HI in a nontraditional setting
Initial health screenings of inmates are carried out within ___ hours of admission to a correctional facility.
24
The ____ is a private, nonprofit organization and the only organization that provides accreditation for all components of adult and juvenile correctional facilities.
ACA
__________________ is a preferred method of external review, because it provides comprehensive, objective analysis of the facility's operations, with a comparison to the facility's policies and procedures.
Accreditation
is a voluntary process in which facilities agree to follow a set of standards and receive recognition for having met those standards.
Accreditation
___________ health plans arose out of employer need to curtail the double-digit premium increases they were experiencing every year.
Consumer-Directed
The purpose of the National ________________ (abbreviated ________ , or ________ ) edits is to prohibit unbundling of procedures, a practice that results in excessive payment to the provider when multiple codes are reported instead of a combination code.
Correct Coding Initiative, NCCI, CCI
A ________________ is an artificial intelligence system to help the physician in selecting a diagnosis.
Decision Support System
The ______________________ (abbreviated ______) law imposes a legal duty on hospitals to screen and stabilize, if necessary, any patient who arrives in the emergency department.
Emergency Medical Treatment And Active Labor Act, EMTALA
A(n) ______________ is a professional contact between a patient and a provider during which services are delivered.
Encounter
T/F Coding of diseases and procedures is routinely done in departments of corrections, jails, and juvenile detention centers.
False
T/F DUI clients are the only court-related clients seen by substance abuse facilities.
False
T/F Dialysis facility records are often thin in nature.
False
T/F Documentation audits are extremely rare in the hospital-based setting.
False
T/F EHR systems are common in correctional facilities.
False
T/F EHRs are not used in freestanding ambulatory care settings.
False
T/F Hospital accrediting agencies require that accredited hospitals in a given region implement region-wide performance improvement programs.
False
T/F ICD-10 coding requirements are making more hospitals adopt electronic health records.
False
T/F If a facility with "deemed" status must undergo a separate survey process by the state agency.
False
T/F Information system requirements for an MCO are the same for hospitals and physician office practices.
False
T/F It is unusual to see professionals such as occupational therapists, recreation therapists, and dietitians working in substance abuse programs.
False
T/F Licensure is a process that requires that a facility meet certain regulations set by the federal government in order to provide care.
False
T/F Medicare providers can decide if they want to adopt meaningful use guidelines.
False
T/F Privacy provisions of HIPAA do not apply to correctional facilities.
False
T/F Substance abuse service providers typically take a non-confrontational approach to the addiction.
False
T/F The principal source of funding for CMHCs is client fees.
False
T/F There is no standard that prohibits inmates from providing or assisting in direct patient care, determining access of other inmates to health services, or handling medical records.
False
T/F Using paper records is still the easiest way to maintain a comprehensive yet readily accessible record.
False
Funding for all correction-related activities comes from taxes appropriated by ___________ legislatures.
Federal and state
In the ____________ system, the patient pays according to the type and amount of service provided.
Fee-for-Service
A ___________ is an account that is set up by the employee through his or her employer to cover health care costs.
Flexible Savings Account (FSA)
The _____________ examined the state of medical education in the United States.
Flexner Report
The _________________ of 1996 (abbreviated _____) is one of the driving forces determining the standards for the data elements that should be maintained for every patient.
Health Insurance Portability and Accountability Act, HIPAA
The _________________ (abbreviated ) ________ is the system required by CMS for coding services provided to Medicare patients.
Healthcare Common Procedural Coding System, HCPCS
The _____________ Act authorized an investigation to determine the need for more hospitals and provided money for their construction.
Hill-Burton
A ________ can be defined as a health care institution that has an organized professional staff and medical staff, and inpatient facilities, and which provides medical, nursing, and related services.
Hospital
A _______ record is often needed to maintain consents, referral information, and so forth, which are frequently maintained in paper format.
Hybrid
The __________ provides accreditation for inpatient mental health facilities
Joint Comission
__________________ physicians are those temporarily working in place of another physician.
Locum Tenens
A person with ESRD is generally eligible for _________ coverage on the basis of the ESRD diagnosis.
Medicare
Patients within a managed care organization are referred to as ______.
Members
The ______________ became an early initiative within the National Institute of Mental Health to create a uniform data system nationwide for reporting mental health statistics.
Mental Health Statistics Improvement Program
What are the three associations that publish health care standards for correctional institutions?
NCCHC, ACA, APHA
The _____________ (abbreviated _____) in the Health and Human Services (HHS) is charged with protecting the integrity of HHS programs such as Medicare by detecting and preventing fraud, waste, and abuse.
Office of the Inspector General, OIG
The __________ (abbreviated ________) of 1986 reorganized the ESRD program and set up 18 network areas across the United States to assess the quality of care given to ESRD patients.
Omnibus Reconciliation Act OBRA
The treatment settings for adolescents span all levels of care and include which of the following?
Outpatient therapy, intensive outpatient programs, short-stay residential inpatient treatment, extended-stay inpatient treatment, and in-school intervention programs
A distinct and organized intensive treatment program for patients who would otherwise require inpatient psychiatric care is known as a _______________ (abbreviated ___)
Partial Hospitalization Program, PHP
_________________ means paid by the day or at a daily rate.
Per diem
As consumers have embraced the notion of empowerment they have become more insistent on participation in the treatment _________.
Planning process
The _________ is a numbered list of the patient's diagnoses or problems, often including allergies and medications.
