Unit 6 Test Flashcards
A health services coordinator is working with a nurse to review charts of patients that left the emergency room (ER) against medical advice due to an increase in the frequency of those cases. Centers for Medicare and Medicaid Services (CMS) regulation standards are 2% or less, and the hospital is averaging 3% a month.
What is the penalty for the hospital?
Reduction in reimbursements
An individual is hired to do the billing for a mental health hospital.
Which coding type is required in this situation?
DSM-5
A health services coordinator has accepted a new role at a primary care medical home. Orientation includes a class about the Joint Commission accreditation and efforts to prepare for an upcoming onsite survey.
Which practice will meet these standards?
Utilizing an electronic medical record that supports a patient portal
A health services coordinator learns about the ability of healthcare providers to e-prescribe medications.
Which patient impact statement accurately characterizes this technology?
The patient will experience fewer lost prescriptions.
A healthcare coordinator is working with a home care provider to transition a client home from the hospital. The coordinator needs to securely and efficiently send pertinent client information to the new location.
How should this task be completed?
Send the information using an encrypted email program
A health services coordinator at a local hospital received a Health Insurance Portability and Accountability Act (HIPAA) violation due to a confidentiality breach with willful neglect. The coordinator corrected the problem within 30 days to meet legal requirements and to avoid further violations.
Which level of violation was committed?
Third tier
A clinical documentation improvement specialist (CDIS) is reviewing a monthly report with a group of cardiac physicians. They are interested in the data needed to determine the allocation of resources to care for, treat, and rate the quality of provider documentation of diagnoses.
Which form of documentation do they need to review?
CIMS
Clinical Information Management Systems
A healthcare services coordinator has been tasked with searching for evidence of risk factors associated with type 2 diabetes. The coordinator decides to focus initial efforts on finding reliable evidence at the highest level that are associated with evidence-based practices (EBPs).
Which form of evidence should be used by the coordinator?
Randomized controlled trials
A nurse manager at a rural hospital is having difficulty persuading an administrator about the critical need to concentrate on hiring staff who possess evidence-based practice (EBP) skills.
Which statement accurately characterizes EBP for these administrators?
It will decrease variations in practice.
An 89-year-old nursing home resident is alert, is oriented, and has provided informed consent for an elective surgical procedure. The daughter is protesting about her mother receiving the procedure and insists that the surgery be canceled. The provider researches the ethical and legal issues associated with the situation before taking action.
Which action should the healthcare provider take based on that review?
Continue with the procedure
A patient is starting to consider different treatments for severe cirrhosis of the liver and has options for surgical interventions, pharmacological treatment, lifestyle changes, or a combination of treatments. The healthcare coordinator is asked to help the patient select the preferred treatment approach.
How should the healthcare coordinator partner with the patient to achieve an optimum outcome?
Explore the options together and understand patient preferences
A case manager working for a home health organization has a caseload of 10 patients with mental illness. The case manager applies a disease management model.
What is the purpose of this model?
Facilitates compliance with treatment plan
HIPAA Tiered Violations
Tier 1 - Unaware violation/$100-$50K
Tier 2 - Reasonable cause/$1K-$50K
Tier 3 - Willful neglect/$10K-$50K
Tier 4 - Willful neglect/no effort to correct within 30 days/$50K-$1.5M
