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RHIA exam study questions

What is a "Zero Balance" Budget? Zero Based Budgets apply to organizations for which each budget cycle poses the opportunity to continue or discontinue services based on the availability of resources.
What is a statement made by one party to induce another party to enter into a contract. ? A Warranty
A viable solution to a staff recruitment problem would be? Telecommuting - An opportunity for employees who cannot travel from home for reasons such as physical or personal limitations to become employed and helps resolve the problem of shortages of qualified employees in critical job functions.
what can organizations use to offer flexibility in hours, location, and job responsibilities as a method to attract and retain employees. Alternative staffing structures.
what is the difference between Qualitative and Quantitative standards Quantitative standards specify the level of measurable work, or productivity, expected for a specific function. Qualitative standards specify the level of service quality expected from a function. diagnostic and procedure codes for in
what is a Indemnification clause? To transfer or assume liability. The indemnitor(the party assuming liability), may agree to hold the other party harmless against claims arising from the indemnitor's own actions or failure to act.
When the operating budget has been developed and approved. who has the responsibility of making sure budget goals are met and that all variances are explained? The department manager
violation of AHIMAS Code Of Ethics triggers: A review by peers with potential disciplinary action
what is liquidity The ease with which assets can be turned into cash. This is important because payroll, loan payments, and other financial obligations are typically paid in cash.
When the project manager records a document with project objectives, scope, deliverables, expected time line, and anticipated cost this document is called.. project charter, statement of work, and project definition document or business plan.
what is considered "alternative work scheduling techniques" Telecommuting , Open systems, and Flextime
the time required to recoup the cost of an investment is called the: payback period
why does a leader use a Strategic Planning process? For assessing a changing environment to create a vision of the future; determining how the organization fits into the future environment based on its mission, vision, and knowledge of its strengths, weaknesses, opportunities, and threats.
The consecutive handling of tasks or products by individuals who perform a specific function in sequence is called Serial work division
Which financial statement reflects the extent to which a healthcare entities revenues exceed expenses? an income statement summarizes the organizations revenue and expense transactions through the fiscal year. the income statement can be prepared at any point in time and reflects up to that point. it is used to review the current fiscal year only.
Why is a strategy map a useful tool? It provides visual representation of an organizations critical objectives and the relationships among them that drive organizational performance. Depicting change is a useful way to help others understand the goals and the course of change
Who are the early Majority? Comprise 34% of the organization. Although usually not leaders, the individuals in this group represent the backbone of the organization, are deliberate in thinking and acceptance of an idea, and serve as a natural bridge between early and late adopters.
What is the role of the project office? A project office is responsible for defining project procedures, conducting risk analysis on projects, and mentoring project managers.
What is a component of the five functions of management. strategic management and thinking
What are the five functions of management organizational learning, change management, strategy development, visioning, and leadership.
What is an important part of change management. Communication is key to engaging others to the visit on and change process. The communication plan must offer groups the opportunity to talk back. Listening to staff concerns through the process is an important element.
What are process measures? The evidence-based best practices that represent a health system’s efforts to systematize its improvement efforts.
What is the difference between leaders and managers. Managers seek methods and ask how something can be done. Leaders seek motives and wonder why things are as they are and how they can be different.
A coding service had 400 discharged records to code in March. The service coded 200 within 3 days, 100 within 5 days, 50 within 8 days, and 50 within 10 days. The average TAT for coding in March was ____. (volume x amount of time ) + any additional volumes and times / total volume required. (200*3) +(100*5) + (50*8) + (50*10) add each answer of problem in parentheses together 600+500+400+500=2,000 divide by total number of records 2,000/400=5
What is the icon used to indicate that a formal procedure is to be carried out the same way every time in a flow chart? The rectangle with double lines on the side is a predefined process icon.
Which financial statement is a snapshot of the accounting equation at a point in time? The balance sheet
An action that can revoke your RHIA and RHIT credential: AHIMA's code of ethics violation.
What is a needs assessment? A combination of methods, media, content and activities into a curriculum that is matched to a specific education, experience and skill level of the audience.
