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99 Cards in this Set

  • Front
  • Back
In the audit cycle, which of the following is completed first? a.) Design audit sheet, incorporating all standards and regulations b.) Analyze, interpret, and present audit results c.) Research regulations and standards d.) Review random sample of records
In the audit cycle, which of the following is completed after the others listed? a.) Review random sample of records to determine whether improvement occurred b.) Analyze, interpret, and present audit results c.) Research regulations and standards d.) Develop audit criteria
A formal, written document summarizing the operational and financial objectives of a business that includes the details of how the objectives are to be attained, including budgets and other financial forecasts is a
business plan
Which of the following is charged with protecting the integrity of the Medicare and Medicaid programs? a.) Office of Civil Rights (OCR) b.) Internal Revenue Service (IRS) c.) Office of the Inspector General (OIG) d.) Reimbursement Integrity Contractors (RICs)
An agreement that a health care provider or health plan reaches with the OIG as part of a settlement agreement when allegations of improper reimbursement have been made
Corporate integrity agreement
Clients often include in the consultant's contract a requirement that the consultant maintains
professional liability insurance coverage
A retrospective review of selected health care records or data documents to evaluate the quality of care, services provided, documentation, or coding compared with predetermined standards is a(n)
A person who is not a member of the covered entity's workforce, but performs work on behalf of the covered entity that involves the use or disclosure of protected health information is a
business associate
Good leaders act
When a contractor works from home, the term "container" refers to
the place in which focused work is performed both physically and mentally
Which of the following would NOT be appropriate to include in a consulting contract? a.) Business associate agreement providing for protection of privacy of PHI b.) Provision for payment contingent upon improving facility revenues c.) Hourly rate of payment for services d.) Description of services
Which of the following is NOT a key element of a business plan? a.) Marketing strategies b.) Financial projections c.) Description of business d.) Statement of health insurance coverage
Which of the following is a true statement concerning financial considerations for the independent health information management consultant?
In addition to salary, consulting revenue should cover FICA taxes, office space, equipment, supplies, and other business expenses
Which of the following is NOT a step in the development of action plans? a.) Determine all steps necessary to attain each goal. b.) Maintain confidentiality of each goal. c.) Assign responsibility for each step. d.) Set deadlines for each goal
Which of the following is likely to result from regulations implementing ARRA and a potential area where HIM consultation is needed? a.) More providers implementing electronic health records b.) Fewer providers accepting Medicare c.) Fewer providers coding with ICD d.) More providers coding with ICD
Which of the following is NOT an area of regulation likely to affect HIM consultants? a.) Federal mandates for ICD coding in the veterinary setting b.) ICD-10-CM/PCS implementation and coding c.) Meaningful use standards under ARRA d.) RAC audits
Which of the following would the HIM consultant be LEAST likely to research in preparing to conduct a documentation audit? a.) Federal and state regulations for the type of facility being audited b.) Accreditation guidelines c.) HIPAA EDI standards d.) Best practices
Which of the following is NOT ordinarily a component of a health care provider's compliance program implemented to guard against fraud and abuse? a.) Internal monitoring and auditing b.) Developing compliance standards and policies c.) Designation of a compliance officer or contact d.) Training and education of the public and patients
Which of the following is NOT of major importance to a successful HIM consulting practice? a.) A large staff of employees b.) Relevant work experience c.) An RHIT or RHIA credential d.) Careful research and planning
