (LOS), count the day of admission but not the day of discharge. A patient admitted on July 25 and discharged on August 3 has which LOS. | 9 days |
| Hospitals categorized as critical access hospital (CAH) are | Those located more tha 35 miles from any other hospital or another CAH |
| Which characteristic of general hospitals | Provide emergency care perform general surgery and admit patients for a range of problems. |
| Physicians who spend most of their time in a hospital setting admitting patients to their inpatient services from local primary care providers are called | Hospitalists |
| Outpatients are treated and released the same day and do not stay overnight in the hospital. Their length of stay (LOS) is maximum of | 23 hours, 59 minutes and 59 seconds |
| Ambulatory surgery patients undergo certain procedures that can be performed on an outpatient basis, which means the patient is | treated and released the same day |
| Hospice care provides comprehensive medical and supportive social, emotional, and spiritual care to terminally ill patients and their families. The goal of hospice is to provide | Palliative care (comfort management) |
| Measurement of the ability of health care facilities to deliver care that is safe and adequate in accordance with federal law and regulation is called federal | Certification |
| Along-term care hospital (LTCH) is defined in the Medicare law as a hospital that has an average inpatient length of stay (LOS) that is | Greater than 25 days |
| Long-term care services that provide assistance with activities of daily living (ADL) are associated with | Custodial care |
| Medicare does not usually reimburse | Residential care facility |
| Pre-admission certification (PAC) is defined as a form of utilization management that | Involves the review for medical necessity of inpatient care prior to inpatient admission |
| Which managed care model provides benefits to subscribers who receive health care services from network providers | Exclusive Provider Organization (EPO) |
| Physicians who are employed by a health maintenance organization (HMO) are members of a | Staff model HMO |
| Independent practice associations negotiate a health maintenance organization contract that manages the predetermined "capitation payment," which what | Care for a group of subscribers |
| "Major medical care" is provided to inmates by who | Federal Medical Centers (FMC's) |
| The Military Health System (MHS)administers health care for active members of the uniformed services (and their dependents) Which provides health care services | Military Treatment Facility and networks of civilian health care professionals |
| Which is the goal of both manual and electronic patient records? | Documentation of patient care. |
| Which is most important for medico-legal purposes. | The entire record. |
| Which is an example of information capture.. | Generating images through x-rays. |
| The primary purpose of the patient record is to provide continuity of care, which means what.. | Documenting services so others have have a source from which to base care on.. |
| SOAP is the abbreviation for what.. | Subjective, Objective, Assessment, Plan |
| The SOAP format is commonly used by physicians to document progress notes, the subjective portion is used for what reason.. | How Patient feels.. |
| The Computer stored Ambulatory Record (COSTAR) System is what.. | Outpatient electronic health record created at Massachusetts General Hospital with the goal of improving the availability and organization of outpatient records.. |
| A consideration when discussing hospital organization is to identify the "population served by a health care facility." This means that health care is provided to specific groups of people. Which is a true statement... | A facility that specializes in the treatment of inpatient children is usually called a pediatric hospital..(Inpatient bed size licensed by the state determines whether hospital is generalized or specialized.. |
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