Deck 9: Decision and Compliance Support: Utilizing the Database

Question 1

Some managed care plans encourage the use of clinical decision support (CDS) functionality by

A) making their use mandatory.
B) offering monetary incentives for care providers who utilize CDS.
C) including the provider's name in literature about CDS.
D) contacting patients to gain their support.

Answer 1

offering monetary incentives for care providers who utilize CDS.

Question 2

Patti Wolfe, a coding supervisor at the local hospital, is auditing the quality of ICD-10-CM coding. She may start by running which type of index to scan for obvious inaccuracies?

A) procedure
B) master patient
C) disease
D) provider

Answer 2

disease

Question 3

Greensburg Medical Center provides each patient with written documentation that details the signs, symptoms, current treatment options, and other pertinent information about their condition(s). This satisfies which menu objective?

A) patient reminders
B) patient education
C) summary of care
D) syndromatic surveillance

Answer 3

patient education

Question 4

A/an ______________________ function includes reminders and alerts, diagnostic and therapeutic guidance, and links to expert resources.

A) registry
B) index
C) medical dictionary
D) clinical decision support

Question 5

Robyn Malone needs to determine the total number of patients assigned to each care provider for a report to Blue Shield. Which type of index should she run?

A) physician (provider)
B) patient
C) disease
D) procedure

Question 6

In a medical office, a standard report that would be run to show how much each patient owes is the

A) revenue analysis report.
B) provider revenue report.
C) patient balances report.
D) payment analysis report.

Question 7

On October 18, an accident occurred on the local interstate highway. Fifteen patients were brought to the local hospital's emergency department with injuries ranging from minor to life-threatening. These 15 patients would be found in the ______________ registry.

A) cancer
B) death
C) trauma
D) implant

Question 8

Michelle has just discovered state statistics regarding the average length of stay in acute, short-term hospitals for appendectomy patients. She runs a report of patients having undergone an appendectomy in the past year at her hospital so she can compare her hospital's average length of stay to that of other hospitals in the state. What is Michelle doing?

A) calculating variance
B) summarizing
C) benchmarking
D) standardizing statistics

Question 9

Some care providers enter into an agreement with managed care plans whereby the provider agrees to provide medical services to plan enrollees at a pre-negotiated rate. The providers are considered to be

A) participating.
B) in-network.
C) contractors.
D) registered.

Question 10

A/an ___________________ report shows a summary but no details.

A) aggregate
B) surrogate
C) custom
D) standard

Question 11

A report that is run on demand is created

A) at the end of each month.
B) at the end of each quarter.
C) yearly.
D) as it is needed.

Question 12

A voluntary, pay-for-performance incentive program that care providers can participate in through the federal government is the

A) Pay for Performance Program.
B) Physician Quality Reporting Initiative.
C) Quality Reporting Initiative.
D) National Practitioner Data Bank.

Question 13

Dr. Ingram saw 1,457 patients in the first quarter of 2017. He kept an up-to-date problem list on 898 of them. On approximately what percentage of patients did Dr. Ingram meet meaningful use of the EHR related to use of a problem list?

A) 1.6 percent
B) 16 percent
C) 62 percent
D) 6.2 percent

Question 14

Public health agencies have a particular interest in the administration of vaccinations. This information is kept in a/an ___________________ registry.

A) immunization
B) cancer
C) disease
D) trauma

Question 15

Danielle ran a report of congestive heart failure patients. The report includes patients' medical record numbers, ages, admission and discharge dates, and attending physicians. What type of report is this?

A) aggregate
B) custom
C) detail
D) summary

Question 16

The chronological listing of all newborns at a hospital is known as a _____________.

A) index
B) custom report
C) standard report
D) registry

Question 17

Meaningful Use requires that each patient, upon request, must be provided with a summary of test results, problem list, medication list, and medication allergies. This core objective is the

A) privacy provision.
B) ability to provide an electronic copy of health information.
C) ability to exchange key clinical information between/among care providers.
D) recording of a medication allergy list.