Which of the following is recommended when setting up a home office? a.) Maintaining highly polished, shiny countertops and office furniture b.) Sharing one telephone line with family members and a fax machine c.) Multitasking by combining child-care duties with consulting activities d.) Using a fax machine for rapid transmission of printed documents that cannot be emailed
The initial CMS Recovery Audit Contractors (RAC) program identified problems with
incorrect coding and a failure to document medical necessity
In 2010, the Bureau of Labor & Statistics projected this to be the fastest growing industry in the US
A multipurpose machine acts as
a printer, fax machine, scanner, and copier
True/False: Individuals whom the consultant knows professionally and personally are the best source of referrals
True/False: In preparing for preliminary meetings with potential clients, the consultant should document the time spent on the initial presentation in order to include it in the first bill presented to the client after the contract has been signed
True/False: It is not advisable for a consultant to network with other consultants because of the risk of losing clients to competitors
True/False: Completion of the audit cycle may involve educating those who document in the records and then conducting a follow-up audit to determine improvement
True/False: When a Recovery Audit Contractor (RAC) identifies a pattern of improper payments that indicates possible fraud, the RAC is required to notify the office of the attorney general of the state in which the suspected offense occurred
True/False: The Patient Protection and Affordable Care Act made compliance programs mandatory for health care providers
True/False: Choosing to be an independent consultant is synonymous with starting a new business and being self employed
True/False: Organizations use the online yellow pages to select consultants more than any other method
True/False: There is no need for an independent, self-employed consultant to develop formal documents such as a mission statement or business objectives
True/False: Leadership has been defined as an influence process
True/False: Interpersonal intelligence is the ability to understand other people, what motivates them, how they work, and how to work cooperatively with them
True/False: High hourly charges by consultants mean that self employment will be financially lucrative and provide more personal freedom
True/False: It is common for an independent consultant to experience gaps in workload
True/False: A window makes an excellent backdrop for a computer workstation
True/False: Transmitting protected health information to and from a client across networks by regular email is preferable to faxing
True/False: The HITECH Act has placed additional obligations for privacy and security on business associates and also extends the threat of civil and criminal penalties for violations of privacy and security standards to business associates
The consultant may likely help with research facilitated by SNOMED CT coding in a
veterinary teaching hospital
The consultant may likely review documentation supporting assignment of present on admission indicators in an
acute care hospital
The consultant may likely review of percentage of residents with decreased independence in their ability to perform activities of daily living in a
nursing facility
The consultant may likely select, implement, and manage an electronic health record (EHR) that streamlines the appointment, clinical, and billing processes in a
physician practice
How long do cancer registries/programs provide follow-up for a cancer patient?
Over their lifetime
Who established and approves cancer registries/programs?
American College of Surgeons Commission on Cancer (ACS - Commission on Cancer)
What are the four types of cancer registries?
Hospital-Based, Population-Based, Central Registry, Special Purpose
What is the primary source used for case finding?
Pathology reports
What is the name of the permanent log of all cancer cases entered into a database?
Accession register
How are the cases listed in that permanent log?
Sequential (annually)
What is the coding system primarily used in the tumor registry?
Name one way that successful follow-up of a cancer patient is defined
- documented contact with the patient through his/her physician - re-admission to the hospital - a clinic visit - a response to a follow-up letter by the patient, a relative or friend, or another registry
What is the Commission on Cancer's target successful patient follow-up rate?
