Missed RHIA Questions
Reviewing claims to ensure appropriate coding for deserved payments is one method of: a. Achieving legitimate optimization b. Improving documentation c. Ensuring compliance d. Using data monitors
Achieving legitimate optimization
. Long-term care hospitals must meet state requirements for ________ and have an agreement with ________ in order to receive payments. a. Acute care hospitals, Medicare b. Medicare, acute care hospitals c. Fiscal intermediaries, Medicare d. Medicare, fiscal intermediaries
Acute care hospitals, Medicare
The accounts receivable collection cycle involves the time from: a. Discharge to receipt of the money b. Admission to billing the account c. Admission to deposit in the bank d. Billing of the account to deposit in the bank
Admission to deposit in the bank
Fifty percent of patients treated at our facilities have Medicare as their primary payer. This is an example of what type of information? a. Patient-specific b. Expert knowledge c. Comparative d. Aggregate
Aggregate
. An alteration of the health information by modification, correction, addition, or deletion is known as a(n): a. Change b. Amendment c. Copy and paste d. Deletion
Amendment
Identifying user information needs is part of the ________ phase of the systems development life cycle. a. Analysis b. Design c. Implementation d. Evaluation
Analysis
In data quality management, the process of translating data into information to be utilized by an application is called: a. Analysis b. Warehousing c. Collection d. Application
Analysis
Which of the following are phases of the systems development life cycle (SDLC)? a. Design, analysis, and alignment b. Maintenance, implementation, and improvement c. Analysis, design, and implementation d. Analysis, alignment, and improvement
Analysis, design, and implementation
Which of the following is a concept designed to help standardize clinical content for sharing between providers? a. Continuity of care record b. Interoperability c. Personal health record d. SNOMED
Continuity of care record
Laboratory data are successfully transmitted back and forth from Community Hospital to three local physician clinics. This successful transmission is dependent on which of the following standards? a. X12N b. LOINC c. RxNorm d. DICOM
LOINC
Which of the following is a component of the resident assessment instrument? a. The resident's health record b. A standard Minimum Data Set (MDS) c. Preadmission Screening Assessment d. Annual Resident Review
A standard Minimum Data Set (MDS)
Identifying appropriate users of specific information is a function of: a. Access control b. Nosology c. Data modeling d. Workflow modeling
Access control
Which of the following must be reported to the medical examiner?
Accidental deaths
The patient accounting department at Wildcat Hospital is concerned because last night's bill drop contained half the usual number of inpatient cases. Which of the following reports will be most useful in determining the reason for the low volume of bills? a. Accounts receivable aging report b. Accounts not selected for billing report c. Case-mix index report d. Discharge summary report
Accounts not selected for billing report
A nurse administrator who is not typically on call to cover staffing shortages gets called in over the weekend to staff the emergency department. She does not have access to enter notes since this is not a part of her typical role. In order to meet the intent of the HIPAA Security Rule, the hospital policy should include a: a. Requirement for her to attend training before accessing ePHI b. Provision for another nurse to share his or her password with the nurse administrator c. Provision to allow her emergency access to the system d. Restriction on her ability to access ePHI
Provision to allow her emergency access to the system
Which of the following statements about new technology items included on the charge description master (CDM) is false ? a. The CDM maintenance committee should review new technology items for FDA approval. b. The CDM maintenance committee should review new technology items for OPPS pass-through assignment. c. The CDM maintenance committee should have a professional coder review code assignments even if codes are suggested by the manufacturer. d. The codes for new technology should not be included in the CDM until coverage has been determined.
The codes for new technology should not be included in the CDM until coverage has been determined.
In the APC system, a high-cost outlier payment is paid when which of the following occurs? a. The cost of the service is greater than the APC payment by a fixed ratio and exceeds the APC payment plus a threshold amount. b. The LOS is greater than expected. c. The charges for the services provided are greater than the expected payment. d. The total cost of all the services is greater than the sum of APC payments by a fixed ratio and exceeds the sum of APC payments plus a threshold amount.
