CEHRS, CBCS Study Questions

Oral information is not covered under the HIPAA Privacy provision. True or False

False

By law, each healthcare office and facility must have a written policies and procedures for back-up of data files, retention, purging and recovery. True or False

True

Depending on the size and organizational structure of an office or facility, the EHR Specialist may be required to perform some daily and monthly front office and billing tasks, as well as job duties that involve computer and other office equipment. True or False

True

HIPAA's Standard Code Sets or Transaction Code Sets (TCS) were created to improve accuracy and effeciency of transactions and reduce administrative costs. True or False

True

Maintaining a list of IT infrastructure and an inventory of all software licenses in the office is important for proper disaster recovery plan and a possible duty for the EHR specialist. True or False

True

Understanding the basic functions of EHR software allows you to navigate through other medical record systems. True or False

True

Vendors and developers create EHR technology to meet the standards and certification criteria of the ONCHIT Certification Program which was adopted by the HHS Secretary to support the achievement of meaningful use (MU). True or False

True

An EHR specialist should perform which of the following actions to protect the private patient information within an EHR?

Turn in an unidentified USB drive they found to the IT department

Who is BCBS?

"Blue Cross Blue Shield". Pioneers in the private health industry and the largest insurance company in the U.S.

What is an HMO?

"Health Maintenance Organization -aka- Manged Care organizations or MCO's Members are part of large group coverage. These types of insurances require authorizations and referrals from their PCP (primary care physician) and the the patient must be seen by an In-Network provider.

What is ONCHIT?

"Office of the National Coordinator for Health Information Technology" (under DHHS) promotes development of HIT infrastructure

What is SNOWMED-CT?

"Systemized Nonmenclature of Medicine-Clinical Terms" It holds all the clinical vocabulary and encompass all terminology used in medicine. Its a reference for all medical terms

What is CCHIT and what do they do?

"The Certification Commission for Health Information Technology" developed certifiication criteria for electronic health records software

When forwarding PHI to another organization it is defined as "Use" of PHI under HIPAA. True or False

False

Under the HITECH Act, what is the time limit to notify patients of a medical record security breach? A. 60 days B. 180 days C. 30 days D. 90 days

60 days

The Office of Inspector General (OIG) outlines _____ Basic Components of a Compliance Plan. A. 7 B. 8 C. 5 D. 10

7

There are _____ Core Functions recommended by the Institute of Medicine for an EMR/EHR. A.7 B.5 C.10 D.8

8

The scheduling template in an EHR system can help determine: A. All the EHR specialist to give the patient advice B. Automatically rescheduling patients if the day is slow C. A lack of resources that prevents ideal patient care D. Both A and B

A lack of resources that prevents ideal patient care Data can be obtained from the use of scheduling templates to identify insufficient equipment or staff levels to achieve optimal workflow and best patient care. Laws prohibit giving medical advice without a license so the EHR Specialist should NEVER offer their own opinions or counsel to a patient.

Which healthcare organization has established specific faxing guidelines to protect patients' medical information? A. AMA B. CMS C. DHHS D. AHIMA

AHIMA

A computer software feature that tracks when a user logs in, and records/reports the applications they use and the information they access is: A. A network scan B. Role based access C. An authorization D. An audit trail

An audit trail

Which form needs to be signed by the patient to allow the release of protected health information to their spouse, partner or sibling? A. Authorization form B. Notice of Privacy Practices C. Non-availability Statement D. Medical Release

Authorization Form

Which of the following is used to make certain that all office computer programs and data are secure in case of a mishap, fire, or natural disaster? A. Back-up operations B. Tracking system C. Passwords D. Fire extinguishers

Back-up operations

Some EHR systems have __________ appropriate for safe medication and vaccination delivery, which reduce medication errors due to illegibility of medical records.

Barcode Scanner

Hospitals and other providers need to have an EHR/EMR system that is certified by?

CCHIT

Which of the following is a tool used by providers to order inpatient medications, testing, therapy or other services for a patient?