Question 18

A local newspaper reporter has contacted your office requesting the total number of patients in the practice who have a diagnosis of Lyme disease, broken into three age ranges-newborn to 18 years old, 19 to 50 years old, and 51 and older-and grouped by ZIP code. To answer this inquiry, the office manager will run which type of report?

A) standard
B) custom
C) benchmarking
D) detail

Question 19

Which entity administers the Meaningful Use program?

A) OIG
B) HITECH
C) CMS
D) HHS

Question 20

The presence of many conditions that pose a threat to public health must be submitted in accordance with applicable law. The ability to do so electronically would satisfy which menu objective?

A) immunization registry
B) patient education
C) syndromatic surveillance
D) summary of care

Question 21

The office manager of Greensburg Medical Center has received a request from the state public health department for a report of patients between the ages of 13 and 25 who are smokers, sorted by ZIP code. To find this information, the office manager will run a/an ____________ report.

Question 22

Reporting cases of fraud and abuse must be made to the

A) National Practitioner Data Bank.
B) Physician Quality Reporting Initiative.
C) Healthcare Integrity and Protection Data Bank.
D) Center for Medicare and Medicaid Services.

Question 23

Hometown Internal Medicine was recently fined $100,000 for overbilling. Since this is considered an adverse action against the office, which data bank does this need to be reported to?

Question 24

Name and describe three of the 15 core objectives required to meet meaningful use, Stage 2 for eligible professionals.

Question 25

You are interested in running a report that just gives totals, or aggregates, rather than information about individual patients or providers; what type of report is this?

Question 26

Many electronic health record programs submit registry information directly to the Center for Medicare and Medicaid Services (CMS) as part of which initiative?

Question 27

Explain how Medicaid-eligible providers will qualify for stimulus grants in their first year.

Question 28

The factors that vary from one patient to the next, for example, diagnosis codes, procedure codes, age, are known as ___________________.

Question 29

The process of ensuring a care provider has the proper qualifications to practice medicine before granting him privileges, contracting with him as part of a managed care plan, or hiring him in a medical practice is

A) checking references.
B) credentialing.
C) licensing.
D) accrediting.

Question 30

The administrators of five hospitals in a major metropolitan area meet monthly. There is a perception among them that there has been a decrease in the number of patients being transferred to nursing homes recently. The administrators each ask the health data analysts from their respective health information management departments to provide a report that shows the number of patients discharged to each of the area nursing homes and for each of the past five calendar years. How will the health data analyst go about providing this information to their administrators?

Question 31

A report that would show how much money each provider generates for the practice is a provider ___________________ summary.

Question 32

What is the name of the index that includes a listing of all patients ever seen in a hospital?

Question 33

Explain how clinical decision support must be connected to the data found in patients' records in order to meet meaningful use.

Question 34

A clinical system, application, or process that helps health professionals make decisions that enhance patient care is known as ______________________.

Question 35

______________ objectives, such as registries, lists, and drug interactions, are additional functions that allow for greater use of EHR functionality.

Question 36

In a hospital, a ____________ registry is maintained daily and includes all inpatients who have left the hospital at the conclusion of their stay.

Question 37

Reports that are built into the software system and do not require any modifications, for instance, a payment analysis report, are what kind of reports?

Question 38

Dr. Rodriguez prefers to monitor his practice's compliance with Meaningful Use requirements. He can do this quickly and easily by using Prime Suite's ____________ capability.

Question 39

In Stage 1 of the Meaningful Use menu objectives, hospitals needed to incorporate _____ of the 10 menu objectives in order to be eligible for incentive grants.

Question 40

What is the benefit of using clinical decision support (CDS) systems?

Question 41

Explain how the National Practitioner Data Bank is used in the credentialing process.

Question 42

Discuss three reasons various registries might be maintained.

Question 43

Explain in-network status in a managed care plan.

Question 44

Give an example of why a hospital may need to refer to a death registry for a given day.

Question 45

Explain the difference between core and menu objectives for eligible professionals.

Question 46

Explain the use of the National Practitioner Data Bank (NPDB).