Problem List
A __________ marks the achievement or lack thereof in the attempts of the consumer or patient to reach the goals stated in the treatment plan.
Progress Note
A ________________ is an authorization to receive a specific health service from a specific health provider that will be paid for by the HMO.
Referral
The first contact the patient usually has with any ambulatory care setting is the ____________ process.
Registration
Dialysis units are ___________ by each state's own agency to determine if they are in compliance with both state and federal guidelines.
Surveyed
T/F A longitudinal patient record maintains health care information on a patient throughout the patient's life.
True
T/F A major use of health information in ambulatory care is the assessment of the quality of care provided by the facility.
True
T/F A physician receives a monthly payment from Medicare Part B based on the number of visits for each patient.
True
T/F A regional health information organization (RHIO) is a health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.
True
T/F According to the DSM-5, adults with a serious mental illness are persons aged 18 and over, who currently have or at any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of a sufficient duration to meet diagnostic criteria.
True
T/F Chemical restraint is the use of a drug or medication not part of a person's usual medical regimen that is administered to control behavior or restrict freedom of movement.
True
T/F Congress created the National Patient Safety Goals (NPSG) program to help accredited health care institutions focus upon specific patient safety concerns.
True
T/F Coordination of benefits means determining who the primary insurance payer is and ensuring that no more than 100 percent of the charges are paid to the provider and/or reimbursed to the patient.
True
T/F Dialysis facilities were among the first health care providers to adopt electronic health records.
True
T/F Documentation requirements for hospital inpatients and outpatients depend on the type of services received.
True
T/F Eligibility refers to whether the person is allowed to receive care under the MCO contract and the dates of coverage.
True
T/F Facilities have the option to choose not to be accredited.
True
T/F Fetal alcohol syndrome and cocaine addiction in newborns can lead to serious health and developmental problems for children.
True
T/F Health information exchange (HIE) is a process that has been defined as the electronic movement of health-related information among organizations according to nationally recognized standards.
True
T/F Health information may be released without prior consent to a health professional directly involved in the care and treatment of the inmate in an emergency situation or when the inmate cannot sign a release.
True
T/F Health information that is basic to all mental health records includes assessment, treatment plan, progress note, and discharge summary.
True
T/F In order to meet the definition of "meaningful use," providers must utilize a certified EHR product in such a way that the electronic exchange of information improves the quality of care provided to patients, including the capability of submitting clinical quality measures data.
True
T/F Maintaining portions of the record electronically is a common practice in ESRD facilities.
True
T/F Managed care is concerned with two types of regulatory organizations: governmental agencies and voluntary accrediting associations.
True
T/F Many dialysis centers still contract with an RHIA or RHIT on a consulting basis to review their documentation systems.
True
T/F Many factors influence what must be documented, including type of facility, types of patients, types of caregivers, and internal and external users of information.
True
T/F Many substance abuse agencies and treatment facilities have established employee assistance programs (EAPs) to serve working adults and their employers.
True
T/F One of the biggest barriers to providing inmates with adequate health care comes from a lack of access to inmate health information from hospitals and clinics.
True
T/F One of the largest databases maintained in most MCOs is the claims database.
True
T/F Patient identifier refers to how the patient is identified in a health information system, whether paper based or electronic.
True
T/F Preventive care and wellness are a central focus of a health maintenance organization and most managed care organizations.
True
T/F The 2008 revisions dropped the requirement mandating facilities to obtain the services of a medical record practitioner, and also deleted the requirement that a member of the facility's staff must be designated to serve as supervisor of medical records.
True
T/F The ESRD facility codes diagnoses using the current version of the International Classification of Diseases approved for use in the United States.
True
T/F The Health Savings Account was created as part of the Medicare Modernization Act and permits individuals and families who purchase high-deductible health insurance coverage to contribute to the account.
True
T/F The MCO produces its revenue by selling an insurance product, which is the ability to provide quality health care to the member.
True
T/F The QIOs work under contract with CMS to improve the quality of care delivered to Medicare beneficiaries.
True
T/F The dialysis facility must also maintain complete, accurate, and accessible records on home patients.
True
T/F The management of health care costs is often more difficult for correctional institutions than for other health care facilities.
True
T/F The patient-centered medical home model was developed in an effort to better coordinate care across the continuum.
True
T/F The two basic coding and classification systems used to collect and manage data in managed care are the ICD diagnosis system and the HCPCS procedure system.
True
T/F There are three common formats for paper records: source oriented, integrated, and problem oriented.
True
T/F Transferring inmates is a regular occurrence in correctional settings and often necessitates the transfer of health records.
True
T/F Treatment programs for individuals with mental illness are often referred to as mental illness with chemical addiction services.
True
T/F Two important documentation requirements in the dialysis patient record are the patient assessment and the patient plan of care.
True
The APHA standards require that inmate health records be kept as a _____ record.
Unit
_________________ focuses on controlling the use of resources by reviewing a facility's efficiency in providing health care services.
Utilization Management
In physician offices the ___________ record format is frequently used.
integrated
A ___________ (abbreviated ___) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it.
personal health record, PHR
CMS maintains coded data submitted by dialysis providers that can be used for purposes other than reimbursement, such as ___________.
research
With ___________, patients and clinicians who are separated by hundreds of miles can interact with one another by electronic means.
telemedicine
T/F Because hemodialysis patients should dialyze at least three times per week, planning a vacation or an extended trip out of town involves coordination with the ESRD facility.
true
When a complete paper record is maintained in one location, this is called a ________ record.
unit
