HIM – Flashcards
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What is true about the AHIMA certification
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Candidates must pass an examination before obtaining any of the credentials
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What evolving role oversee the process that begins at the time of documentation through billing?
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Revenue cycle manager
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The new model of HIM practice is?
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Information focused
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HIM has been recognized as an allied health profession since
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1928
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RHIA
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Registered Health Information Administrator
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CCHIIM
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Comission on certification for health informatics and information management
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The primary function of AHIMA is
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Foster professional developement of its members
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Which of the following entities are at the head of the AHIMA volunteer structure and hold responsibility for managing the property, affairs, and operations of AHIMA
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Board of Directors
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The traditional model of HIM practice was:
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Department focused
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CoP
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communities of practice
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AHIMA
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American Health Information Management Association
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The formal approval process for academic programs in health information management is called:
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Accreditation
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Which of the following accredits academic programs in health information management?
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CAHIIM
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CAHIIM
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Commisssion on accreditation for health informatics and information management education
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CCA
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certified coding associate
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Which of the following make up a virtual network of AHIMA members?
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AHIMA Communties of Practice
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RHIT
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Registered health information technician
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The primary goal of the Hospital Standardization Program was?
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To raise the standards of surgical practice
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ACS
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American College of Surgeons
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Which of the following functions as the legislative body of AHIMA?
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AHIMA house of delegates
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CCS
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certified coding specialist
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The formal process for conferring a health information credential is called
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Certification
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Members of the AHIMA house of delegates are
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Elected by members in state component organizations
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Which organization issues and maintains ethical standards for the health information management profession?
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The American Health Information Management Association
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To avoid making mistakes, HIT's should try to base their work-related decisions on their own moral values whenever possible
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False
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Which organization issues and maintains ethical standards for the health information management profession?
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The American Health Information Management Association
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I am concerned about the possibility that the PHI that I am releasing as an ROI coordinator will be re-released to another inappropriately. Why would I be concerned with a secondary release of information?
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PHI could be released without patient authorization
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What has brought about changes based on access, security, linking data, and more?
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Electronic health record
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What does PHI stand for?
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Protected Health Information
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HIT's have ethical obligations to their employers and the people who recieve and provide services in their organizations, but generally they have no real obligations to the public at large
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False
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An HIM professional's ethical obligations:
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Apply regardless of employment site
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List the seven steps in the ethical decision making process
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What is the question? What are the facts? What are the values? What are my options? What should I do? What justifies my choice? What can I do to prevent this ethical problem?
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The ethical decision making process includes consideration of steps to ensure that the same issue does not come up again
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True
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Define Confidentiality
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The limitation of the use and disclosure of private information
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What does ACS stand for
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American College of Surgeons
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The right of individual patients to determine what healthcare services they do or do not undergo
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Autonomy
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Given the competing interests and limited resources of the parties involved, the consideration of fairness to those affected by decisions
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Justice
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The principle that requires that one party must do no harm to another, as in the physician's Hippocratic oath
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Nonmaleficence
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The promotion of good for others or the provision of helpful services for others
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Beneficience
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The application of ethical principles to decisions that affect human lives
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Bioethics
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What has brought about changes based on access, security, linking data, and more?
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Electronic health record
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Define Privacy
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the right of the individual to be left alone
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Which of the following is a core ethical obligation of HIT's
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Protecting patients' privacy and confidential communications
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Which of the following activities is considered an unethical practice?
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Backdating progress notes
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An individual stole and used another person's insurance information to obtain medical care. This action would be considered
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Medical identity theft
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Joint Commission
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Acute Care Hospitals Long-term care facilities Ambulatory care facilities Psychiatric facilities Home health agencies
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Examples of Allied Health Professions
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audiology clinical laboratory science diagnostic medical sonography/imaging technology dietetics and nutrition emergency medical technology health information management occupational therapy optometry pharmacy physical therapy respiratory therapy speech language pathology and audiology surgical technology
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Biologics Control Act of 1902
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Research on controlling epidemics Now called National Institutes of Health (NIH) Mission is to uncover new medical knowledge that can lead to health improvements for all
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Social Security Act of 1935
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old age and unemployment programs Provided states funding for maternal and infants , rehab of crippled children, public health and for children under 16
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Hospital Survey and Construction Act of 1946
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Known as Hill-Burton Act Authorized grants to build new hospitals and modernize older ones Goal of 4.5 beds per 1,000 person Increased from 6,000 hospitals to approx 7,200 acute care hospitals Down to 4,927 hospitals in 2002- due to fewer admissions, decreased length of stay and diagnostic related groups
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Licensure
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is a government activity It is mandatory and required by law. It gives legal approval for a facility to offer the service for which it is license
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What three things must a facility must meet in dealing with a licensure?
