health care delivery systems

Question 1

abstracting

Answer 1

data entry of codes and other pertinent information

Question 2

accreditation

Answer 2

voluntary process that a health care facility or organizations undergoes to demonstrate that it has met standards beyond those required by law.

Question 3

biometrics

Answer 3

an identifier that measures a borrowers unique physical characteristic or behavior and compares it to a stored digital template to authenticate the identity of the borrower, such as fingerprints.

Question 4

(CMS)centers for Medicare and Medicaid services.

Answer 4

DHHS agency that administers medicare, medicaid CHIP.

Question 5

code of federal regulations

Answer 5

codifications of the general and permanent rules published in the federal register by executive departments and agencies of the federal government

Question 6

coding

Answer 6

assigning numeric and alphanumeric codes to diagnoses, procedures and services; this function is usually performed by credentialed individuals.

Question 7

continuum of care

Answer 7

complete range of programs and services with the type of health care indicating the health care services provided

Question 8

contract services

Answer 8

arranging with outside agencies to perform certain functions such as health information services

Question 9

(cpt) curent procedural terminology

Answer 9

published annually by the American medical association; codes are 5 digits assigned to ambulatory procedures and services

Question 10

deemed status

Answer 10

hospitals that are accredited by approved accreditation organizations are determined to have met or exceeded conditions of participation to participate in the medicare and medicaid programs.

Question 11

deeming authority

Answer 11

when an accrediting organizations standards have met or exceeded CMS’s conditions of participation to participate in the medicare and medicaid programs.

Question 12

digital signature

Answer 12

type of electronic signature that uses public key cryptography.

Question 13

electronic health record

Answer 13

automated record system that contains a collection of information documented by a number of providers at the different facilities regarding one patient.

Question 14

gina- genetic information nondiscrimination act

Answer 14

prohibits group health plans and health insurance companies from denying coverage to a healthy individual or charging higher premiums based solely on a genetic predisposition to development of disease in the future.

Question 15

hcpcs lvl II(national) codes

Answer 15

developed by the centers for medicare and medicaid services and used to classify report procedures and services. codes are reported to 3rd party payers for reimbursement purposes

Question 16

healthcare integrity and protection bank-HIPDB

Answer 16

created as a part of HIPAA to combat fraud and abuse in health insurance and health care delivery by alerting users to conduct a comprehensive review of a practioner’s, providers, or supplier’s past actions.

Question 17

health care procedure coding system -HCPCS

Answer 17

comprimised of lvl 1 (cpt) and lvl 2 (national)codes

Question 18

health plan employer data and information set -HEDIS

Answer 18

the national committee for quality assurance (NCQA) tool used for health plans to collect data about the quality of care and service they provide

Question 19

Incomplete record processing

Answer 19

include the assembly and analysis of discharged patient records

Question 20

ICD-1-0-CM INTERNATIONAL CLASSIFICATION OF DISEASES, TENTH RVISION CLINICAL MODIFICATION

Answer 20

used in the US to collect information about diseases and injuries and to classify diagnoses and procedures

Question 21

Intranet

Answer 21

private network that utilizes internet protocols and technology and allows user to immediately and simultaneously access health care information with complete security and an audit trail, regardless of where users are located.

Question 22

MIPS- merit based incentive payment system

Answer 22

payment system establishes as a part the medicare access and CHIP reauthorization act of 2015 that was signed into law on 4/16/15 that moves clinician medicare part b payment to a performance based payment system.

Question 23

smart card

Answer 23

a card that contains a small central processing unit, some memory, and a small rectangular gold-colored contact area that interacts with card reader

Question 24

SCHIP- state children’s health insurance program

Answer 24

health insurance program for infants, children, and teens that covers health care services such as doctor visits, prescribed meds, and hospitalizations. aka tittle XXI of the balanced budget act of 1997.