How do you calculate Range The range of a set of data is the difference between the highest and lowest values in the set. To find the range, first order the data from least to greatest. Then subtract the smallest value from the largest value in the set.
How do you calculating shelf space needed for filing medical records? multiply the # of shelves selected by the linear inches of shelf space (usually 33) .Multiply the anticipated discharges by the # of projected years . Multiply the average thickness of the records by the #of records. divide inches needed by linear inches
How do you calculate Proportionate mortality ratio? (PMR) is the measure of mortality due to a specific cause during a specific time Period. the number of deaths due to a specific disease in a specific period in time /the total number of deaths for all cases for the same time period x 100
How do you calculate case mix index? relative weight = weight x discharges sum relative weights/ sum of discharges = case mix index
How do you determine staffing levels needed? number of volume of work/maximum expectation per work hour. sum all answers in each category and divided by hours in each shift.
How do you calculate nosocomial infection rate or rate of occurrence Total number of hospital-acquired infections for a given period/ total number of discharges including deaths for the same period x 100
Having more than one person do the checking for the same case is called? Interrater reliability method by
Which basic Services provided by in the hie insurance that information can be retrieved as needed Secure data transport
When all computers receive the same message at the same time but only one computer at a time can transfer information, what type of network is this? Bus topology is the simplest Network topology connecting one device to another along a backbone.
What is a user case use case is a set of scenarios that describe an interaction between a user and a system
What is the relationship between a use case and an actor an actor represents a user or another system that will interact with the system being modeled a use case is an external view of the system that represents some action the user might perform in order to complete a task
A centralized database that captures, shorts, and processes patient data and then send it back to the user is called? Clinical data Repository
What is the key to an effective retention and retrieval system of health records
What type of health information exchange architectural model is a Federated - inconsistent database The Federated - inconsistent database - model 4 HP includes multiple Enterprises a green to connect and share specific information in a point-to-point manner
When an individual is allowed to accesse ePHI if he or she has a proper login and password, belongs to a specific group, and his or her workstation is located in a specific place within the facility what kind of Access Control is this Context based access is the most stringent type of Access Control it 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
When analyzing the reason for changes in the hospital's Medicare case mix index over what levels of detail should the analyst start with? Ms-drg triples, pairs, and singles
When a patient is assigned a health record number on the first visit that is kept for all subsequent visits this is called? Unit numbering
A system that gathers data from a variety of sources and assist in providing structure and visual Tools in order to facilitate and improve outcomes and decision-making tasks is called Decision support system
Data that can be extracted from individual health records about patients is called? Aggregate data is used to develop information about groups of patients
what application of statistical techniques allow informed decisions to be made Based on data Data analytics
What underlying technology used to store documents in addition to bar codes on medical record documents may be available to enhance accuracy of indexing features on forms? (OCR) optical character recognition
A simple random sample that may be generated by selecting every fifth or even tenth number of the sampling frame is called? Systematic random sample
Which identity matching process ensures that the HIV organization can identify the right patient as it seeks to exchange information? Person identification
What are examples of due diligence when it comes to purchasing an EHR system from a vendor? Site visits, corporate visits, reference checks, credit checks on owners of vendor company.
