EHR Study Guide Chapter 1

HITECH Act
What government regulation is intended to promote the use of EHRs in physician’s practices and hospitals through the use of financial incentives?
Implement the EHR
In order to be eligible for financial incentives through the HITECH Act, what are healthcare providers required to do?
Meaningful use
The utilization of certified
EHR technology to improve quality, efficiency, and patient safety in the healthcare system is known as what?
Accountable care organization
A network of doctors and hospitals that shares responsibility for managing the quality and cost of care provided to a group of patients is known as a
health information technology (HIT)
What term refers to the computer hardware, software, and networks that are used to record, store, and manage health information?
assigning diagnosis codes
which task is not performed by a practice management program?
to follow up on the status of the claim
What is the PMP used for after a claim file has been transmitted?
to ensure prompt payment of claims
Why is monitoring claim status necessary?
procedure coding management
According to the institute of medicine which of the following core functions should not necessarily be included in an EHR?
record patients payments and generate receipts
process the financial transactions
calculate charges for office visits
D. All of these are correct
A practice management program (PMP) is a software program that is used to
decision support
order management
population reporting and management
D. All of these are correct
According to the institute of medicine which of the following core functions should be included in an EHR
electronic prescribing
A major component of EHR order management is
after-visit summary
A communication tool that provides the patient with relevant and actionable information and instructions is the
patient’s identity
what information cannot be included when electronic health records are used to advance medical knowledge through research?
documentation
Every time a patient is treated by a healthcare provider a record is made of the encounter this record ids known as
medical documentation and billing cycle
The ten-step process tht results in timely payment for medical services is known as the
access to appropriate educational materials on health topics
ability to report on home monitoring and testing to their physician
instructions for preparing for common medical tests
D. All of these are correct
the patient’s name
the patient’s contact information
the patient’s reason for the visit
D. All of these are correct
You are preregistering a new patient Which of the following pieces of information should you collet?
at check in
When are copayments routinely collected?
cash flow
What is the movement of monies into or out of a business?
salaries
utilities
insurance
D. All of these are correct
Which of the following are recurring expenses for most medical practices?
the patient authorizes the release of information required to process an insurance claim
the patient authorizes the health plan to send payments directly to the provider
the patient accepts responsibility for payment of charges not paid by the health plan
D. All of these are correct
What does the signature on the patient information form indicate?
coding
The process of translating a description of a diagnosis or procedure into a standardized code
personal information
employment information
insurance data for an insurance claim form
D. All of these are correct
The patient information form contains
insurance identification card
You are checking in an existing patient who hasn’t been to the office for some time which documents should you photocopy and/or scan and add to the patient’s chart?
both diagnoses and procedures
what must be carefully documented for each patient visit for the physician to receive payment?
ICD
which of the following refers to diagnostic codes?
CPT
which of the following refers to procedure codes?
encounter form
A(n)________is a list of procedures and diagnoses for a patient’s visit
complaint code
The patient’s primary complaint (the illness or condition that is the reason for the visit) is assigned a
procedure code
Each procedure (service, treatment, or test) the physician performs is assigned a
procedure list
A(n)__________is a listing of standard charges for procedures
procedures the provider performed while the patient was in the office
the date of the office visit
the patient’s diagnosis
D. All of these are correct
What information does a health plan need to pay a claim?
a clearinghouse
A company that receives electronic claims and forwards the claim to the payer is known as
adjudication
What is a series of steps designed to determine whether a claim should be paid?
the transactions included on the claim
the amount paid
explanation of why certain charges weren’t paid
D All of these are correct
Each remittance advice is compared against the claim to check that
the codes on the payment transactions match those on the claim
the payment listed for each procedure is as expected
any unpaid charges are explained
D. All of these are correct
Each remittance advice is compared against the claim to check that
issues a refund
When a medical practice receives an overpayment from a health plan it
the amount paid by the health plan and the remaining balance owed by the patient
what information is listed on a statement?
managing the activities associated with a patient encounter to ensure the provider is paid
Revenue cycle management refers to
ensure the security and privacy of health information
HIPPA was designed to
EDI
what is an electronic format that providers and health plans must use to send and receive healthcare transactions?
computer to computer
Electronic data interchange involves sending information from
X12-837 Health Care Claim
most physician practices are required to use the HIPAA-standard electronic claim format called
HIPAA Omnibus Rule
Finalized in 2013, this legislation made significant changes to the privacy security and enforcement provisions of the original HIPAA legislation
NPI
Under the HIPAA administrative simplification legislation each healthcare provider was assigned a unique identification number known as
protected health information
Information about a patients health or payment for healthcare that can be used to identify
physical safeguards
administrative safeguards
technical safeguards
D. All of these are correct
The HIPAA security standards comprise
technical safeguards
The automated processes used to protect data and control access to data are
breach
which term refers to the acquisition access use or disclosure of unsecured PHI in a manner not permitted under the HIPAA privacy rule thus compromising the security or privacy
technical
Laura works at a large clinic where her duties mainly consist of scheduling appointments because she does not deal with any financial tasks Laura does not have access to the billing data this is an example of what type of security safeguard?
individuals
the secretary of health and human services
the media
D. All of these are correct
If a breach of unsecured health information affects more than 500 individuals the HIPAA breach notification rule requires covered entities and their business associates to notify
HITECH
This legislation is part of the American Recovery and Reinvestment Act of 2009 that provides financial incentives to physicians and hospitals to adopt EHRs and strengthens HIPAA privacy and security regulations
Office of Civil rights (OCR)
The HIPAA security rule and the HIPAA privacy rule are enforced by the
business associate
An individual or entity that creates receives maintains or transmits PHI on behalf of a covered entity and may also include subcontractors of an entity is known as a
audit trail
A report that traces who has accessed electronic information when information was accessed and whether any information was changed is a(n)
incident
Laura a new medical office receptionist accidentally sent the patient’s PHI to the wrong provider under HIPAA privacy rule this is known as a(n)
technical safeguard
An automated process used to protect data and control access to data is known as a(n)
physical safeguards
Mechanisms that are required to protect electronic systems equipment and data from threats environmental hazards and unauthorized intrusion are known as
administrative safeguards
Administrative policies and procedures designed to protect electronic health information
audit
A formal examination or review undertaken to determine whether a healthcare organization’s staff members comply with regulations is known as a(n)
bundled payments
Single payments to multiple providers involved in an episode of care creating a sense of shared accountability among providers are known as
ePHI
___________ is protected health information that is created stored transmitted or received electronically
ERA
An electronic document that lists patient dates of services charges and the amount paid or denied by the insurance carrier is the
fee-for-service
A model of physician reimbursement in which payment is provided for specific individual services provided to a patient is known as
Notice of privacy practices
Linda a new patient received a printed document that explains the medical offices use and disclosure of PHI what is the name of this document
a patient portal
Dr. Klager encourages his patients to use a secure online website that allows them to communicate with their provider and access their health information at any time this tool is known