RHIA Domain 4 2024 Test Questions with Correct Answers
7 views 0 purchase
Course
RHIA Domain 4
Institution
RHIA Domain 4
RHIA Domain 4 2024 Test Questions with Correct Answers
What is coordination of benefits? - Answer-In many instances, patients have more than one insurance policy and the determination of which policy is primary and which is secondary is necessary so that there is no duplication in payment of benef...
RHIA Domain 4 2024 Test
Questions with Correct
Answers
What is coordination of benefits? - Answer-In many instances, patients have more than
one insurance policy and the determination of which policy is primary and which is
secondary is necessary so that there is no duplication in payment of benefits. This
process is called coordination of benefits
Data-mining efforts of recovery audit contractors (RAC) allow them to deny payments
without ever reviewing a health record based on the information they gather without
having access to the record. Which of the following would be an example of a potential
denial based on information the RAC contractor would have without the health record?
a. A coder assigning the wrong DRG for a patient
b. Billing for two colonoscopies on the same day for the same Medicare beneficiary
c. An inaccurate principal diagnosis
d. A principal procedure code - Answer-Answer: B
Through the use of the RACs' proprietary software, RACs are able to detect improper
payments. Underpayment and overpayment amounts can be subject to an automated
review
The universal protocol requires a "time-out" prior to the start of any surgical or invasive
procedure to conduct a verification of: - Answer-b. Patient, procedure, and site
A Joint Commission accredited organization must review their formulary annually to
ensure a medication's continued: - Answer-The formulary is composed of medications
used for commonly occurring conditions or diagnoses treated in the healthcare
organization. Organizations accredited by the Joint Commission are required to
maintain a formulary and document that they review at least annually for a medication's
continued safety and efficacy
Efficacy and safety
ou are the coding manager and are completing a review of a new coder's work. The
case facts are that the patient was admitted for the treatment of dehydration secondary
to chemotherapy for primary liver cancer. The new coder sequenced the principal
, diagnosis as liver carcinoma. Which of the following would be the correct principal
diagnosis?
a. Liver carcinoma
b. Admission for chemotherapy
c. Dehydration
d. Complication of chemotherapy - Answer-Answer: C
The principal diagnosis is governed by the circumstances of admission, which in this
case is dehydration
The health record review process and what other aspect allow for the highest level of
quality in clinical documentation?
a. Training on the revenue cycle
b. Medical necessity
c. Training on basics of coding
d. Physician queries - Answer-Correct Answer: D
The primary operational components of the CDI program are the record review and the
query process. The review process and the physician query process allow for the
highest level of quality in clinical documentation
A quality data review that is based on specific problems after an initial baseline review
that has been completed in a hospital is called a(n):
a. Focused inpatient review
b. Compliance initiative
c. Internal audit
d. Concurrent review - Answer-Correct Answer: A
The HIM department can plan focused reviews based on specific problem areas after
the initial baseline review has been completed. This would be called a focused inpatient
review
In a typical acute-care setting, the explanation of benefits, Medicare summary notice,
and remittance advice documents (provided by the payer) are monitored in which
revenue cycle area?
a. Preclaims submission
b. Claims processing
c. Accounts receivable
d. Claims reconciliation and collections - Answer-Correct Answer: D
The last component of the revenue cycle is reconciliation and collections. The
healthcare facility uses the explanation of benefits (EOB), Medicare summary notice
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Scholarsstudyguide. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.09. You're not tied to anything after your purchase.