Acute rehabilitation programs are generally offered
in a hospital
These scores provide a reliable and valid method of documenting the severity of disabilities as well as outcomes in rehabilitation
True/False: Scores are assigned in 13 motor areas and 5 cognitive areas
Limits or prevents the fulfillment of one or several roles that are regarded as normal (depending on age, sex, social, and cultural factors) for a given individual by definition, this means
A device that is designed to replace a missing extremity or partially missing extremity is a
The prospective payment system for inpatient rehabilitation is based on
Case Mix Groups (CMGs)
In an inpatient rehabilitation facility, the IRF-PAI differs from the UB-04 in that it requires submission of
the etiological diagnosis (what causes the disability)
Allows a person who has limited mobility to perform many everyday functions in the home, at work, or school
Environmental control units (ECUs)
This is any temporary or permanent loss or abnormality of a body structure or function, whether physiological or psychological
Which of the following is NOT a factor in determining the case-mix group (CMG)? a.) International Classification of Functioning, Disability, and Health (ICF) codes b.) comorbidities c.) FIM scores d.) age
Devices that provide stability and support for individuals who have trouble walking are
ambulation aids
External appliances that supplement an extremity's function or improve stability and positioning are
orthotic devices
Devices that replace missing body parts are
Wheeled chairs that assist those for whom ambulation is difficult or not possible are
mobility devices
Computers that control environments and wheelchairs are
high-technology assistive devices
A restriction or inability to perform an activity in the manner or within the range considered to be normal for a human being is a
A comprehensive outpatient rehabilitation facility receives reimbursement from Medicare under
Part A
True/False: The Joint Commission and CARF are the nationally recognized agencies that review care provided in rehabilitation facilities for accreditation purposes
True/False: The Medicare prospective payment system reimburses rehabilitation services under DRGs
True/False: The admission history and physical performed on a rehabilitation patient includes a functional history, which covers the patient's functional status prior to the onset of illness or injury
True/False: The categories that form the basis of the inpatient rehabilitation facility prospective payment system are known as Impairments, Disabilities, and Handicaps (IDHs)
True/False: National databases maintained on spinal cord and traumatic brain injuries facilitate research in rehabilitation and promote uniform treatment, leading to improved functional outcomes
True/False: The Glasgow Coma Scale is associated with the assessment of spinal cord injuries
True/False: The IRF-PAI utilizes the same coding rules as the UB-92
True/False: The FIM instrument for measuring independence has not yet been proven reliable or valid
True/False: The Patient Protection and Affordable Care Act enacted a "National Pilot Program on Payment Bundling" designed to test the feasibility of bundling payments for post-acute care providers (such as rehabilitation providers) with the acute care hospital payment for a given episode of care
True/False: A life-care plan lists the items required over a lifetime for the individual, their cost, and the frequency of replacement and serves as a medical legal document that may guide court decisions regarding a settlement
True/False: The Rancho Los Amigos Scale is beneficial in communicating to other members of the rehabilitation team the level of recovery of a patient with traumatic brain injury
Are devices that provide additional stability and support for an individual who has trouble walking
Ambulation aids
A dynamic document that details current and future health care needs based on published standards of practice is a
life care plan
This is the development of a person to the fullest physical, psychological, social, vocational, avocational, and educational potential consistent with his or her physiological or anatomic impairment and environmental limitations
Are therapists who address activities of daily living, upper extremity movement, higher cognitive, and community skills, among other areas of rehabilitation
Occupational therapists (OTs)
Are therapists who help patients improve their strength, range of motion, balance, and mobility, among other things
Physical therapists (PTs)
A physical medicine and rehabilitation physician is a
This approach to rehabilitation teams means that the team members work together in a synergistic fashion to solve specific problems for the patient
interdisciplinary approach
This is established and operated exclusively for the purpose of providing diagnostic, therapeutic, and restorative services to outpatients for rehabilitation of injured, disabled, or sick persons at a single fixed location by or under the supervision of a physician
An inpatient facility that provides acute medical care
Acute care hospital
A center for rehabilitation that is not physically part of another facility
Freestanding rehabilitation center
Rehabilitation services provided to patients in their home or by an agency
Home health rehabilitation
Provide inpatient rehabilitation services for patients with acute illness superimposed on chronic disability or for medically complicated patients
Long term acute care hospitals
Rehabilitation therapy provided to patients who do not stay overnight
Outpatient rehabilitation
Inpatient rehabilitation for patients who are progressing too slowly to meet criteria for standard rehabilitation programs
Skilled rehabilitation programs
Teaches patients activities of daily living, such as dressing, bathing, grooming, etc.
Occupational therapist (OTs)
Physical medicine/rehabilitation physician specialist who heads the rehabilitation team
Assists the newly disabled person and family in adjusting to the disability
Coordinates funding resources for the patient
Social worker
Evaluates and treats aphasia, apraxia, dysarthria, etc.
Speech-language pathologist