CPOE

With an integrated hospital EHR system, which of the following is an appropriate way for a physician to order medications, tests, or other services for a patient? A. CCHIT B. CPOE C. ePrescribing D. eFax

CPOE

Healthcare professionals should have basic skills in what? A. Use of cash register B. Knowledge in determining diagnoses C. Computer skills D. Know how to repair office equipment

Computer Skills

Which of the following steps comes first when processing a request for medical records? A. Confirm that there is a written authorization B. Release only the information requested for the specific dates requested C. Access the record and the section being requested D. Verify the patient's name, date of birth, record number

Confirm that there is a written authorization

Healthcare documentation is vital to and provides? A. Discontinued procedures B. Continuity of healthcare C. Advanced directives D. Authorizations

Continuity of Healthcare

PMS stands for: A. Provider Management System B. Physician Medical Software C. Procedural Medical Structure D. Practice Management System

Practice Management System

Both paper and electronic files have a "status" associated with them. Which of the following is not a valid file status? A. Damaged B. Active C. Closed D. In-Active

Damaged

When registering a patient, which area of the medical record would the patient's date of birth be located in? A. Demographics B. Personal history C. Insurance D. Guarantor

Demographics

Part B covers what?

Doctor visits, medical equipment, prosthetics/orthotics

Modular EHR

EHR is NOT fully integrated with PMS system. Legacy systems may need an interface to communicate appropriately with the EHR and other software. Includes only continents that are specific for medical record documentation of services. May NOT include disease registry.

This enables a physician to transmit a prescription electronically to a patient's pharmacy.

Electronic Prescribing

Which of these converts email information into a scrambled or encoded format before sending the message? A. Virus protection B. Firewalls C. Encryption D. Passwords

Encryption

An electronic record can only be accessed and used by one person at a time. True or False

False

If a patient fails to keep their appointment, it should be deleted from the schedule to show that the patient was not seen. True or False

False

HIPAA's Standard Code Sets or Transaction Code Sets (TCS) were created to improve accuracy and effeciency of transactions and reduce administrative costs. True or False

False Anonymity means the information cannot be traced back to a PATIENT. De-Identification of patient specific information is important, and identifying information such as name, medical record number, social security number, address, phone, etc. must be removed for purposes other than TPO or other authorized release.

Fraud is a practice which is consistent with generally accepted medical and business standards. True or False

False Fraud occurs when someone knowingly, willfully and/or intentionally submits false information. Abuse refers to actions that are not normally considered fraudulent, but are not accepted as sound business practices. For example: It is considered Abuse to bill Medicare at a higher rate because it doesn't follow accepted practices. However, if someone billed for services that the patient never received, that would be Fraud.

While responsibilities of the Healthcare Professional that deals with EHR may vary, for the most part there are 3 categories of activities and tasks: Accounting, Clinical, and Billing. True or False

False The primary tasks and responsibilities fall into the categories of: Administrative, Clinical and Billing.

an EMR & EHR are synonyms? True or false

False an EMR is created by one physician/provider and the EHR is a combination of many EMR's and the patients aggregate medical record from a number of providers

What is Medicare?

Federal funded health care coverage to 65 and older. They also offer benifits to those under 65 with certain disabilities and those with end-stage renal disease (ESRD)- permanent kidney failure requiring a transplant.

What is a Comprehensive/Complete EHR

Fully integrated with PMS (practice management system) software and may include diseases registry/repository.

When an OB-GYN (obstetrician gynecologist) devotes two afternoons per week to seeing pregnant patients, she is using an appointment scheduling method called: A. Double booking B. Wave scheduling C. Grouping D. Buffering

Grouping

A coding book that contains codes for products and supplies is:

HCPCS

HITECH stands for: A. Hospital Information Technology for Electronic Clinical Health B. Health Insurance Treatment for Economic Chart Help C. Health Insurance Technology for Electronic Clinical Help D. Health Information Technology for Economic and Clinical Health

Health Information Technology for Economic and Clinical Health. (HITECH) Act was enacted as part of the ARRA (stimulus package) to strengthen HIPAA privacy and security with regard to the changes in electronic technology since 1996 when HIPAA was legislated. Additionally, HITECH encourages the adoption of Meaningful Use of Electronic Health Records.

