PART 2 Flashcards
If a healthcare practice or facility receives high performance scores, which one of the following might happened?
a. They might receive financial incentives
b. They might receive financial penalties or fines
c. They may have to increase their efforts at quality improvement
d. The might have to begin seeing less patients
They might receive financial incentives
If payment of a service or procedure is denied based on National Correct Coding Initiative (NCCI) edits, the provider
a. can seek payment from the beneficiary if a Notice of Exclusions from Medicare Benefits (NEMB) is obtained.
b. cannot seek payment from a Medicare beneficiary even if an Advance Beneficiary Notice (ABN) or a Notice of Exclusions from Medicare Benefits (NEMB) is obtained.
c. can submit an Advance Beneficiary Notice (ABN) to seek payment from a Medicare beneficiary.
d. can seek payment from a Medicare beneficiary if an Advance Beneficiary Notice (ABN) or a Notice of Exclusions from Medicare Benefits (NEMB) is obtained.
cannot seek payment from a Medicare beneficiary even if a ABN or a NEMB had been obtained
Jennifer submits a written request to Houston Hospital for a copy of her PHI on August 19. The information is stored offsite. By what date must the covered entity comply?
A: 9/30/2015 12:00:00 AM
B: 8/29/2015 12:00:00 AM
C: 9/19/2015 12:00:00 AM
D: 10/18/2015 12:00:00 AM
10/18/2015 12:00:00 AM(October 18 (60 days))
Jessica is the leader of a project team working on the definition of the woman’s health service line. Several departments are so enthusiastic about the progress that they ask for additions to the project. This is not uncommon, and is known as
A. add-ons.
B. scope creep.
C. effort expansion.
D. deliverable increase
Scope creep
Mary Ellen Smith has been an excellent biller for the past 5 years. Lately you notice that she has the highest error rate and lowest productivity rate of the entire billing section. She also seems to be distracted and unhappy. You have a conversation with her and she confides that she is having many “Personal Problems” that are causing her enormous stress. As her supervisor you
A. accept this explanation and determine that it is probably a temporary situation.
B. issue a verbal warning to Mary Ellen to shape up.
C. issue a written warning with a date to review her progress.
D. refer her to the Employee Assistance Program.
Refer her to the Employee Assistance Program
You want to depict the movement of patient information from the time of admittance to the point of discharge. Which of the following tools is most appropriate?
A: Data modeling
B: Data flow diagram
C: Decomposition diagram
D: Hierarchy chart
Data flow diagram
You sit on the quality improvement team for the Nursing department that meets to generate ideas to address verbal order documentation problems about the “Read Back Verbal Order” policy. What QI tool would prove useful in sharing input and various recommendations for solving this problem?
a. flowchart
b. scatter diagram
c. check sheet
d. brainstorming
Brainstorming
Your HIM department is moving to a new location and in order to arrange your employees and functions for optimal work flow efficiency and to decide which employees need to be placed close to each other, the tool you decide to use is a
A. data flow diagram.
B. PERT chart.
C. proximity chart.
D. flow process chart.
Flow process chart
You need a system that will work with your existing system but not necessarily from the same vendor. What type of system are you looking for?
a. commercial
b. interfaced
c. integrated
d. cloud computing
Interfaced
You are preparing a training program for specific functional areas of the department (e.g. coding, transcription). Which of the following is the primary factor to consider in developing an effective training program?
a. cost of training the employees
b. number of employees to be trained
c. objectives of each functional area
d. credentials of the employees
Objectives of each functional area
