chapter 11 Review

Which if the following is NOT objective information?

Family History.

Which of the following is NOT an advantage of a numeric filing system?

Filing activity is greatest when the system is initiated.

Medical facilities should keep records on minor for how long?

Until the minor reaches the age of majority, plus 3 years

The medical record should be released only with a ?

written release from the patient.

How are corrections made to the electronic health records?

A new entry or addendum must be added close to the original entry with the correction information and the initialed.

Disadvantage of the EHR system include?

All of the above

Many healthcare facilities now use voices recognition software for transcription. The system can be used to dictate which types of reports?

All of the above

The advantage of using the color-coding filing system are the following:

All of the above

The medical assistant should consider which of the following when selecting filing equipment?

All of the above

Which of the following is not an advantage of color-coded filing system?

All of the above are advantage.

For a record to be admissible as evidence in court, the person dictating or writing the entries must be able to attest that they were true and correct at the time they were written. The best indication of this is the provider's signature or initials in the typed or EHR entry?

Both statement are true.

Which of the following function of an electronic record can store lists of billing codes and current procedural terminology?

Charge capture

Which statement is NOT accurate about correcting charting errors?

Draw two clear lines through the error.

The type of electronic record of health-related information about a patient that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff from more than one healthcare organization is a ?

EHR

They type of electronic record of health-related information about an individual that can be created, gathered, managed, and consulted only by authorized clinicians and staff in a single healthcare organization is an?

EMR

In a paper record, which of the following is never an acceptable method of correction to a handwritten entry?

Erase or use correction fluid.

How would you properly index the name "Jill Freeman,MD." for filing if you has an other patients with the same name but without the title?

Freeman,Jill M.D

What is one id the benefits if using a paper health record?

Good evidence of patients care

What is the HIPPA privacy rule requirement for the retention of health records?

HIPPA does not include requirements.

HIPPA recommends that physicians keep the records on patient for at least?

HIPPA does not recommend a number of years.

Which section of the law, commonly known as the Economic Stimulius Package, pertains to healthcare?

HITECH Act

Which of the following is NOT needed when describing a patient's chief complaint?

How many family members are healthy.

IN most cased, does the electronic health records system require more or less storage space than a paper filing system?

Less

Which of the following indirect filing system is used by a majority of large clinics and hospitals?

Numeric filing

Which EHR system backup is probably the least trouble and required the least amount of hardware?

Online backup system

A set of physical properties, the values of which determine characteristics or behavior, is called ?

Parameters

The physical medical record belongs to the ?

Physician or provider

Which of the following is NOT a method of organizing a medical record?

Progressively

Which of the following health information exchange allows providers to find and/or request information on a patient from other providers?

Query-based exchange

Improved outcome is part of which of the stage of meaningful use?

Stage 3

How would you properly index the name "Amanda M. Stiles-Duncan" for filing?

Stilesduncan,Amanda M

Information that is gained by questioning the patient or that is taken from a form is called information?

Subjective

Who is responsible for calming patients fears and concerns about switching to an electronic medical record system?

The entire team at the office.

Who ultimately decides whether a medical record can be released?

The patient

Which statement is NOT true regarding the reasons for keeping accurate medical records?

The patient's family may want to examine the records and correct errors.

Who is the legal owner of thr information stored in a partient's record?

The physician or agency where serves were provided.

How can the EHR function to best help improve a facility appointment show rate?

The system can be programmed to initiate remind and confirmation calls to patients.

The most frequently used follow-up method is a ?

Tickler file

What is the most important reason for telling the physician when a charting errors is discovered later?

To protect the patient's health and well being.

Advantage of the EHR system include?

ability if the physician to see more patients in a day.

The newest component used today to complete transcription an authenticate records is software?

voice recognition.

Files for patient who have died, moved away, or otherwise terminated their relationship with the physician are called file?

closed.

A correction to a medical record can be made by?

drawing a line through the entry and writing the correction information.

A filing system in which an intermediary source of reference, such as a file card, must be consulted to locate specific files is called a(n) system?

indirect filing

Perhaps the most essential action for the medical assistant working with a patient and using an electronic records is to?

make frequent eye contact with the patient and smile

Continuity of care means?

medical attention that continues smoothly from one provider to another so that the patient receives the most benefit.

A strong, highly glazed composition paper or heavy card stock is called?

pressboard

The process of moving a n active file to inactive status is called?

purging

The "R" entry is the SOAPER charting the method means?

response

The preferred filing method for a physicians's office is ?

the one most preferred by the staff.