When virtually all applications are provided by a single vendor this frequently makes it easier to add new applications from that vendor but potentially even more difficult to add products from other vendors Best of fit
What are examples to a e-health applications The application of e-commerce to the healthcare industry. The links to healthcare Equipment and supply vendors, providers, and health plans and the transactions for exchanging data in healthcare eligibility comma referrals, claims,
What type of data display tool is used to display discrete categories A bar graph
What transmission medium is used to carry information between devices on the network Infrared light
In interoperability standard that define specific standards needed to assist patients in making decisions regarding care and Healthy Lifestyles specifically to enable the exchange of data between patients and their caregivers than networks Consumer empowerment
The Daily Report used to track the many reasons that accounts may not be ready for billing Accounts not selected for billing report or discharged not billed report
What is an advantage of the unit filing system One benefit of the unit filing system is that all records for both specific patient, both inpatient and outpatient, or file together
What are the three advantages of the median Relatively easy to calculate, based on the whole distribution not just a portion of it, it is not influenced by extreme values or unusual outliers in the frequency distribution
Access to multiple repositories of information from overlapping patient populations that are maintained and separate systems and databases Enterprise Master patient indexes
Why would abstractor be the best data conversion strategy for a physician practice that has a high rate If an organization is adopting an EHR where there are considerable discrete data and a supporting CDS it may want to extract some of or all of certain records so that the data are not only accessible for viewing but also available for processing
What are mainframe computers Mainframe computers use a single large computer with many terminals directly connected to it and sharing the resources of the single computer
This personal health record model allows an authorized patient to extract data from the provider's record. The record is still maintained by the provider but is available to patients in an online format EHR extension model
Which chart is used to display data from one or more variables Bar charts are used for nominal or ordinal variables
Which graph would you use to display time trends The line graph
What is DICOM
What is a tool commonly used in performance Improvement to assess the level of satisfaction with a process by its customers A survey
A network made accessible to trusted individuals outside of the facility is called an Extranet
Isn't it charge to provide clinical decision support it requires two things what are they Structured data and a clinical data Repository
What is best of breed An organization has acquired the best products from various vendors
Implementation of all aspects of the EHR component in all organizational units virtually simultaneously Big Bang rollout
What is the alternative hypothesis The alternative hypothesis is the compliment to the null hypothesis and typically require some action to be taken
When developing the data elements that go into a database the field should Normalized normalization is breaking the data mitt elements into the level of detail desired by the facility for example last name and first name should be separate fields
Tools required in healthcare organizations designed to perform intricate data sources and retrievals using online or real-time transaction processing is called Data Repository
One of the controls for accuracy of the MPI Limiting access to the index and limiting the ability to make changes to the few Key Personnel the first step to maintaining an accurate index is to obtain the correct information and admission or registration
What diagram is used to plot the points of to continuous variables that may be related to each other in some way Scatter diagram
What is the first step in statistical hypothesis Defining the null and alternative hypothesis
What is Hospital compare Hospital repair reports on 94 measures of Hospital Quality Care of heart attack heart failure and pneumonia and prevention of surgical infection hospitals that report all measures receive full payment updates for Medicare
Which topology of a network uses a central Hub as a traffic cop Star topology
Which phase of the system development life-cycle does initial training on a new information system General Lee occur During the implementation phase of the sdlc, a comprehensive plan for implementing the new system is developed the plan would include all plans for training managers technical staff and other end users
Invest numerical filing system records are filed according a three part number made up of two digit pairs The basic terminal digit filing system contains 10000 divisions, made up of 100 sections ranging from 00 to 99 divisions within each section ranging from 00 to 99 in a terminal digit filing system that shelving units are equally divided into 100 sections
These measures are used to report Mobility, mortality, and natality at the local, state, and National levels Mini Healthcare statistics are reported in the form of a ratio proportion or rate
What is the optimal relationship between strategic planning and strategic Information Services planning in strategic planning discussions, they should ensure that information Services leadership is also engaged in these discussions and examine the organization's view of the role that information service technology will play in the organization future
How do you calculate the gross autopsy rate Number of autopsies / the total number of deaths x 100
The most common architecture used in EHR in hospitals today is Client /server
This tool is used to gather data on Sample observations in order to detect patterns Check sheet
In what time frame do covered entities have to respond to requests for protected health information Covered entities must respond to requests to access protected health information within 30 days there can be a further 30-day extension however but the first response must be within 30 days
According to HiTech who would be excluded as a business associate Housekeeping staff
Why aren't firewalls effective for preventing all types of attacks on a Healthcare System As important as firewalls are to the overall security of Health Information Systems, they cannot protect the system from all types of attacks many viruses for example, can hide within documents that will not be stopped buy a firewall
What are addressable security rule implementation specifications They should be implemented unless an organization determines that the specification is not reasonable and appropriate if this is the case the organization must document why and adopting equivalent measure that is reasonable and appropriate to do so
What is an example of facility Access Control Facility access control standard requires covered entities take control and validate a person's access to the facility including visitor control an example of this would be a visitor sign-in sheet
Why must each physician practice obtain a business associate agreement with an entity or Hospital A physician who are a separate covered entities are dictating information on their private patients it would be necessary for Physicians to obtain a business associate agreement with the facility.