The cost of the service is greater than the APC payment by a fixed ratio and exceeds the APC payment plus a threshold amount.
n original goal of HIPAA Administrative Simplification was to standardize: a. Privacy notices given to patients b. The electronic transmission of health data c. Disclosure of information for treatment purposes d. The definition of PHI
The electronic transmission of health data
A patient requests that disclosures made from her medical record be limited to specific clinical notes and reports. Given HIPAA requirements, how must the hospital respond? a. The hospital must accept the request but does not have to agree to it. b. The hospital must honor the request. c. The hospital must guarantee that the request will be followed. d. The hospital must agree to the request, providing that state or federal law does not prohibit it.
The hospital must accept the request but does not have to agree to it.
What is the first consideration in determining how long records must be retained? a. The amount of space allocated for record filing b. The number of records c. The most stringent law or regulation in the state d. The cost of filing space
The most stringent law or regulation in the state
If a health plan analyst wanted to determine if the readmission rates for two hospitals were statistically different, what is the null hypothesis? a. The readmission rates are not equal. b. The readmission rates are equal. c. The readmission rate for one hospital is larger than the other. d. The readmission rate for one hospital is smaller than the other.
The readmission rates are equal.
The Medical Record Committee is reviewing the privacy policies for a large outpatient clinic. One of the members of the committee remarks that he feels that the clinic's practice of calling out a patient's full name in the waiting room is not in compliance with HIPAA regulations and that only the patient's first name should be used. Other committee members disagree with this assessment. What should the HIM director advise the committee? a. HIPAA does not allow a patient's name to be announced in a waiting room. b. There is no violation of HIPAA in announcing a patient's name, but the committee may want to consider implementing practices that might reduce this practice. c. HIPAA allows only the use of the patient's first name. d. HIPAA requires that patients be given numbers and that only the number be announced.
There is no violation of HIPAA in announcing a patient's name, but the committee may want to consider implementing practices that might reduce this practice.
Generally, substantial performance by one party to a contract will obligate the other party: a. To perform their contractual obligations b. Not to perform their contractual obligations c. To void the contract d. To invalidate the contract
To perform their contractual obligations
Mary Smith, RHIA, has been charged with the responsibility of designing a data collection form to be used on admission of patients to the acute-care hospital in which she works. What is the first resource she should use? a. UHDDS b. UACDS c. MDS d. ORYX
UHDDS
In which record numbering system is the patient assigned a health record number on the first visit that is kept for all subsequent visits? a. Unit numbering b. Index unit numbering c. Serial-unit numbering d. Serial numbering
Unit numbering
A set of scenarios that describes an interaction between a user and a system is called a(n): a. Use case b. RHIO c. Test case d. Use description
Use case
Which of the following is a statement made by one party to induce another party to enter into a contract? a. Ultra vires b. Warranty c. Agreement d. Indemnification
Warranty
Under RBRVS, which elements are used to calculate a Medicare payment? a. Work value and extent of the physical exam b. Malpractice expenses and detail of the patient history c. Work value and practice expenses d. Practice expenses and review of systems
Work value and practice expenses
Today, Janet Kim had her first appointment with a new dentist. She was not presented with a Notice of Privacy Practices. Is this acceptable?
No; it is a violation of the HIPAA Privacy Rule.
Which of the following is a kind of technology that focuses on data security? a. Clinical decision support b. Bitmapped data c. Firewalls d. Smart cards
Firewalls
Patient accounting is reporting an increase in national coverage decisions (NCDs), and local coverage determinations (LCDs) failed edits in observation accounts. Which of the following departments will be tasked to resolve this issue? a. Utilization management b. Patient access c. Health information management d. Patient accounts
Health information management
This type of data display tool is used to illustrate frequency distributions of continuous variables, such as age or length of stay (LOS).
