1
Chapter 1
Introduction to Health Care Information
MULTIPLE CHOICE
1. The number-one reason for maintaining patient records is:
a. Legal documentation
b. Communication
c. Patient Care
d. Billing and reimbursement
Answer: pg. 9
2. Which is generally not considered part of a patient’s medical record:
a. Problem list
b. Medication Record
c. Progress Notes
d. Digital images or films
Answer pg. 12
3. Medical records that are created and organized around the patient’s problems are known as:
a. Chronological organized medical records
b. “Source – oriented” medical records
c. Content Based Medical Records
d. Patient Oriented Medical Records
Answer pg. 14 - 15
4. A method for measuring performance that allows for the design of measurement systems that
align with the organization’s strategy goals and examines multiple measures along several
dimensions is known as:
a. Benchmarking
b. Outcome measures
c. Balanced scorecard
d. Clinical Value Compass
Answer: pg. 37
5. The category of statistics that are routinely gathered for health care executives are:
a. Census statistics
b. Discharge statistics
c. Mortality Statistics
d. Both a and b
Answer: pg. 36
6. Which standard billing form is submitted for health care provider services such as those
provided by a physician’s office to third party payers:
a. UB-04
b. CMS-1450
c. CMS-1500
, 2
d. UB-82
Answer: pg. 22
7. What is a federally mandated standard assessment tool used to collect demographic and
clinical information specifically about long-term care facility residents:
a. MDS
b. ACDS
c. UHDDS
d. HEDIS
Answer: pg. 28
8. The main source(s) of data that go into hundreds of aggregate reports or queries that are often
developed and used by providers and executives in health care organizations are:
a. Patient records
b. Uniform billing information
c. Discharge data sets
d. All of the above
Answer: pg. 33
9. HEDIS measures are specifically used to measure and compare the performance of:
a. Hospitals
b. Skilled nursing facilities
c. Physician practices
d. Health plans
Answer: pg. 40
10. Which organization is responsible for investigating fraud involving government health
insurance programs?
a. OIG
b. CMS
c. AMA
d. WHO
Answer: pg. 33
TRUE/FALSE
1. As part of the patient’s medical record, the identification form or face sheet is considered both
a clinical and administrative document
True
False
Answer: pg. 11
2. CPT codes are published by the American Hospital Association (AHA) and updated each year
True
False
Answer: pg. 31 (CPT codes are published by the American Medical Association (AMA))
, 3
3. DRGs are used as the basis for determining appropriate inpatient reimbursement for Medicare,
Medicaid, and other health care insurance beneficiaries
True
False
Answer pg. 30
4. Medicare cost reports are filed annually by all hospitals, physician offices, home health
agencies, skilled nursing facilities, and hospices that accept Medicare or Medicaid.
True
False
Answer pg. 35 (physician offices are not required to submit)
5. Health care information systems and health care processes are unrelated and should be
considered independently
True
False
Answer: pg. 21 (processes are entwined)
6. Centers for Medicare and Medicaid Services (CMS) currently requires health providers to
submit claims electronically unless the provider qualifies for a waiver
True
False
Answer: pg. 22
7. CMS requires that all UB-04 claims include a valid 10 position unique National Provider
Identifier (NPI) for each HIPAA-covered health care provider
True
False
Answer pg. 24
8. An electronic health record (EHR) is an electronic record of health-related information on an
individual that can be managed, shared, and controlled by that individual
True
False
Answer: pg. 6 (Personal health record)
9. Medicare and Medicaid do not have the authority to access a patient’s medical record to
confirm the accuracy of a filed claim by checking for documentation
True
False
Answer: pg. 9 (CMS does have the authority to access a patient’s medical record to validate
a claim)
10. ACDS is a uniform data adopted by the federal government and used as the standard for
Medicare and Medicaid programs specifically in an ambulatory and outpatient care settings
True
, 4
False
Answer: pg. 28
SHORT ANSWER/ESSAY
Name and describe some common sources of comparative data and explain their potential value
to a health care manager.