Why would a vehicle license plate not be an identifier under the Privacy Rule It does not identify the Carson, it does not relate to the person's past present or future physical or mental health condition, is not held by a covered entity or its business associate
What is the business record exception It is the rule under which a record is determined to be hearsay if it was made at or near the time bye, or from information transmitted by a, a person with knowledge, it was kept in the course of a regularly conducted business activity
What is the one required implementation specification centered on security incident procedures Covered entities must identify and respond to suspected or known security incidents, meditate to extant practice Apple, harmful events of security incidents that are known to the covered entity and document security incidents and their outcomes
What is the minimum necessary principal Facilities, programs, and Workforce members when using disclosing or requesting protected health information must make reasonable efforts to limit Phi to the minimum amount necessary to accomplish the intended purpose of the use disclosure or request
What is a two-factor authentication system The three methods of two-factor authentication which are something you know such as a password or pin something you have such as an ATM card token or swipe smart card or something you are such as a biometric fingerprint voice scan Iris or retina scan
How long must covered entities maintain and retain policies and procedures implemented to comply with the security rule The maintenance of policies and procedures implemented to comply with the security rule must be retained for six years from the date of its creation or date when it was last in effect whichever is later
Why were the federal Rules of Evidence recently amended In response to the tremendous volume of evidence maintained in electronic format the US Supreme Court a new legal term has evolve discovery creating a new paradigm with respect to the production of documents as a discovery method
Why should facility access controls be in place Facility access controls includes establishing safeguards to prohibit the physical hardware and computer system itself from unauthorized access while ensuring that proper authorized access is allowed
What is expert determination and safe harbor Expert determination and safe harbor are office of civil rights sanctions HIPAA Privacy Rule the identification methods
What are the two ways to Deidentify information A formal determination is made by a qualified statistician. the removal of specified identifiers of individual is required, and is adequate only if the covered entity has no knowledge that the remaining information could be used to identify the individual
What penalties can be enforced against a person or entity who willfully and knowingly violates the HIPAA Privacy Rule with the intent to sell, transfer, or use phi for commercial Advantage, personal gain, or malicious harm? A fine of not more than $250,000, not more than 10 years in jail or both may be imposed
What is the access control standard The implementation of technical policies and procedures for electronic information systems that maintain electronic protected health information in order to allow access only to those persons or software programs that have been granted access rights
What are the two required into addressable implementation specifications included in the access control standard The to required specifications are the use of unique user identification and emergency access procedures. The two addressable specifications are automatic log off and encryption and decryption
Is a covered entity required to scan paper records so that they may provide electronic copies of the medical record upon request No, if a covered entity does not maintain the entire designated record set electronically there is not a requirement that the covered entity scanned paper documents so the documents can be delivered electronically
What is the first consideration for a healthcare facility regarding a health risk analysis They must consider their own characteristics and environment and Implement reasonable and appropriate measures to process against reasonably anticipated threats and Hazards to the security of phi
What is the security risk analysis It is a process that provide covered entities and business associates with the structural framework upon which to build their security plan
What safeguards comprise over half of all the safeguards included in the security rule Administrative safeguards comprise over half of the safeguards included in the security rule administrative safeguards are administrative actions such as policies and procedures and documentation retention
What are administrative safeguards used for They are meant to manage the selection, development, implementation, and maintenance of security measures to protect ephi and manage the conduct of the covered entities or business associates Workforce
What is the emergency medical treatment and active Labor Act Emergency patients must be made aware of their rights transfer and acceptance policies and procedures must be delineated to ensure facilities comply with the emergency medical treatment and active Labor Act
What is the time frame for accounting of disclosures per hitech 3 years
What is the administrative simplification portion of the title II of HIPAA It requires the establishment of national standards for electronic Healthcare transactions and National identifiers for providers health insurance plans and employers
