Unit 2

Question 1

Third party payer

Answer 1

insurance carrier or company

Question 2

What is a Healthcare Professional?

Answer 2

nurse, medical assistant, or other technician who directly cares for the patient

Question 3

What is a Care Provider?

Answer 3

A physician, physician’s assistant, dentist, psychologist, nurse practitioner, or midwife; these individuals can diagnose and give orders for diagnostic or therapeutic services.

Question 4

What is a Medical Transcriptionist?

Answer 4

A healthcare professional who converts recorded dictation into typed report form using word processing software.

Question 5

What are outguides?

Answer 5

these are cardboard or plastic folders that take the place of health records that have been removed from file

Question 6

What is Electronic health record (EHR)?

Answer 6

An EHR captures more information than an EMR and is designed to be exchanged and used at any point of care, following the patient. EHRs need to meet Meaningful Use standards

Question 7

What is Electronic medical record (EMR)?

Answer 7

An EMR provides a digital record of the traditional chart used within one location. It does not meet the certification requirements of Meaningful Use because of its limited functionality.”

Question 8

What are digitized health records?

Answer 8

health records kept in an electronic binary format

Question 9

What are Physician Extenders and what can they do?

Answer 9

may also give orders, and these include physicians’ assistants (PAs), certified nurse practitioners (CNPs), certified registered nurse anesthetists (CRNAs) or nurse midwives, all of whom work under the supervision of a medical doctor (MD) or doctor of osteopathy (DO).

Question 10

What are Allied Health Professionals?

Answer 10

nvolved with the delivery of health or related services pertaining to the identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others.

Question 11

Care coordinators do what?

Answer 11

coordinate care of the patient and are typically nurses or social workers

Question 12

Case Managers do what?

Answer 12

are usually nurses, but some are health information professionals or social workers. A case manager’s role is to ensure that healthcare services are not being under- or overutilized.

Question 13

quantitative analysis does what?

Answer 13

ensures that all of the required documents are present.

Question 14

Delinquent records are what?

Answer 14

records that remain incomplete for more than 30 days

Question 15

Authentication is what?

Answer 15

In a paper record, the signature of the person who wrote an entry in a health record, showing authorship; in a digital environment, the security process of verifying an individual’s right to access a system or portion of it

Question 16

Unit Record is what?

Answer 16

system in which all records for one person are filed together under one medical record number in one location.

Question 17

Document imaging/scanning is what?

Answer 17

process of digitizing images of documents into computer readable format.

Question 18

Privacy officer is what?

Answer 18

deals with compliance with privacy laws, etc

Question 19

Encoder software is what?

Answer 19

tech used to assign ICD or CPT codes based on the coder’s input of terms

Question 20

grouper software is what?

Answer 20

tech used to categorize an inpatient admission or an outpatient encounter into a payment classification

Question 21

Computer assisted coding is what ?

Answer 21

software that improves the efficiency and quality of coding

Question 22

compliance officer?

Answer 22

responsible for monitoring for fraud

Question 23

Revenue cycle managers?

Answer 23

responsible for the functions that lead to and efficient, effective revenue cycle from the time a patent is registered for care until the bill is paid in full

Question 24

eHealth management

Answer 24

the processes and policies that govern the digital collection, maintenance, and archival of data

Question 25

Enterprise system

Answer 25

A health system, made up of a hospital or hospitals, physicians’ practices, long-term care facilities, outpatient (ambulatory) diagnostic and therapeutic facilities, and the like

Question 26

Information( data ) governance

Answer 26

ensures that the data collected are accurate and that processes and policies ensure the validity of the data collection ad the storage of it

Question 27

Information security

Answer 27

The administrative, technical, and physical safeguards put in place to ensure the validity and safety of digital data.

Question 28

Cancer registry

Answer 28

A database of all patients diagnosed or treated for a malignant neoplasm (cancer) in a hospital; the hospital registry data are submitted to a state cancer registry, then reported to the Centers for Disease Control and Prevention (CDC).

Question 29

Recovery audit contractor (RAC)

Answer 29

A position resulting from the Medicare Modernization Act of 2003, with the purpose of recovering improper Medicare payments.