Capstone - NHAnow.com Review Questions

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Terms in this set (68)
EHR - an electronic record of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created, managed, and reviewed by authorized providers and staff from more than one health care organization.
EMR - an electronic record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single health care organization.
what are 3 advantages of computer scheduling?can display available & scheduled times, as well as length & type of appt required & day or time preferences; can also track future apptsWhen are patients scheduled in wave booking?At the same time each hourHow are patients scheduled in cluster or categorization booking?book times of day for specific kinds of patientsAn office schedules appointments every 20 minutes, with 30 minutes blocked off for lunch. However, the provider usually spends 30 minutes with each patient and takes 20 minutes for lunch. The waiting room is usually full. How could this office run more smoothly?set up a meeting w provider to go over scheduling options - suggest reducing time she takes for lunch & scheduling appts every 30 min alternatively, if any pots are short appts, you could suggest going to cluster booking w longer appts in morning & shorter appts in the afternoonT/F: Medical practices never charge for no-shows.falseWhy is automated call routing a good strategy for preventing no-shows?can give the patient the option to confirm or cancel the appt; system can also be programmed to repeat the call until the pt respondsA patient was scheduled for an appointment, but the doctor was called away due to an emergency. How should the medical administrative assistant handle the situation?try to reach the patient & let them know what happened. offer alternatives for reschedulingwhy is it important to get preauthorization if the patients insurance requires you to do so?if insurance company requires this & its not done, the patient runs the risk of having to pay the full amount for procedure rather than having opportunity to make other arrangementswhy is it important to document no-shows?MA provides provider w info about a pt that may warrant further action; if legal action is ever taken, documentation can be used as evidence of patients actionslist 3 ways a medical office can accommodate patients who have vision losshaving signage in Braille so the patient can find the office, having documents in Braille & large print; having modifications built into the computer if the patients is asked to complete any forms electronicallywhy is health insurance important?Serves as protection against financial losses due to illness or injury. Provides financial support for medical needs, hospitalization, medically necessary diagnostic tests and procedures, and many kinds of preventive services.T/F: If preauthorization is required but not done, the insurance carrier will not pay for the medical services provided.truewho is considered a guarantor?the patients who is also the owner of a primary insurance planwhat is the birthday rule?Applies to dependent children whose parents have more than one insurance policy. The health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan.what are CPT codes used to describe?services provided by providersWhat is the HIPAA notice of privacy practices form?under HIPAA, medical practices are not allowed to release info unless patients first sign a notice of privacy practices form - explains what's in a patients medical record, the patients health info rights & the medical practices responsibilities to the patientname 3 forms that may be found in a patients medical recordconsent to release info, patient financial responsibility form, advance directiveswhen are regular referrals needed?a provider decides that the patient needs to see a specialistwhat is included in an accurate, up-to-date medical record?all info relevant to patient medical care & insuranceHow does HIPAA protect patients?By giving them more control over their medical records; authoring them to make informed choices about the uses of their PHI; setting boundaries on the use and release of health records; establishing safeguards that providers must follow to ensure that the privacy of health information is protected; holding violators accountable if patients' privacy is compromised through both civil and criminal penalties; and protecting the balance struck between public health concerns and the disclosure of PHI.T/F: when storing files, the minimum necessary is to keep the files turned to the wall so that they cannot be seen by those walking by.truewhat is a notice of privacy practices?A written document that explains to patients how their protected health information will be used and protected by the medical officewith whom are covered entities allowed to share info?according to the privacy rule, they are allowed to share info relevant to the patients care w a spouse, family member, friend, or other individual identified by the patientWhen is a patient's privacy not protected?