Name one type of protected health information that specifically must be identified in an authorization Distinction of psychotherapy notes is important due to the HIPAA requirements that these notes may not be released unless specifically identified in an authorization
What type of network uses a private tunnel through the internet as a transport medium that will allow the transmission of e-phi to occur between the coder and the facility's security A virtual private Network uses a secure tunnel through a public network, usually the internet, to connect remote sites and users security procedures include firewalls encryption and server Authentication
Why is the clinic practice of calling out a patient's full name not a violation of the hit of HIPAA Privacy Rule Calling out a patient's name in a waiting room or even on the facility's paging system is considered an incidental disclosure and therefore allowed in the Privacy Rule
When responding to request for individual access to Pho how should an individual be charged for the service The HIPAA Privacy Rule permits reasonable cost base charges for labor Postage and supplies involved in photocopying health information for the patient and his or her personal representative
The legal term used to describe when a patient has the right to maintain control over certain personal information is referred to as in healthcare related context privacy is the right of the patient to control disclosure of personal health information
If a patient request that disclosures made from her medical record be limited to specific clinical notes and reports given the HIPAA requirements how much the hospital respond Covered into the response to the patient by describing measures it has taken but does not guarantee that information is protected against incidental or accidental disclosure
For research purposes what is required for authorization The privacy rules General requirement is that authorization must be obtained for uses and disclosures of pH I created for research that includes treatment the individual
What are the requirements regarding fundraising solicitations and PHI
Why is it a violation of HIPAA to send fundraising solicitations only to cardiac patients Fundraising May Target a department of service or treating physician however if a fundraising activity targets individuals based on diagnosis prior authorization is required HITECH has strengthened fundraising requirements
What are the three elements of individually identifiable PHI identify the person or provide a reasonable basis to believe the person could be identified from the information given. relate to one's past, present, or future physical or mental health condition.held or transmitted by a covered entity or its business as
What are the circumstances where are the minimum necessary requirement does not apply Health care providers for treatment, individual or his or her personal representative, pursuant to individuals authorization to the Secretary of HHS investigations, compliance review or enforcement, as required by law or privacy Rule compliance
What is the Stark law The Stark law or federal physician self-referral statute prohibits Physicians ordering services for Medicare patients from entities which with the physician or an immediate family member has a Financial relationship
If fundraising activities are going to benefit the covered entity The CE must inform individuals in its NPP that protected health information may be used for the purpose and must include in fundraising materials instructions to the individual on how to opt out of receiving such materials in the future
Who is required to receive training in PHI policies and procedures Every member of a covered entities Workforce must be trained in PHI policies and procedures new members must be trained within a reasonable period of time after joining the workforce whenchanges are made to policies and procedures regarding privacy the wo
Covered entities must maintain reasonable and appropriate administrative, Technical, and physical safeguards to protect the EPI. What are the four General requirements of compliance Ensuring the confidentiality integrity and availability of all eph are they create receive maintain or transmit identify hand protect against reasonably anticipated threats to security or Integrity of the information protect against reasonably anticipated
What are the five accreditation decision categories of The Joint Commission Contingent accreditation
What is episode of care Episode of care reimbursement is a healthcare payment method in which providers receive one lump sum for all the services they provide related to a condition or disease
Long-term hospitals must meet state requirements for____ I'm having a great night with ____in order to receive payments Long-term care hospitals must meet State requirements for acute care hospitals and must have a provider agreement with Medicare in order to receive medicare payments
What is the role of fiscal intermediaries Fiscal intermediary verify that long-term care hospitals meet the required average length of stay of greater than 25 days
What is a charge description master Elements such as department and item number item description Revenue code HCPCS code price and activity status
Why is achieving legitimate optimization important When coders optimize the coating process they attempt to make code in for reimbursement as accurate as possible in this way the healthcare facility can obtain the highest dollar amount Justified within the terms of the government or insurance program
what is the formulary The formulary is composed of medications used for commonly occurring conditions or diagnosis treated in the healthcare organizations organizations accredited by The Joint Commission must document medications continued safety and efficacy annually
