Deck 16: Consulting

Question 1

In the audit cycle, which of the following is completed first?

A) design audit sheet, incorporating all standards and regulations
B) analyze, interpret, and present audit results
C) research regulations and standards
D) review random sample of records

Answer 1

research regulations and standards

Question 2

In the audit cycle, which of the following is completed after the others listed?

A) review random sample of records to determine whether improvement occurred
B) analyze, interpret, and present audit results
C) research regulations and standards
D) develop audit criteria

Answer 2

analyze, interpret, and present audit results

Question 3

A formal, written document summarizing the operational and financial objectives of a business that includes the details of how the objectives are to be attained, including budgets and other financial forecasts is a(n) ___________________________.

A) audit
B) business plan
C) business associate agreement
D) corporate integrity agreement

Answer 3

business plan

Question 4

Which of the following is charged with protecting the integrity of the Medicare and Medicaid programs?

A) Office of Civil Rights (OCR)
B) Internal Revenue Service (IRS)
C) Office of the Inspector General (OIG)
D) Reimbursement Integrity Contractors (RICs)

Question 5

A corporate integrity agreement is an agreement that _____________________________.

A) a consultant reaches with the client that protects the institution from any liability arising from the misconduct of the consultant
B) a health care provider or health plan reaches with the ONC to ensure the integrity of health care data submitted to a health information exchange
C) a health care provider or health plan reaches with the OIG as part of a settlement agreement when allegations of improper reimbursement have been made
D) a consultant reaches with the client to ensure that all of the necessary components of the business associate agreement are in place to protect the privacy of personal health information accessed by the consultant to fulfill the terms of the contract

Question 6

Clients often include in the consultant's contract a requirement that the consultant maintain ___________________________.

A) professional liability insurance coverage
B) all equipment and resources necessary to complete the contract
C) all protected health information necessary to complete the contract
D) the same professional credentials that are required of the facility's permanent staff

Question 7

A retrospective review of selected health care records or data documents to evaluate the quality of care, services provided, documentation, or coding compared with predetermined standards is a(n) ______________________.

A) audit
B) contract
C) business plan
D) corporate integrity agreement

Question 8

A person who is not a member of the covered entity's workforce, but performs work on behalf of the covered entity that involves the use or disclosure of protected health information is a(n) ___________________.

A) client
B) employer
C) employee
D) business associate

Question 9

Good leaders _____________________.

A) act ethically
B) act on self-interest
C) have a high cognitive IQ
D) base their power on mandated authority

Question 10

When a contractor works from home, the term "container" refers to ___________________________.

A) the terms of the contract
B) the money provided to the contractor up front to begin work
C) the place in which focused work is performed both physically and mentally
D) the device in which medical documentation is transported between the facility and the contractor

Question 11

Which of the following would NOT be appropriate to include in a consulting contract?

A) business associate agreement providing for protection of privacy of PHI
B) provision for payment contingent upon improving facility revenues
C) hourly rate of payment for services
D) description of services

Question 12

Which of the following is NOT a key element of a business plan?

A) marketing strategies
B) financial projections
C) description of business
D) statement of health insurance coverage

Question 13

Which of the following is a true statement concerning financial considerations for the independent health information management consultant?

A) Consultants can ordinarily expect to work at least 260 billable days per year.
B) Consultants rarely have to wait for payment for longer than 90 days, so maintaining cash reserves is not an issue for most consultants.
C) In addition to salary, consulting revenue should cover FICA taxes, office space, equipment, supplies, and other business expenses.
D) Starting a health information management consulting business requires raising a large amount of funding from loans or investors prior to launching the consulting firm.

Question 14

Which of the following is NOT a step in the development of action plans?

A) Determine all steps necessary to attain each goal.
B) Maintain confidentiality of each goal.
C) Assign responsibility for each step.
D) Set deadlines for each goal.

Question 15

When the project for which the consultant has been hired expands beyond the contractually agreed upon services, this is referred to as ___________________ .

A) scope creep
B) audit expansion
C) corporate integrity breach
D) ergonomics

Question 16

Which of the following is NOT an area of regulation likely to affect HIM consultants?

A) federal mandates for ICD coding in the veterinary setting
B) ICD-10-CM/PCS implementation and coding
C) meaningful use standards
D) RAC audits

Question 17

Which of the following would the HIM consultant be LEAST likely to research in preparing to conduct a documentation audit?

