Deck 1: Introduction to Health Information Technology and Medical Billing

Question 1

What government regulation is intended to promote the use of EHRs in physician's practices and hospitals through the use of financial incentives?

A) HITECH Act
B) Affordable Care Act (ACA)
C) HIPAA Security Rule
D) HIPAA Privacy Rule

Answer 1

HITECH Act

Question 2

In order to be eligible for financial incentives through the HITECH Act, what are healthcare providers required to do?

A) demonstrate a need for financial assistance
B) implement the EHR
C) demonstrate meaningful use of electronic health records
D) complete the application process

Answer 2

demonstrate meaningful use of electronic health records

Question 3

The utilization of certified EHR technology to improve quality, efficiency, and patient safety in the healthcare system is known as what?

A) medical security implementation
B) meaningful use
C) healthcare improvement
D) All of these are correct.

Answer 3

meaningful use

Question 4

What term refers to the computer hardware, software, and networks that are used to record, store, and manage health information?

A) practice management program (PMP)
B) health information technology (HIT)
C) electronic data interchange (EDI)
D) electronic health record (EHR)

Question 5

A practice management program (PMP) is a software program that is used to

A) record patients' payments and generate receipts.
B) process the financial transactions.
C) calculate charges for office visits.
D) All of these are correct.

Question 6

Which task is not performed by a practice management program?

A) creating financial reports
B) billing patients
C) assigning diagnosis codes
D) receiving electronic payments

Question 7

What is the PMP used for after a claim file has been transmitted?

A) to follow up on the status of the claim
B) to send an electronic message to the health plan if there is a delay
C) to receive a document that lists the amount that has been paid on each claim
D) All of these are correct.

Question 8

Why is monitoring claim status necessary?

A) to reduce duplication of claims
B) to reduce claim processing cost
C) to ensure prompt payment of claims
D) All of these are correct.

Question 9

According to the Institute of Medicine, which of the following core functions should be included in an EHR?

A) decision support
B) order management
C) population reporting and management
D) All of these are correct.

Question 10

A major component of EHR order management is

A) electronic prescribing.
B) electronic transmission.
C) EHR results reporting.
D) EHR decision support.

Question 11

Which of the following is a method of patient support commonly offered by electronic health records (EHRs)?

A) access to appropriate educational materials on health topics
B) ability to report on home monitoring and testing to their physician
C) instructions for preparing for common medical tests
D) All of these are correct.

Question 12

A communication tool that provides the patient with relevant and actionable information and instructions is the

A) patient portal.
B) after-visit summary.
C) post-visit instructions.
D) electronic health records.

Question 13

What information cannot be included when electronic health records are used to advance medical knowledge through research?

A) disease registries
B) immunization status
C) patient's identity
D) patient progress and outcomes

Question 14

Every time a patient is treated by a healthcare provider, a record is made of the encounter. This record is known as

A) documentation.
B) patient encounter.
C) medical history.
D) diagnosis.

Question 15

The ten-step process that results in timely payment for medical services is known as the

A) reimbursement cycle.
B) medical documentation and billing cycle.
C) medical coding and billing cycle.
D) cash flow cycle.

Question 16

You are preregistering a new patient. Which of the following pieces of information should you collect?

A) the patient's name
B) the patient's contact information
C) the patient's reason for the visit
D) All of these are correct.

Question 17

When are copayments routinely collected?

A) at check-in
B) during patient chart review
C) at checkout
D) at either check-in or checkout

Question 18

Which of the following are recurring expenses for most medical practices?

A) salaries
B) utilities
C) insurance
D) All of these are correct.

Question 19

The process of translating a description of a diagnosis or procedure into a standardized code is known as

A) posting.
B) processing.
C) coding.
D) None of these are correct.

Question 20

You are checking in an existing patient who hasn't been to the office for some time. Which documents should you photocopy and/or scan and add to the patient's chart?

A) insurance identification card
B) debit or credit card
C) birth certificate
D) social security card

Question 21

What must be carefully documented for each patient visit for the physician to receive payment?

A) diagnoses
B) procedures
C) encounter notes
D) both diagnoses and procedures

Question 22

A(n) ______ is a list of procedures and diagnoses for a patient's visit.

A) encounter form
B) remittance advice
C) patient information form
D) schedule of benefits

Question 23

The patient's primary complaint (the illness or condition that is the reason for the visit) is assigned a

A) procedure code.
B) complaint code.
C) diagnosis code.
D) medical code.

Question 24

Each procedure (service, treatment, or test) the physician performs is assigned a

A) procedure code.
B) complaint code.
C) diagnosis code.
D) medical code.

Question 25

A(n) ______ is a listing of standard charges for procedures.

A) list of benefits
B) encounter form
C) fee schedule
D) procedure list

Question 26

What information does a health plan need to pay a claim?

A) procedures the provider performed while the patient was in the office
B) the date of the office visit
C) the patient's diagnosis
D) All of these are correct.

Question 27

A company that receives electronic claims and forwards the claim to the payer is known as

A) a clearinghouse.
B) a superbill.
C) a processor.
D) a coding agency.

Question 28

What is a series of steps designed to determine whether a claim should be paid?