What is the role of a recovery audit contractor A program created through the Medicare monitor ization Act of 2003 to identify and recover improper Medicare payments paid to Health Care Providers on their fee for service Medicare plans
Why is a program for evaluation payment patterns electric reports also known as pepper important to hospitals when it comes to recovery audit contractors Pepper identifies those claims that could be targeted by the RAC and can be a great tool for Recovery audit contractor preparations because they outlined the hospital's medicare payment patterns compared to other hospitals in the state
The explanation of benefits, Medicare summary notice, and remittance advice documents only part of which revenue cycle area Claims reconciliation and collections
What is it called when accrediting bodies such as the Joint Commission or American osteopathic Association can survey facilities for compliance with the Medicare conditions of participation of hospitals instead of the government? Deemed status
What is an integrated delivery system The collaboration and integration of healthcare providers the goal of the integrated delivery system is to seamlessly deliver care along the Continuum of Care so one bill would be generated
Why should coding assigned by coders be compared to coating that appears on the claim This process will help identify whether the communication software between the health record system and the billing system is functioning correctly the HR department should share this comparison with patient financial services and information technology
What should be included in a query to a physician Name and contact number of the individual initiated the query and account number
What is a governmental designation by the state that is necessary for the facility to offer services Every state has a certain licensure regulations that Healthcare facilities must meet in order to remain in operation license regulations may include very specific requirements for the content format retention and use of patient records
Which revenue cycle area uses an internal auditing system or scrubber to ensure they were freed claims are submitted to third-party payers Claims processing
What is the purpose of a recovery audit contractor Recovery audit contractors work with a mission of reducing medical improper payments through detection and collection of overpayments identification of underpayments and implementation of actions that will prevent future improper payments
What is the Medicare summary notice or MSN The Medicare summary notices or the MSN details amount billed by the provider, amounts approved by Medicare, how much Medicare reimbursed the provider, and what the patient must pay to the provider by way of deductible copayment
What are the two areas the OIG says is responsible for 70% of bad claims Failure to document medical necessity appropriately and insufficient or missing documentation
What is resource-based relative value scale(RBRVS) A schema used to determine how much money Medicare providers should be paid. It is partially used by Medicare in the United States and by nearly all Health maintenance organizations(HMOs)
What are the three elements of the resource-based relative value scale Each resource-based relative value scale comprises of three elements physician work, physician practice expense, and malpractice, Each of which is a national average in the Federal Register
Why is it important to communicate that I service is hard-coded into the CDM If the decision is not effectively communicated the result could be duplicate building that in turn could result in over payment to the facility
If a non-participating provider accepting assignment how much would he or she be paid He or she is paid 95% of the Medicare fee schedule an example, the Medicare fee schedule amount is $200 the participating provider receives 160 which is 80% of 200 but that non-participating provider receives only $152 which is 95% of the $160
According to the Medicare fee schedule if a participating provider accept an assignment how much will he or she be paid 80% of the total fee and example if the total feed was $200 the participating provider with get 160 dollars which is 80% of $200
What is it called when the hrum department plans a focused review based on specific problem areas after the initial Baseline review has been completed This would be called a focused inpatient review
what is a physician champion Physician Champions assistant educating medical staff members on documentation needed for accurate billing
When must a history and physical be completed Within the first 24 hours following admission CMS requires that the history and physical examination must be completed no more than 30 days before or 24 hours after admission and the report must be placed in the record within 24 hours after admission
When do facilities begin counting days in accounts receivable Once the claim is submitted to the third party payer for reimbursement the accounts receivable clock begins
Which agency overseas identity theft violations The Federal Trade Commission has oversight responsibility for identity theft regulations and requires financial institutions and creditors to develop and Implement written identity theft prevention programs
What is the process for adding new technology into the charge description master Reviewing new technology for FDA approval, outpatient prospective payment system pass through assignment, to have a coding professional check the codes from the manufacturer for accuracy
Created by: Leameana