RHIA Final Exam | Questions And Answers Latest {2024- 2025} A+ Graded | 100%
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Accountable Care Organizations (ACOs) - group of service providers working together to manage and
coordinate care to Medicare fee-for-service beneficiaries
biotechnology - field devoted to applying techniques of biochemistry, cellular biology, biophysics, and
molecular biology to address issues related to humans, agriculture, and the environment (EX: Pharma
and medical device)
deemed status - designates facility is in compliance with Medicare Conditions of Participation
Health Maintenance Organization (HMO) - usually only pays for care within own network; primary
doctor coordinates care
Health Savings Account (HSA) - savings accounts designed to help people save for future medical and
retiree health costs on a tax-free basis--part of 2003 Medicare bill--AKA medical savings accounts
Integrated Delivery System (IDS) - combines financial and clinical aspects of healthcare and uses a group
of healthcare providers, selected on basis of quality and cost management criteria, to furnish
comprehensive health services across the continuum of care
investor-owned hospital chain - group of for-profit healthcare facilities owned by stockholders
Managed Care/Managed Care Organization (MCO) - delivers medical care and manages all aspects of
care or payment of care by limiting providers, discounting payment, or limiting access to care. AKA
coordinated care organization
medical staff bylaws - spell out qualifications for physicians before they are able to practice in a given
hospital. legally binding--changes to "laws" must be approved by a vote of medical staff and hospital's
governing body
medical staff classification - organization of physicians according to clinical assignment
,Multihospital system - two or more hospitals owned, leased, sponsored, or contract managed by a
central organization
network - group of hospitals, physicians, providers, or payers collaborating to coordinate and deliver
services to their community
Point of Service (POS) plan - managed care plan where enrollees are encouraged to select healthcare
providers from a network under contract, but are allowed to go out of network and pay a larger share of
the cost
Preferred Provider Organization (PPO) - network contractually agreed to specified reimbursement,
providing reimbursement for covered benefits regardless if in network, and offered by non-HMOs
retail clinics - treat non-life-threatening acute illness and offer routine wellness services--flu shots,
physicals, prescription refills, etc
Surgeon General - appointed by POTUS. has responsibility for public health service workforce
telehealth - system that links healthcare organizations and patients from different geographic locations
and transmits texts and images for medical consultation and treatment
TRICARE - covers care for retired veterans, active military members, and dependents of active and
retired members of the 7 armed forces
Value-Based Purchasing (VBP) - pays for care that rewards better value, patient outcomes, and
innovation, rather than just volume of care provided
data - raw facts generally stored as characters, words, symbols, measurements, or statistics
derived data - consists of factual details aggregated or summarized from a group of health records that
provides no means to identify specific patients. not considered part of the legal health record
,clinical practice guidelines - information that provides physicians with pertinent health information
beyond the health record itself; used to determine treatment options
metadata - set of data that gives information about other data, such as: name of element, locator key,
ownership, entity relationship, date entered in system, system origin, etc
ancillary (services, functions) - secondary. services/functions provided to support the primary function.
EX: OT ancillary service for physician, biomedical research ancillary function of health record
LOINC codes - Logical Observation Identifiers, Names, and Codes. used for identifying lab test results
Uniform Hospital Discharge Data Set (UHDDS) - inpatient data set incorporated into federal law and
required for Medicare reporting
Auditing Integrity - inadequate functions that make it impossible to detect when an entry was modified
or borrowed from another source and misrepresented as an original entry by an authorized user
quantitative analysis - review of health record to ensure completeness and accuracy; assure record
meets all documentation requirements; all parts are present; generally retrospective
data content standards - allow data to be shared in a uniform way--clear guidelines for the acceptable
values for specified data fields--allows users to interpret data in the same way
provider - entity responsible for ensuring quality of health record documentation
components of Resident Assessment Instrument (RAI) - Minimum Data Set (MDS--SNF and LTC), Care
Area Assessments (CAA), RAI utilization guidelines. RAIs used to collect necessary information from and
about the facility resident
data dictionary - standardize definitions and ensure consistency of use--enhances use across systems
database - tool used to collect, retrieve, report, and analyze data. cannot function without management
system to manipulate and control data it stores--stored in one place and accessed by many systems
, migration plan - strategic plan that identifies applicants, technology, and operational elements needed
for the overall information technology program in a healthcare entity
record retention - Medicare COP requires record retention of 5 years
data definition steward - business role with major responsibilities, including identifying specific data
needed to operate business processes, recording metadata, and identifying and enforcing quality
standards
hybrid health records - mixture of paper and electronic, or multiple electronic systems that do not
communicate or are not logically architected for record management
dimensions of Data Quality - relevancy, granularity, timelines, currency, accuracy, precision, consistency
primary purpose for documenting and maintaining health records - effective communication among
caregivers for continuity of care
components of quality - appropriateness, technical excellence, accessibility, acceptability
nonrepudiation - methods (along with documentation) by which data are maintained in an accurate
form after their creation, free of unauthorized changes, modifications, updates, or similar edits
case finding - methods used to identify patients who have been seen and treated in the facility for the
particular disease or condition of interest to the registry
object-oriented database - object that contains both data and their relationships in a single structure
National Committee on Vital and Health Statistics (NCVHS) - government agency that led development
of basic data sets for health records and computer databases