Histogram
If parties to a contract agree to hold each other harmless for each other's actions or inactions, this is referred to as a(n): a. Indemnification b. Liability c. Offer d. Warranty
Indemnification
What must be in place to enhance the retrieval process for scanned documents? a. Electronic signature b. Indexing system c. RFID device d. Table of contents
Indexing system
The process of preventing the spread of communicable diseases in compliance with applicable legal requirements is performed in this quality management function. a. Infection control b. Clinical quality assessment c. Utilization management d. Risk management
Infection control
Which health record format is arranged in chronological order with documentation from various sources intermingled? a. Electronic b. Source-oriented c. Problem-oriented d. Integrated
Integrated
Allowing different health information systems to work together within and across organizational boundaries is referred to as: a. Telehealth b. Interoperability c. Informatics d. Interfaces
Interoperability
To ensure quality of data, the cancer committee reviews the abstracting done by the cancer registry personnel. This type of reliability check is called: a. Precision b. Recheck c. Interrater d. Construct
Interrater
Which of the following statements is true of structured query language (SQL)? a. It is both a data manipulation and data back-up mechanism. b. It defines data elements and manipulates and controls data. c. It is the computer language associated with document imaging. d. Users are not able to query a relational database.
It defines data elements and manipulates and controls data.
A coding service had 400 discharged records to code in March. The service coded 200 within 3 days, 100 within 5 days, 50 within 8 days, and 50 within 10 days. The average turnaround time (TAT) for coding in March was: a. 3 days b. 5 days c. 6.5 days d. 9 days
(200 × 3) + (100 × 5) + (50 × 8) + (50 × 10) / 400 = 5 days (LaTour et al. 2013, 815).
Per HITECH, an accounting of disclosures must include disclosures made during the previous: a. 10 years b. 6 years c. 3 years d. 1 year
. 3 years
. With what agency may patients file a complaint if they suspect medical identity theft violations? a. Internal Revenue Service b. Office of Civil Rights c. Centers for Medicare and Medicaid Services d. Federal Trade Commission
. Federal Trade Commission
Which of the following is an effective method of evaluating responses to a request for proposal (RFP)? a. Testing the new system b. Negotiating contracts with all vendors and assessing the best price c. Attending user group meetings d. Visiting sites that use the systems of product competitors
Attending user group meetings
Which of the following is a mechanism that records and examines activity in information systems?
Audit controls
The Medicare programs that encourage patients to review provider bills carefully and to report any discrepancies to the Secretary of HHS are called: a. Beneficiary incentive programs b. OIG work plans c. Compliance initiatives d. Operation Restore Trust programs
Beneficiary incentive programs
An evaluation of the benefits that have accrued from the EHR investment that is performed at specific milestones in the life of the project and used to help in future systems planning, designing, and implementing is called a: a. Benefits realization study b. Goal-setting exercise c. Cost-benefit feasibility study d. Productivity improvement study
Benefits realization study
A subpoena duces tecum compels the recipient to:
Bring records to a legal proceeding
All computers on this type of network receive the same message at the same time, but only one computer at a time can transfer information; and if one segment of the network goes down, the entire network is affected. a. Star topology b. Ring topology c. Bus topology d. Logical topology
Bus topology
. Community Hospital is terminating its business associate relationship with a medical transcription company. The transcription company has no further need for any identifiable information that it may have obtained in the course of its business with the hospital. The CFO of the hospital believes that to be HIPAA compliant all that is necessary is for the termination to be in a formal letter signed by the CEO. In this case, how should the director of HIM advise the CFO? a. Confirm that a formal letter of termination meets HIPAA requirements and no further action is required b. Confirm that a formal letter of termination meets HIPAA requirements and no further action is required except that the termination notice needs to be retained for seven years c. Confirm that a formal letter of termination is required and that the transcription company must provide the hospital with a certification that all PHI that it had in its possession has been destroyed or returned d. Inform the CFO that business associate agreements cannot be terminated
Confirm that a formal letter of termination is required and that the transcription company must provide the hospital with a certification that all PHI that it had in its possession has been destroyed or returned