Authorizations are required for which of the following? A. Health information for another provider B. Report for an insurance company C. Health information for hospital accreditation D. Health information for an attorney

Health Information for an attorney

HIPAA stands for: A. Health Insurance Portability and Accountability Act B. High Insurance Protection and Accountability Act C. Health Information Portability Accounts Act D. High Information Protection and Accountability Act

Health Insurance Portability and Accountability Act

Which of these manuals would include inpatient surgical procedures

ICD-9-CM

Meaningful Use (MU) is an incentive program administered by CMS, which sets specific objectives to use certified EHR technology to do all but which of the following? A. Improve care coordination, and population and public health B. Increase computer skills and usage C. Improve quality, safety, efficiency, and reduce health disparities D. Engage patients and their family

Increase computer skills and usage

What is Health Information Technology (HIT)

Information technology, computers and laptops, telecommunications used to conduct daily operations in a healthcare environment

Which of the following is not considered PHI? A. Social Security Number B. Address C. Insurance company D. Date of Birth

Insurance Company

Which of these is required in order for the PMS and EHR computer systems to work together? A. Portable Devices B. Interoperability C. Sharing Printers/Scanners D. Modem

Interoperability Computer systems must have interoperability and share clinical data transmission standards (i.e. SNOMED-CT being mapped to ICD diagnosis codes) in order to exchange information and work together.

Which of these is not an advantage of EHR? A. Efficiency, ease of access B. Large storage requirements C. Cost reduction D. Safe, quality care

Large storage requirements

A practice management or other system that pre-dates the EHR requirement and may not be fully integrated without a program patch or system upgrade is called a A. Legacy system B. Incremental system C. Hybrid system D. Modular system

Legacy system

Active Listening does not involve which of the following? A. Letting the patient talk until they are done and then telling them what you need to B. Utilizing motivational interviewing including asking the patient to "teach back" to you C. Making eye contact, reading facial expression and body language D. Asking for clarification and restating information

Letting the patient talk until they are done and then telling them what you need to

Part C covers what?

Medicare Advantage (formerly Medicare plus- HMO program)

CMS developed the _____ to promote correct coding methodologies.

National Correct Coding Initiative

A PAR provider submits a claim for a Medicare/Medicaid patient. What amount would the patient be responsible for?

Nothing

What is a Hybrid Conversion?

Patient records are partially on paper and partially electronic. This is the least costly way and new patients and electronic Medication Administration Record (eMAR) may be on the new EHR, but existing patents and other documents are still in paper records

What is a legacy system?

Old technology, hardware, computer system, software. Pre dated before the EHR and EMR

Which of the following is not considered a safeguard under the security rule? A. Technical B. Physical C. Administrative D. Operational

Operational

What is a PAR?

Participating Provider who accepts services from the insurance company as paid in full and can't bill the patient for the difference. (This doesn't include deductible and copay/ coinsurance amounts).`

Which of the following is not a covered entity? A. Insurance Company B. Patient C. Provider D. Clearinghouse

Patient

What is a PPO?

Preferred Provider Organizations contracts with a group of preferred providers but isn't as restrictive as HMO/MCO. The insurance will pay higher percentages for covered services that are provided by an In- Network provider, but the patient can also choose to receive care from an Out- of- Network provider with a greater portion of the bill being the patients responsibility. PPO's are increasingly becoming one of the most common types of insurances in the field.

Managing an individual's access to certain areas of the PMS and EHR systems based on job function to protect the security of PHI is referred to as: A. Fully integrated systems B. National Correct Coding Initiatives C. Loops and segments D. Role Based Access Controls

Role based Access Controls

If the EHR system crashed or a disaster occurred, which of these would be the best to restore the EHR from? A. Regular back-up of information B. A paper copy of all medical records C. A duplicate EHR system D. Obtain copies of the patients own records

Regular back-up of information

What are RBRVSs?

Resource-Based Relative Value Scale: for physician services, the ambulance fee schedule, and the hospital outpatient payment system. A relative value scale permits comparisons of the resources needed or appropriate prices for various units of service. It takes into account labor, skill, supplies, equipment, space, and other costs for each service or procedure.

Patient time is valuable. Being sure to schedule appointments properly is to avoid wait times is important. If there are excessive wait times, which of these would not be an appropriate response? A. Apologize for the delay B. Offer a new appointment C. Offer an opening with another physician in the practice D. Send them to a new provider

Send them to a new Provider

Patient Rights, under HIPAA, do not include: A. Right to request a discount B. Right to request an amendment C. Right to request confidential communication D. Right to request a copy of disclosures

Right to request a discount

A reference database of medical vocabularies.