Answer: pg. 38-43
Chapter 1
Introduction to Health Care Information
MULTIPLE CHOICE
1. The number-one reason for maintaining patient records is:
a. Legal documentation
b. Communication
c. Patient Care
d. Billing and reimbursement
Answer: pg. 9
2. Which is generally not considered part of a patient’s medical record:
a. Problem list
b. Medication Record
c. Progress Notes
d. Digital images or films
Answer pg. 12
3. Medical records that are created and organized around the patient’s problems are known as:
a. Chronological organized medical records
b. “Source – oriented” medical records
c. Content Based Medical Records
d. Patient Oriented Medical Records
Answer pg. 14 - 15
4. A method for measuring performance that allows for the design of measurement systems that
align with the organization’s strategy goals and examines multiple measures along several
dimensions is known as:
a. Benchmarking
b. Outcome measures
c. Balanced scorecard
d. Clinical Value Compass
Answer: pg. 37
5. The category of statistics that are routinely gathered for health care executives are:
a. Census statistics
b. Discharge statistics
c. Mortality Statistics
d. Both a and b
Answer: pg. 36
6. Which standard billing form is submitted for health care provider services such as those
provided by a physician’s office to third party payers:
a. UB-04
b. CMS-1450
c. CMS-1500
, 2
d. UB-82
Answer: pg. 22
7. What is a federally mandated standard assessment tool used to collect demographic and
clinical information specifically about long-term care facility residents:
a. MDS
b. ACDS
c. UHDDS
d. HEDIS
Answer: pg. 28
8. The main source(s) of data that go into hundreds of aggregate reports or queries that are often
developed and used by providers and executives in health care organizations are:
a. Patient records
b. Uniform billing information
c. Discharge data sets
d. All of the above
Answer: pg. 33
9. HEDIS measures are specifically used to measure and compare the performance of:
a. Hospitals
b. Skilled nursing facilities
c. Physician practices
d. Health plans
Answer: pg. 40
10. Which organization is responsible for investigating fraud involving government health
insurance programs?
a. OIG
b. CMS
c. AMA
d. WHO
Answer: pg. 33
TRUE/FALSE
1. As part of the patient’s medical record, the identification form or face sheet is considered both
a clinical and administrative document
True
False
Answer: pg. 11
2. CPT codes are published by the American Hospital Association (AHA) and updated each year
True
False
Answer: pg. 31 (CPT codes are published by the American Medical Association (AMA))
, 3
3. DRGs are used as the basis for determining appropriate inpatient reimbursement for Medicare,
Medicaid, and other health care insurance beneficiaries
True
False
Answer pg. 30
4. Medicare cost reports are filed annually by all hospitals, physician offices, home health
agencies, skilled nursing facilities, and hospices that accept Medicare or Medicaid.
True
False
Answer pg. 35 (physician offices are not required to submit)
5. Health care information systems and health care processes are unrelated and should be
considered independently
True
False
Answer: pg. 21 (processes are entwined)
6. Centers for Medicare and Medicaid Services (CMS) currently requires health providers to
submit claims electronically unless the provider qualifies for a waiver
True
False
Answer: pg. 22
7. CMS requires that all UB-04 claims include a valid 10 position unique National Provider
Identifier (NPI) for each HIPAA-covered health care provider
True
False
Answer pg. 24
8. An electronic health record (EHR) is an electronic record of health-related information on an
individual that can be managed, shared, and controlled by that individual
True
False
Answer: pg. 6 (Personal health record)
9. Medicare and Medicaid do not have the authority to access a patient’s medical record to
confirm the accuracy of a filed claim by checking for documentation
True
False
Answer: pg. 9 (CMS does have the authority to access a patient’s medical record to validate
a claim)
10. ACDS is a uniform data adopted by the federal government and used as the standard for
Medicare and Medicaid programs specifically in an ambulatory and outpatient care settings
True
, 4
False
Answer: pg. 28
SHORT ANSWER/ESSAY
Name and describe some common sources of comparative data and explain their potential value
to a health care manager.
Answer: pg. 38-43