A) adjudication
B) claim processing
C) claim transmittal
D) compliance

Question 29

The remittance advice provides details about each patient transaction, including

A) the transactions included on the claim.
B) the amount paid.
C) explanation of why certain charges weren't paid.
D) All of these are correct.

Question 30

Each remittance advice is compared against the claim to check that

A) the codes on the payment transactions match those on the claim.
B) the payment listed for each procedure is as expected.
C) any unpaid charges are explained.
D) All of these are correct.

Question 31

When a medical practice receives an overpayment from a health plan, it

A) keeps the funds.
B) notifies the patient.
C) issues a refund.
D) files the payment in the PMP.

Question 32

Most medical practices

A) do not have a regular schedule for sending statements to patients.
B) have a regular schedule for sending statements to patients.
C) send statements to patients on the fifteenth of the month.
D) send statements to patients on the thirtieth of the month.

Question 33

Revenue cycle management refers to

A) documenting medical practice revenue.
B) managing the activities associated with a patient encounter to ensure the provider is paid.
C) filing collection notices.
D) filing insurance claims in a timely fashion.

Question 34

What is an electronic format that providers and health plans must use to send and receive healthcare transactions?

A) HIPAA Privacy Rule
B) HIPAA Electronic Transaction and Code Sets
C) HIPAA Security Rule
D) EDI

Question 35

Electronic data interchange involves sending information from

A) paper chart to computer.
B) fax machine to computer.
C) computer to computer.
D) recorder to computer.

Question 36

Most physician practices are required to use the HIPAA-standard electronic claim format called

A) X12-835 Claims Payment and Remittance Advice.
B) X12.278 Health Care Services Review.
C) X12-837 Health Care Claim.
D) X12.270/271 Health Care Eligibility Benefit Inquiry and Response.

Question 37

Finalized in 2013, this legislation made significant changes to the privacy, security, and enforcement provisions of the original HIPAA legislation.

A) HIPAA Omnibus Rule
B) Electronic data exchange (EDI)
C) HIPAA Privacy Rule
D) Protected health information (PHI)

Question 38

The automated processes used to protect data and control access to data are

A) administrative safeguards.
B) technical safeguards.
C) physical safeguards.
D) functional safeguards.

Question 39

Laura works at a large clinic where her duties mainly consist of scheduling appointments. Because she does not deal with any financial tasks, Laura does not have access to the billing data. This is an example of what type of security safeguard?

A) administrative
B) physical
C) technical
D) functional

Question 40

If a breach of unsecured health information affects more than 500 individuals, the HIPAA Breach Notification Rule requires covered entities and their business associates to notify

A) individuals.
B) the Secretary of Health and Human Services.
C) the media.
D) All of these are correct.

Question 41

An individual or entity that creates, receives, maintains, or transmits PHI on behalf of a covered entity and may also include subcontractors of an entity is known as a

A) clearinghouse.
B) patient.
C) provider.
D) business associate.

Question 42

A report that traces who has accessed electronic information, when information was accessed, and whether any information was changed is a(n)

A) clearinghouse summary.
B) business associate trace.
C) breech report.
D) audit trail.

Question 43

Laura, a new medical office receptionist, accidentally sent the patient's PHI to the wrong provider. Under HIPAA Privacy Rule, this is known as a(n)

A) incident.
B) audit.
C) breach.
D) negligence.

Question 44

An automated process used to protect data and control access to data is known as a(n)

A) technical safeguard.
B) audit trail.
C) administrative safeguard.
D) physical safeguard.

Question 45

Mechanisms that are required to protect electronic systems, equipment, and data from threats, environmental hazards, and unauthorized intrusion are known as

A) technical safeguards.
B) the audit trail.
C) administrative safeguards.
D) physical safeguards.

Question 46

Administrative policies and procedures designed to protect electronic health information are known as

A) technical safeguards.
B) the audit trail.
C) administrative safeguards.
D) physical safeguards.

Question 47

A formal examination or review undertaken to determine whether a healthcare organization's staff members comply with regulations is known as a(n)

A) regulation review.
B) audit trail.
C) audit.
D) enforcement.

Question 48

Single payments to multiple providers involved in an episode of care, creating a sense of shared accountability among providers, are known as

A) shared payments.
B) one-time payments.
C) bundled payments.
D) network payments.

Question 49

______ is protected health information that is created, stored, transmitted, or received electronically.

A) PHI
B) EHR
C) PHR
D) ePHI

Question 50

An electronic document that lists patients, dates of service, charges, and the amount paid or denied by the insurance carrier is the

A) ERA.
B) EHR.
C) EOB.
D) EFT.

Question 51

A model of physician reimbursement in which payment is provided for specific, individual services provided to a patient is known as

A) pay-for-performance.
B) fee-for-service.
C) bundled payments.
D) network payments.

Question 52

Linda, a new patient, received a printed document that explains the medical office's use and disclosure of PHI. What is the name of this document?

A) HIPAA Privacy Rule Statement
B) Notice of Privacy Practices
C) Notice of Office Use and Disclosure
D) HIPAA Notice

Question 53

Dr. Klager encourages his patients to use a secure online website that allows them to communicate with their provider and access their health information at any time. This tool is known as

A) a patient portal.
B) personal health records.
C) post-visit instructions.
D) electronic health records.