SNOMED-CT

This is a comprehensive clinical vocabulary that encompasses all medical terms and diagnoses: A. HIPAA B. CPT C. SNOWMED-CT D. ICD

SNOWMED-CT This clinical vocabulary is then linked up to diagnostic descriptions that are used for ICD (diagnostic) coding.

All but which of the following are reasons to utilize Clinical templates? A. Standard documentation formats B. Saves on benefits and payroll expenses C. Reduce duplicate or unnecessary care D. Clinical Decision Support (CDS)

Saves on benefits and payroll expenses

What is a deductible?

Specified amount of money you must pay out of pocket before you insurance will cover services

Why do you need to contact the insurance before my procedure?

The health insurance company needs to know about certain procedure or services before they are performed, as they may require that you have the procedure at a certain hospital/facility and /or have a certain provider perform that procedure. Someone from our office will contact the insurance on your behalf to find out for you

Commercial / Private Insurance

The most common health insurance organizations are found in this category. They encompass group plans, individual plans and prepaid health plans: BCBS, HMO, PPO

What is Information Technology? (IT)

The use of Computers, laptops, tablets for telecommunications and networking to enter, process, edit, secure and exchange electronic data

Railroad / Travelers Medicare

This is a Federally-funded plan for those individuals retired from the Railroad industry.

A medical record is a collection of an individuals healthcare info? True or False

True

Which of the following best describes the primary goal of "screening" telephone calls? A. Determining whether the calls are emergencies B. Preventing calls from reaching the physician C. Handling calls at the lowest level possible D. Understand the purpose of the call so it can be properly directed

Understanding the purpose of the call so it can be properly directed

ABN (Advanced Beneficiary Notice)

a Medicare waiver that notifies the patient that Medicare might not pay for a service, either because it is a noncovered service or because medical necessity, as defined by Medicare, might not be met. Form that says a healthcare insurance may not pay for a procedure.

What is a Copay

a predetermined flat-rate fee that you pay the provider at the time of service. (The amount may depend on the service that was provided)

What is a Deductible?

a specified amount of money you must pay out of pocket before your insurance will cover services. Deductibles are usually set on a yearly basis for individuals or families. (think about auto insurance deductibles, as a similar example)

Total Conversions means what?

all patients data is converted at once to EHR. Its costly but all data is in one system

Back up files should be stored: A. Near the mainframe computer or server B. In the office manager's file drawer C. In the physician's office D. Away from the premises

away from the premises

It is important to notify patients when transitioning to a new EMR/EHR system. CMS recommends three C's for communicating to the patient. They include all but A. Close B. Connect C. Celebrate D. Collaborate

celebrate

What is the Coinsurance amount?

co-insurance is a percentage of the bill that a patient has to pay for certain services. If the patient has more than one insurance after the primary insurance is taken the secondary will kick in so its often a 20% or 30% the patient has to pay. After the "primary" insurance has paid their portion (80% or 70%)

COWS "Computers on Wheels"

computers or laptops that sits on a wheeled cart that can be rolled from room to room within the facility. Widely used for record keeping

WOWS "Wireless on Wheels"

wireless device that don't require a network plug in or internet connection within the treatment room

Incremental conversion means what?

gradual change to EHR, lower cost, smoother transition and less impact on office, however paper is still used and not all patient data available

What is Medicade?

health insurance for the poor and disabled

Part A covers what?

hospitalization

Health Level Seven (HL7)

messaging and communication standards between multiple applications: scheduling, medical record and image management, patient administration, observation reporting, financial management, public health notifications and patient care

The Minimum Necessary rule is A. Maximum necessary for the job B. Only applies sometimes C. One-page minimum D. Minimum amount of information required to accomplish the job

minimum amount of information required to accomplish the job

Part D covers what?

prescription drugs

What is a Non-PAR?

provider is allowed to bill the patient for any difference in cost that is not received from the insurance carrier.

Practice Management System (PMS)

software system in medical offices that conduct day to day operations such as scheduling, billing, and financial data, this system is often used alongside EHR systems

LOINC (Logical Observation Identifiers Names and Codes)

terms and codes used for electronic exchange of lab results and clinical observation

Telemedicine/e-health/Tele-health/e-Medicine

using technology to help, give advice, diagnose a patient over Skype, Face-time (no physical contact)