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40 Cards in this Set
- Front
- Back
- 3rd side (hint)
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what term is used in reference to objective descriptions of processes, procedures, people and other observable objects and activities
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DATA
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provide vital clinical and administrative support services to patients, medical staff, visitors and employees
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ANCILLARY SUPPORT SERVICES
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ancillary function of the health record
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BIOMEDICAL RESEARCH
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used in reference to electronically accessed information the provides physicians with pertinent health information
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CLINICAL PRACTICE GUIDELINES
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systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances
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CLINICAL PRACTICE GUIDELINES
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To what authority do hospitals report vital statistics?
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The National Vital Statistics System
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An attempt to contain hospital inpatient costs and improve quality by restructuring services
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PATIENT-FOCUSED CARE
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Level of skilled care needed by patients with complex medical conditions, typically Medicare patients who have multiple medical problems
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SUB-ACUTE CARE
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Quality components
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ACCESSIBILITY, APPROPRIATENESS, TECHNICAL EXCELLENCE AND ACCEPTABILITY
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T or F: Turnaround times are examples of qualitative standards and error rates are examples of quantitative standards
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FALSE
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Specify the level of service quality expected from a function: Accuracy Rate and Error Rate
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Qualitative Standard
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Specify the level of measurable work or productivity expected for a specific function: Number of units of work for a specified period of time or turnaround time
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quantitative
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Mechanisms that record and examine activity in information systems
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Audit Controls
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Protects medical records and other individually identifiable health information from being used or disclosed in any form
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Privacy Rule
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Average Daily Census
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Total service days for the unit for the period
_______________________________ Total number of days in the period |
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Percentage of Occupancy
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Total service days for a period
___________________________X 100 Total bed count days in the period |
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Hospital Death Rate (GROSS)
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Number of deaths of inpatients in period
__________________________x 100 Number of discharges (including deaths) |
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Gross Autopsy Rate
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Total inpatient autopsies for a given period
___________________________X 100 Total inpatient deaths for the period |
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Net Autopsy Rate
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Total inpatients for a given period
___________________________X 100 Total inpatient deaths minus unautopsied coroners’ or medical examiners’ cases |
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Hospital Autopsy Rate (adjusted)
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Total hospital autopsies
___________________________X 100 Number of deaths of hospital patients whose bodies are available for hospital autopsy |
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Fetal Death Rate
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Total number of intermediate and/or late fetal deaths for a period
_________________________X 100 Total number of live births + intermediate and late fetal deaths for the period |
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Neonatal Mortality Rate
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Total number of newborn deaths for a period
_________________________X 100 Total number of newborn infant discharges (including deaths) for the period |
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Maternal Mortality Rate
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Total number of direct maternal deaths for a period
___________________________X 100 Total number of obstetrical discharges (including deaths) for the period |
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Caesarean Section Rate
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Total number of caesarian sections performed in a period
_________________________X 100 Total number of deliveries in the period (including caesarian sections) |
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groups that classify patients into clinically cohesive groups that demonstrate similar consumption of hospital resources and LOS patterns
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DRG
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based on the grouping of procedures by CPT/HCPCS codes that have similar costs or resource inputs
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APC-Ambulatory Payment Classification
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the exchange standard for laboratory results, enabling standards to be developed and adopted relatively quickly
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LOINC- Logical Identifier Names and Codes
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Diagnosis described as "possible", "probable", "likely" and "rule out" are reported as if present for which type of patient records
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Inpatient
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Infectious and Parasitic Diseases
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001-039
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The Federal physician self-referral statute is known as....
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Stark Law
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Responsible for ensuring the quality of health record documentation
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provider
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Codes assigned to a patient who is seeking health services but is not necessarily sick
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v codes
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Insufficient and missing documentation and __________ are two areas that the OIG says is responsible for 70 percent of bad claims
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Failure to document medical necesity
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If the nonPar physician chooses to accept assignment, he or she is paid ___ of the MFS.
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95%
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reimburses phyicians according to a fee schedule based on predetermined values assigned to specific services
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RBRVS -Resource-Based Relative Value Scale
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a number used to multiply each RVU so that it better reflect a geographical area's relative costs
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GPCI
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Geographic Pricing Cost Index
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converts RVUs into payments
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National Conversion Factor
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method of grouping patients according to a predefined set of characteristics
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Case mix
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average DRG weight for the patients discharged from the hospital
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case-mix index
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a measure of the resources used in treating patients in each or group of hospitals
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CMI ( case mix index)
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