RHIA 2024 Test Questions with Revised Answers
When is a physician query not appropriate - Answer-a query may not be appropriate when the clinical information or clinical picture does not appear to support the documentation of a condition or procedure. in situations in which healthcare entity's pol...
RHIA 2024 Test Questions with
Revised Answers
When is a physician query not appropriate - Answer-a query may not be appropriate
when the clinical information or clinical picture does not appear to support the
documentation of a condition or procedure. in situations in which healthcare entity's
policies can provide guidance on a process for addressing the issue without querying
the attending physician.
What is clustering - Answer-practice of coding or charging one or two middle levels of
service codes exclusively under the philosophy that, although some will be higher and
some lower, the charges will average out over an extend period
Before a hospital is permitted to open and provide medical services, they must go
through which process - Answer-Licensure
On Medicare patients, how often must the home health agency's assessment and care
plan be updated - Answer-at least every 60 days or as the severity of the patient's
condition requires
What method of reimbursement is practiced when an insurance company would
reimburse the practice for its treatment of a condition over a period of time - Answer-
Episode-of Care
The health plan reimburses a doctor $15 per patient per month. In Jan a doctor saw 300
patients and received $4500 from the health plan. What method is of reimbursement is
the health plan using - Answer-Capitated rate
Capitated Rate - Answer-method of payment for health services in which the third-party
payer reimburses providers a fixed, per capita amount for a period.
what is generally found in a query to a physician - Answer-name and contact number of
the individual initiating the query and account number
What payment arrangement is streamlined by the use of Chargemasters - Answer-Fee-
for-service
Reimbursement methodology that issues payments to healthcare providers on the basis
of the charges assigned to each of the separated services that were performed for the
patient - Answer-Fee-for-service
what are chargemasters used for - Answer-to list the individual charges for every
element entailed in providing service
, How does undercoding affect MS-DRG case mix - Answer-makes it lower than
warranted by the actual service/resource intensity of the facility.
where do MS-DRG sets exits - Answer-where the listings of diagnoses are used to drive
the grouping are the same but the presence or absence of a complication or comorbidity
diagnosis (CC) or major complication or comorbidity diagnosis (MCC) assigns the case
to higher or lower MS-DRG
A ____ assists in educating medical staff members on documentation needed for
accurate billing - Answer-Physician Champion
What is a critical path in a PERT Chart - Answer-the path with the greatest duration -
the path that will take the longest amount of time to complete the total project.
A technique for measuring healthcare entity performance across the four perspectives -
Answer-Balanced Scorecard methodology
what are the four perspectives of measuring an organization's performance - Answer-
customer, financial, internal processes, and learning and growth
the financial statement that presents a record of operations by showing revenue and
expenses over a period of time is called - Answer-Income statement
a director of health information services in a hospital wants to implement a computer-
based patient record system over the next two years. she gets support from the CIO,
who champions the project with the administrative team. The CIO has become the
projects ______ - Answer-Sponsor
Employees covered by the provisions of the Fair Labor Standards Act are called ______
- Answer-Nonexempt Employees
What type of skill is greatest at top level management - Answer-Conceptual skills
the performance standard "Respond to release information request for continuing care
in one working day 95% of the time" is an example of a: - Answer-Quality Standard
what method of educational delivery is a required session for all facility employees to
attend - Answer-in-service education
Health Record Matrix - Answer-Once the LHR is defined, it is best practice to create a
health record matrix that identifies and tracks the physical location of each paper
document and the source of each electronic document that constitutes the LHR. in
addition to defining the content of the LHR, it is best practice to establish a policy
statement on the maintenance of it.
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