CCA 3 Domain 4 Compliance

Randomly audit EHR documentation for patients readmitted within 30 days.

A hospital allows the use of the copy functionality in its EHR system for documentation purposes. The hospital has established explicit policies that define when the copy function may be used. Which of the following would be the best approach for conducting a retrospective analysis to be determine if hospital copy policies are being followed?

Concurrent review

A quantitative review of the health record for missing reports and signatures that occurs and signatures that occurs when then patient is in the hospital is referred to as a?

Fraud

An intentional representation that an individual knowingly does to be false and knowing that the act could result in some unauthorized benefit to some other person is an example of:

Ethics

For coding and billing professionals, being compliant means to perform one's job functions according to the laws, regulations and guidelines with intergrity as set forth by Medicare and other third-party payers. This is an example of:

CMS

In determining the data collection requirements for Medicare patients in a long-term care facility, the health information technician would consult standards from:

Nursing staff

In developing a coding compliance program, which of the following would not be ordinarily included as participants in coding compliance education?

Improve program integrity for Medicare by educating beneficiaries to report errors noticed on their explanation of benefits (EOBs) to the Department of Health and Human Services (HHS)

One objective of the Balanced Budget Act (BBA) of 1997 was to:

50%

The Joint Commission requires that the medical record delinquency rate quarter averaged from the last four quarterly measurements is not greater than ____ of the average monthly discharge rate?

Recovery Audit Contractors

The Medicare Modernization Act (MMA) of 2003 called for CMS to launch a Medicare payment recovery demonstration project. The purpose of the act eventually resulted in the implementation of a group contracted by the government to monitor suspicious and improper activity of Medicare payments including overpayments and underpayments. What is this group?

False Claims Act

This was passed during the Civil War in order to prohibit contractors of any kind from knowingly filing a false or fraudulent claim, using a false record or statement, or conspiring to defraud the US government?

Legal health record

What is the term used for the record of care in any health-related setting, used by healthcare professionals while providing patient-care services or for administrative, business, or payment purposes?

Applies to all orders and all medication-related documentation that is handwritten (including free-text computer entry) or on pre-printed forms.

Which of the following is true about Joint Commission's "Do Not Use" abbreviation list?

Nurse working on the unit where the patient is located

Which of the following personnel should be authorized, per hospital policy, to take a physician's verbal order for the administration of medication?

Provider

Who is responsible for ensuring the quality of health record documentation?