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physical aspects of the facility services provided personnel employed
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Certification
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is a government activity allows a facility to be reimbursed by the government for providing services to patients enrolled in certain government programs participation is voluntary but facility must meet regulations established by the dept of Heath and Human Services (DHHS) these regulations are called Conditions of Participation (COP) which are found in the Federal Register compliance with these regulations is monitored by each state thru an agreement with the DHHS. These standards are considered minimal.
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Accreditation
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is completely voluntary it implies there is a voluntary conformance to high standards , which are more rigorous than the minimum licnensing or certification standards The individual accrediting agency and experts in the field develops standards Standards are revised as changes in the art of medical practice , government regulations, demand or public need occurs.
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Certificate of Need (CON)
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New construction (proposed) Modification of existing site Major equipment expenditures Or to provide new services
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Public Law 89-97 of 1965
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Amendment to Social Security Act Medicare originally designed for people 65 years of age or older. Medicaid originally designed for medically indigent. Medicaid joint program with states
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Public Law 92-603 of 1972
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Mandated utilization review for Medicare patients at hospitals and extended care facilities. Now included Medicaid Established professional standards review organizations (PSRO)
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Utilization Review Act of 1977
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Mandated continued stay reviews for Medicare and Medicaid patients
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Peer Review Improvement Act of 1982
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PSRO changed to Peer Review Organizations Looked at medical necessity and appropriateness of certain admissions prior to admisssion. Named changed to Quality Improvement Organization.
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Tax Equity and Fiscal Responsibility Act of 1982
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Called for gradual implementation of prospective payment system for Medicare reimbursement
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Prospective Payment Act ( 1982) Public Law 98-21 of 1983
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Created diagnostic related groups for inpatient hospital care
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Consolidated Omnibus Reconciliation Act of 1985
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reimbursement denied for substandard quality of care
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Omnibus Budget Reconciliation Act of 1986
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PRO's, report substandard care to licensing and certification agenicies
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Healthcare Quality Improvement Act of 1986
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Established the National Practitioner Data Bank ( NPDB ) Clearing house for malpractice and other quality issues
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Omnibus Budget Reconciliation Act of 1989
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Created the Agency for Healthcare Quality and Research- develop outcome measures to evaluate quality
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Omnibus Budget Reconciliation Act of 1990
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Required PROs to report actions taken against physicians to state medical boards and licensing agencies
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Mental Health Parity Act of 1996
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Applies to group self-funded group plans or large group fully insured group health plan. Provide equity for mental health benefits with medical/surgical benefits.
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Health Insurance Portability and Accountability Act of 1996
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Portability of health insurance after leaving employment. National standards for electronic transactions. National identifiers for providers, health plans and employers. Privacy Security Healthcare Integrity and Protection Database.
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American Recovery and Reinvestment Act
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Health information technology for economic and clinical health ( HITECH) Act Government involvement in standard development for exchange of health information. Strengthened privacy and security standards Made office of the national coordinator for health information technology technology a permanent office.
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Patient Protection and Affordable care Act of 2010
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Institute health insurance market reforms. Development of state based HIE's ( health insurance exchange) Expansion of Medicaid Individual mandate Implementation of ACO's
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American Health Information Management Association (AHIMA)
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Professional organization for managers of health records services and healthcare information. Started in 1928 Commission on accreditation for health informatics and information on management education. commission on certification for health informatics and information management
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Commission on Certification of Health Information Technology (CCHIT)
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mission is to accelerate adoption of health information technology. certifies health information technology based on criteria- functionality, intteroperability, privacy, security
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Hospitals can be classified by
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Number of beds types of services provided types of patients serviced for profit or non-profit status Type of ownership- government owned ( VA, metro) proprietary ( Kaiser) voluntary ( UH, cleveland clinic)
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Organization of Hospital Services
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Board of directors Professional medical staff Executive administrative staff Medical and surgical services Patient care ( nursing ) services Diagnostic and laboratory services Support Services
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Board of Directors
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Primary responsibility for setting the direction of hospital- Strategic direction, mission, values, establish by laws based on legal and licensing requirements, select qualified administrator-approved organization and makeup of clinical staff, monitoring quality of care
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Government-Sponsored Reimbursement Systems
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Public Law 89-97- Amendment to the Social Security Act Medicare Title XVIII Medicaid Title XIX
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Medicare
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is funded by the government Retired and disabled Part A- inpatient, home healthcare, nursing home, funded through payroll taxes. Part B- doctors, outpatient hospital, medical services and supplies, others not covered under Part A -monthly premiums
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Medicaid
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Low-income Americans Jointly funded by federal,state, and local governments
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BOK
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Bodies of Knowledge
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What is the AHIMA State Component Association for Arkansas called?
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ArHima http://www.arhima.org/About.html