Which of the following interoperability standards defines specific standards needed to assist patients in making decisions regarding care and healthy lifestyles, specifically to enable the exchange of data between patients and their caregivers via networks? a. Consumer empowerment b. Quality c. Medication management d. Personalized healthcare
Consumer empowerment
This type of chart is used to focus attention on any variation in a process and helps the team to determine whether that variation is normal or a result of special circumstances. a. Pareto chart b. Pie chart c. Control chart d. Line chart
Control chart
It is the year 201X. The federal government is determined to lower the overall payments to physicians. To incur the least administrative work, which of the following elements of the physician payment system would the government reduce? a. Conversion factor b. RVU c. GPCI d. Weighted discount
Conversion factor
Determining costs associated with EHR hardware and software acquisition, implementation, and ongoing maintenance represents which type of analysis? a. Benefits realization study b. Goal-setting exercise c. Cost-benefit feasibility study d. Productivity improvement study
Cost-benefit feasibility study
Which process requires the verification of the educational qualifications, licensure status, and other experience of healthcare professionals who have applied for the privilege of practicing within a healthcare facility? a. Deemed status b. Judicial decision c. Subpoena d. Credentialing
Credentialing
What is it called when accrediting bodies such as the Joint Commission or American Osteopathic Association can survey facilities for compliance with the Medicare Conditions of Participation for hospitals instead of the government? a. Deemed status b. Judicial decision c. Subpoena d. Credentialing
Deemed status
Records that are not completed by the physician within the time frame specified in the healthcare organization policies are called: a. Default records b. Delinquent records c. Loose records d. Suspended records
Delinquent records
A radiology department is planning to develop a remote clinic and plans to transmit images for diagnostic purposes. The most important set of standards to implement in order to transmit images is: a. X12N b. LOINC c. IEEE 1073 d. DICOM
Digital imaging and communication in medicine (DICOM)
Dr. Jones comes into the HIM department and requests that the HIM director pull all of his records from the previous year in which the principal diagnosis of myocardial infarction was indicated. Where would the HIM director begin to pull these records? a. Disease index b. Master patient index c. Operative index d. Physician index
Disease index
The personal health record model that maintains provider control of content while allowing online access to the authorized patient is the: a. Shared data record model b. EHR extension model c. Provider-sponsored information management model d. Smart card model
EHR extension model
A Joint Commission accredited organization must review their formulary annually to ensure a medication's continued: a. Safety and dose b. Efficiency and efficacy c. Efficacy and safety d. Dose and efficiency
Efficacy and safety
Which of the following best describes the intent of strategic information systems planning? a. Provide the potential for growth and expansion b. Ensure that all information technology initiatives are integrated and aligned with the healthcare entity's overall strategy c. Assess community or market needs and resources d. Ensure ongoing accreditation
Ensure that all information technology initiatives are integrated and aligned with the healthcare entity's overall strategy
E-discovery rules were created in response to the tremendous volume of evidence maintained in electronic format that is pertinent to lawsuits and amended which legislation? a. Federal Rules of Evidence b. State Rules of Evidence c. Federal Rules of Civil Procedure d. State Rules of Civil Procedure
Federal Rules of Civil Procedure
In which type of health information exchange architectural model does the entity operate much like an application service provider (ASP) or bank vault? a. Consolidated b. Federated—consistent databases c. Federated—inconsistent databases d. Switch
Federated—consistent databases
This data mining technique discovers relationships between attributes within data sets and displays them in a linked network graph to enable the user to better visualize the patterns. a. Machine learning b. Linkage analysis c. Neural networks d. Logistic regression
Linkage analysis
In analyzing the reason for changes in a hospital's Medicare case-mix index over time, the analyst should start with which of the following levels of detail? a. Account level b. MS-DRG level c. MDC level d. MS-DRG triples, pairs, and singles
MS-DRG triples, pairs, and singles
What is the name of the statement sent after the provider files a claim that details amounts billed by the provider, amounts approved by Medicare, amount Medicare paid, and amount the patient must pay? a. EOB b. MSN c. EOMB d. ABN
MSN Medicare summary notices
The practice of undercoding can affect a hospital's MS-DRG case mix in which of the following ways?
Makes it lower than warranted by the actual service or resource intensity of the facility
Which type of identity theft occurs when a patient uses another person's name and insurance information to receive healthcare benefits?