-if access to records from a nursing home are needed to ensure that the provider's are caring for the residents properly and the facility is clean. - when there is need to protect the public from epidemic or cases of sexually transmitted diseases (STDs) or cases of HIV/AIDS. - When police reports about a gunshot wounded are required. -when there are concerns about child abuse.what is an incidental disclosure?Secondary use that cannot be reasonably prevented, is limited in nature, and occurs as a result of another use or disclosure that is permitted.what is OSHAs mission?to protect the health & safety of everyone in the workplacewhat are the consequences of fraud?The OIG has the authority to exclude individuals and entities who have engaged in fraud and abuse from participating in Medicare, Medicaid, and other federal health care programs. The office also can impose penalties on offenders. The OIG keeps an office list of excluded individuals / Entities (LEIE)what is the difference between Medicare & Medicaid?medicare - insurance for those 65+ or those under 65 w disabilities medicaid - for those considered medically indigentwhat are 3 things that must be included in an emergency preparedness plan?info about how to inform patients & employees about an emergency, how to evacuate, & who should be left behind to monitor critical equipment before evacuatingWhy was the Patient's Bill of Rights established?Established to strengthen consumer confidence by ensuring that the health care system is fair and responsive to consumers' needs, provides them with credible, effective mechanisms for addressing their concerns, and encourages them to take an active role in improving and ensuring their health; to reaffirm the importance of a strong relationship between patients and their health care professionals; and to reaffirm the critical role consumers play in safeguarding their health by establishing rights and responsibilities for all participants in improving their health.T/F: Patients have no choice in the providers they seefalsewhat is not included in the patients bill of rights?the right to take home one's own medical recordwhat is abandonment?When a provider discontinues medical care without giving the proper noticeWhat is informed consent?When a patient gives written approval for a procedure or test based on information presented by the provider. This process ensures that the patient is prepared to make a sound decision about her care.T/F: consent is required for minors in life-threatening situationfalsewhat is a deductible?the amount of money patients must pay out of pocket before the insurance company will start to pay for covered benefitswhat is an explanation of benefits (EOB)?A document that identifies what was paid, reduced, or denied; the patient receives an EOB from the insurance carrierwhat information does the patient need before undergoing a medical test or procedure?date & time of the test, what to do to prepare & info about readmission testingwhat are 3 tasks that have to be done before closing the office for the day?check that all patients have left the facility, straighten up exam rooms for the next day, lock file cabinets that contain patient recordsT/F: the accounting system does not have to be addressed until the end of the dayfalse - must be prepared for the day (balancing day sheets, securing encounter forms for each pt w an appt, & ensuring the amount of petty cash available is correctwhy is the telephone important to the medical office?chief way patients communicate w the provider; being polite & courteous can encourage patients to come back & being rude can chase them awaywhat components are included in a business letter?opening, salutation, body, complimentary closing, reference initials, signaturewhy do MAs need to know how to use a word processing program?bc writing letters, memos, & reports is an important part of the jobT/F: sending a fax is the most secure way of sending informationfalse - other people can read faxeswhat are 3 acceptable times that info can be shared, as set forth by HIPAA?for patient care & treatment coordination, to pay providers & facilities for health care & among family, friends & relatives whom the patient has identified as being involved w their health carewhat is the primary use for spreadsheets?enter & store data in table formaccording to HIPAA, what info is a provider not allowed to share without the patients permission?sharing health info w the patients employer, for marketing purposes or sharing mental health info obtained in counseling sessionswhy would a medical practice use social media?to advertise the practice & make announcementswhat are 2 methods of learning proper terminology pronunciation?saying the word out loud & checking a medical dictionary to see how the word is spelled phoneticallyT/F: adding an -s to a word is the only way to make a medical term pluralfalse! adding an -es to words ending in -s, -x, or -y; removing the -y adding an -ies to words ending in -y preceded by a consonant, & removing an -x & adding a -ceswhat 2 word parts are combined to form medical terms?prefixes & roots, suffixes & roots, or both prefixes & suffixes w rootswhat does the abbreviation BP mean?blood pressurewhy does a MA need to understand abbreviations?providers often use them in notes & prescriptions & must be recorded into medical record or explained to pharmacy; MAs may be asked to explain instructions to ptswhat does SOAP stand for?subjective, objective, assessment, planwhat is PHI?protected health info. PHI is any info in any form that contains patient identifiable info.what does a neurologist do?doctor of the nervous systemIf the root "radio" means x-ray, what does the term radiograph mean?-graph means recording instrument; thus, radiograph means an instrument used to make an xrayif the root "path/o" means disease, what does the word pathology mean?-ology means study of; thus the word pathology means the study of disease