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)