Medical
Protocols that support communication between applications are often referred to as: a. Application program b. Interface code c. Messaging standards d. Source code
Messaging standards
Name of element, definition, application in which the data element is found, locator key, ownership, entity relationships, date first entered system, date element terminated from system, and system of origin are all examples of: a. Autoauthentication fields b. Metadata c. Data d. Information fields
Metadata
The baby of a mother who is 15 years old was recently discharged from the hospital. The mother is seeking access to the baby's health record. Who must sign the authorization for release of the baby's health record? a. Both mother and father of the baby b. Maternal grandfather of the baby c. Maternal grandmother of the baby d. Mother of the baby
Mother of the baby
Which tool is used to determine the most critical areas for training and education for a group of employees? a. Performance evaluation b. Needs assessment c. Orientation assessment d. Job specification
Needs assessment
Using the information provided, if this is a participating physician who accepts assignment, how much can he or she expect to be reimbursed by Medicare? Physician's normal charge = $340 Medicare fee schedule = $300 Patient has met his deductible
Nonparticipating providers (nonPARs) do not sign a participation agreement with Medicare but may or may not accept assignment. If the nonPAR physician elects to accept assignment, he or she is paid 95 percent (5 percent less than participating physicians). For example, if the MFS amount is $200, the PAR provider receives $160 (80 percent of $200), but the nonPAR provider receives only $152 (95 percent of $160). In this case, the physician is participating so he or she will receive 80 percent of the MFS or $240 (80 percent of $300) (LaTour et al. 2013, 449).
The term used to describe breaking data elements into the level of detail needed to retrieve the data is: a. Normalization b. Data definitions c. Primary key d. A database management system
Normalization
Lane Hospital has a contract with Ready-Clean, a local company, to come into the hospital to pick up all the facility's linens for off-site laundering. Ready-Clean is: a. A business associate because Lane Hospital has a contract with it b. Not a business associate because it is a local company c. A business associate because its employees may see PHI d. Not a business associate because it does not use or disclose individually identifiable health information
Not a business associate because it does not use or disclose individually identifiable health information
The basic component of a(n) ________ is an object that contains both data and their relationships in a single structure.
Object-oriented database
Phil White had coronary artery bypass graft surgery. Unfortunately, during the surgery, Phil suffered a severe stroke. Phil's recovery included several settings in the continuum of care: acutecare hospital, physician office, rehabilitation center, and home health agency. This initial service and subsequent recovery lasted 10 months. As a member of a managed care organization in an integrated delivery system, how should Phil expect that his healthcare billing will be handled?
One fixed amount for the entire episode that is divided among all the physicians, facilities, and other healthcare providers
. What is the most common method for implementing entity authentication? a. Personal identification number b. Biometric identification systems c. Token systems d. Password systems
Password systems
Which of the following basic services provided by a health information exchange (HIE) entity matches identifying information to an individual? a. Consent management b. Person identification c. Record locator d. Identity management
Person identification
Under the HIPAA Security Rule, these types of safeguards have to do with protecting the environment: a. Administrative b. Physical c. Security d. Technical
Physical
Ted and Mary are the adoptive parents of Susan, a minor. What is the best way for them to obtain a copy of Susan's operative report? a. Wait until Susan is 18 b. Present an authorization signed by the court that granted the adoption c. Present an authorization signed by Susan's natural (birth) parents d. Present an authorization that at least one of them (Ted or Mary) has signed
Present an authorization that at least one of them (Ted or Mary) has signed
Which of the following are used to report information about mortality and morbidity at local, state, and national levels? a. Rates, populations, and ratios b. Ratios, proportions, and continuous variables c. Proportions, populations, and continuous variables d. Proportions, ratios, and rates
Proportions, ratios, and rates
The best reason for implementing IS technology in healthcare is to: a. Provide effective and efficient patient care services b. Keep up with rapid technological change c. Provide a competitive edge in marketing the healthcare entity d. Support all IS initiatives identified by managers in the healthcare entity
Provide effective and efficient patient care services
A patient is admitted to the hospital with shortness of breath and congestive heart failure. The patient undergoes intubation with mechanical ventilation. The final diagnoses documented by the attending physician are: Congestive heart failure, mechanical ventilation, and intubation. Which of the following actions should the coder take in this case? a. Code congestive heart failure, respiratory failure, mechanical ventilation, and intubation b. Query the attending physician as to the reason for the intubation and mechanical ventilation to add as a secondary diagnosis c. Query the attending physician about the adding the symptom of shortness of breath as a secondary diagnosis d. Code shortness of breath, congestive heart failure, mechanical ventilation, and intubation
Query the attending physician as to the reason for the intubation and mechanical ventilation to add as a secondary diagnosis
Which of the following would be used to determine what the users need in an information system?
