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T/F: Progressively is a method of organizing a medical record

False

What is the name of the type of info that is gained by questioning the patient?

Subjective

T/F: When taking a patient's cheif complaint you should ask how many family members are healthy?

False

T/F: Releasing a record, with regard to filing it, means: placing a mark indicating the item is ready to be filed

True

What is the proper way to index the name Amanda M. Stile-Duncan

StileDuncan, Amanda M

Who is the legal owner of the info stored in a patients record?

The Physician or facility "Maker"

Care which continues smoothly from one provider to another so that the patient receives the most benefit is called?

Continuity of Care

What is the name of the legal instrument authorizing one to act as the agent of the guarantor?

Power of Attorney

T/F: Family history is objective info?

False

What is the most important reason to tell the physician when there is an error in charting that is discovered later?

could effect the wellbeing of the patient

T/F: Draw 2 clear lines through an error in a patient medical record

false

What is the name of the filing system where an intermediary source of reference such as a file card is used to locate specific files?

Indirect Filing

What is the proper way to index the name Jill Freeman, MD.

Freeman, Jill (MD)

Name three types of filing equipment found in the medical record office

Rotary, lateral and automated

Name three advantages of color coded filing system:

misfiled chart is easily found
refile quickly
faster way of finding the patient

When is the only time a patients medical record can be released?

when a patient signs a consent form expressed permission

how long should you keep records on file for minors?

until they are 18yrs old and 3 years after

What 3 things must be addressed on an informed consent form?

Nature of procedure of treatment
risks/ benefits of the procedure of treatment
any reasonable alternatives to the procedure or treatment
risks of not performing procedure

what are the 3 stages of machine transcription?

dictating into adication unit
listening to what has been dictated
keyboarding

name 3 things that the medical assistant should do when preparing a file for a new patient:

name spell correct
all forms completed
get copy of insurance card

what is the name of the item used to provide space for temporary filing of materials?

out guide or out folder

what is the most efficient type of medical record?

computer based

what is the name of the method of filing where by 1 report is laid on top of an older report resembeling a roof?

shingled

what kind of files are filed for patients who have died, moved away or otherwise terminated their relationship with the physician?

closed files

what is the length of time recommended by HIPAA for a physician to keep medical records on patients that have died?

2yrs

what things should you consider when selecting filing equipment?

space cost fire protection and confidentiality

what is the name of the strong highly glazed compostion paper or heavy card stock?

pressboard

T/F Authenticated is a characteristic of high quality health data?

false

quality assurance is concerned with.....,...... and ....... of medical service

overuse, underuse and misuse

are mammograms for at risk patients overused or underused?

underused

where would you aquire a nosocomial infection?

hospital

NCHS keeps stats on

communicable diseases teen preg, common health HIV

Total power failure in a hospital would be considered a .......event

Sentinal event

what is the characteristic of high quality data that assures multiple users can obtain the data at one time?

accessibility

what year did HIPAA become effective?

2003

what is the name of the non profit organization that assists health care facilities by providing accrediations service?

JACHO

T/F: Exceeding standards and provides optimal healthcare to patient is in the interest most health care facilities now

true

T/F institute training on the job is one of demmings 14 poionts for management

true

t/f: Collection integrating and analyzing are tasks that health professionals perform data

true

what is te name of the organization that supports health info personal

AHIMA

hipaa places great restricitions on patients info for used for..... ..... purposes of .....

marketing soliciation and sales

what is the high quality data characterisitics that suggests that info in the database about a patient can be trusted

reliability

t/f: a pharmacy is allowed to offer patietns info to another entity that intern uses the info to solicit sale of related product to the patient

flase

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