Questionnaire
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 determine if hospital copy policies are being followed? a. Randomly audit EHR documentation for patients readmitted within 30 days. b. Survey practitioners to determine if they are following hospital policy. c. Institute an in-service program for all hospital personnel. d. Observe the documentation practices of all clinical personnel.
Randomly audit EHR documentation for patients readmitted within 30 days.
Which of the following healthcare entities' mission is to reduce Medicare improper payments through detection and collection of overpayments, identification of underpayments, and implementation of actions that will prevent future improper payments?
Recovery audit contractor
providers who do not implement an EHR will eventually be penalized through: a. Reduction in Medicare payments b. Reduction in amount of reimbursement from private insurance programs c. Increased administrative costs to process claims d. Restrictions from providing some patient care services
Reduction in Medicare payments
What could an analysis of a flowchart identify? a. Productivity levels b. Customer needs c. Key performance measures d. Redundancies in a process
Redundancies in a process
Which of the following basic services provided by an HIE entity identifies participating users and systems? a. Identity management b. Person identification c. Registry and directory d. Secure data transport
Registry and directory
Which of the following are considered dimensions of data quality? a. Relevancy, granularity, timeliness, currency, accuracy, precision, and consistency b. Relevancy, granularity, timeliness, currency, atomic, precision, and consistency c. Relevancy, granularity, timeliness, concurrent, atomic, precision, and consistency d. Relevancy, granularity, equality, currency, precision, accuracy, and consistency
Relevancy, granularity, timeliness, currency, accuracy, precision, and consistency (RGTCAcPC)
As an EHR implementation project proceeds, additional hospital departments add requirements for the system, and the project becomes more complex. This is known as:
Scope creep
A measure of variability that describes the deviation from the mean of a frequency distribution in the original units of measurement is called the: a. Mean b. Mode c. Standard deviation d. Standard variance
Standard deviation
For an EHR to provide robust clinical decision support, what critical element must be present? a. Structured data b. Internet connection c. Physician portal d. Standard vocabulary
Structured data
A health information exchange entity that has no access to personal health information is an example of this kind of architectural model:
Switch
If an analyst is studying the wait times at a clinic and the only list of patients available is on hard copy, which sampling technique is the easiest to use? a. Survey sampling b. Systematic sampling c. Cluster sampling d. Stratified sampling
Systematic sampling
The technology, along with the policies and procedures for its use, that protects and controls access to ePHI are: a. Administrative safeguards b. Technical safeguards c. Physical safeguards d. Integrity controls
Technical safeguards
The HIPAA Privacy Rule permits charging patients for labor and supply costs associated with copying health records. Mercy Hospital is located in a state where state law allows charging patients a $100 search fee associated with locating records that have been requested. Which of the following statements is true when applied to this scenario? a. State law will not be preempted in this situation. b. The Privacy Rule will preempt state law in this situation. c. The Privacy Rule never preempts existing state law. d. The Privacy Rule always preempts existing state law.
The Privacy Rule will preempt state law in this situation.
Community Hospital wants to provide transcription services for transcription of office notes of the private patients of physicians. All of these physicians have medical staff privileges at the hospital. This will provide an essential service to the physicians as well as provide additional revenue for the hospital. In preparing to launch this service, the HIM director is asked whether a business associate agreement is necessary. Which of the following should the hospital HIM director advise to comply with HIPAA regulations? a. Each physician practice should obtain a business associate agreement with the hospital. b. The hospital should obtain a business associate agreement with each physician practice. c. Because the physicians all have medical staff privileges, no business associate agreement is necessary. d. Because the physicians are part of an Organized Health Care Arrangement (OHCA) with the hospital, no business associate agreement is necessary.
a. Each physician practice should obtain a business associate agreement with the hospital.