A) federal and state regulations for the type of facility being audited
B) accreditation guidelines
C) HIPAA EDI standards
D) best practices

Question 18

Which of the following is NOT ordinarily a component of a health care provider's compliance program implemented to guard against fraud and abuse?

A) nternal monitoring and auditing
B) developing compliance standards and policies
C) designation of a compliance officer or contact
D) training and education of the public and patients

Question 19

Which of the following is NOT of major importance to a successful HIM consulting practice?

A) a large staff of employees
B) relevant work experience
C) an RHIT or RHIA credential
D) careful research and planning

Question 20

A health information consultant charges $150 per hour and works the equivalent of 200 billable eight-hour days per year. Taxes, insurance, travel, and other expenses consume about 70 % of the consultant's gross revenue. What is the consultant's net annual income after taxes and other expenses?

A) $30,000
B) $72,000
C) $168,000
D) $240,000

Question 21

Which of the following is recommended when setting up a home office?

A) maintaining highly polished, shiny countertops and office furniture
B) sharing one telephone line with family members and a fax machine
C) multitasking by combining child-care duties with consulting activities
D) using a fax machine for rapid transmission of printed documents that cannot be emailed.

Question 22

The initial CMS Recovery Audit Contractors (RAC) program identified problems with ________________________________.

A) workforce shortages due to the low number of health information consultants
B) widespread lack of compliance with HIPAA privacy and security regulations
C) incorrect coding and a failure to document medical necessity
D) intentional filing of false claims by health care providers

Question 23

Which of the following is NOT a major factor in determining the fee charged by a consultant?

A) costs to provide services
B) fees charged by other consultants
C) the reputation and experience of the consultant
D) household operational costs

Question 24

A multipurpose machine acts as _________________________.

A) a printer, fax machine, scanner, and copier
B) a printer, collator, and binder
C) a computer and fax machine
D) a computer and telephone

Question 25

Individuals whom the consultant knows professionally and personally are the best source of referrals.

Question 26

In preparing for preliminary meetings with potential clients, the consultant should document the time spent on the initial presentation in order to include it in the first bill presented to the client after the contract has been signed.

Question 27

It is not advisable for a consultant to network with other consultants because of the risk of losing clients to competitors.

Question 28

Completion of the audit cycle may involve educating those who document in the records and then conducting a follow-up audit to determine improvement.

Question 29

When a Recovery Audit Contractor (RAC) identifies a pattern of improper payments that indicates possible fraud, the RAC is required to notify the office of the attorney general of the state in which the suspected offense occurred.

Question 30

The Patient Protection and Affordable Care Act made compliance programs mandatory for health care providers.

Question 31

Choosing to be an independent consultant is synonymous with starting a new business and being self-employed.

Question 32

Organizations use the online yellow pages to select consultants more than any other method.

Question 33

There is no need for an independent, self-employed consultant to develop formal documents such as a mission statement or business objectives

Question 34

Leadership has been defined as an influence process.

Question 35

Interpersonal intelligence is the ability to understand other people, what motivates them, how they work, and how to work cooperatively with them.

Question 36

High hourly charges by consultants mean that self-employment will be financially lucrative and provide more personal freedom.

Question 37

It is common for an independent consultant to experience gaps in workload.

Question 38

A window makes an excellent backdrop for a computer workstation.

Question 39

Transmitting protected health information to and from a client across networks by regular email is preferable to faxing.

Question 40

The HITECH Act has placed additional obligations for privacy and security on business associates and also extends the threat of civil and criminal penalties for violations of privacy and security standards to business associates.

Question 41

Being of good repute means that others believe an individual is trustworthy, hard-working, and honest.

Question 42

A consultant must guard against conflicts of interest and maintain high ethical standards.

Question 43

A(n) ________________________________ is a formal written document summarizing the operational and financial objectives of a business.​

Question 44

A person who is not a member of the health care provider's workforce but who performs work on behalf of the provider that involves the use or disclosure of protected health information is a(n) ________________________________.​

Question 45

The science of _____________________________________ involves designing workspaces and equipment to fit the human body to maximize comfort, convenience, and efficiency and to prevent work-related physical problems.​

Question 46

A(n) __________________________ is a retrospective review of selected health care records or data documents to evaluate the quality of care, services provided, documentation, or coding compared with predetermined standards.​

Question 47

The _______________________________ is a subdivision of the U.S. Department of Health and Human Services whose mission is to protect the integrity of Department of Health and Human Services (HHS) programs, as well as the health and welfare of the beneficiaries of those programs.​

Question 48

A(n) ___________________________________ is an agreement that a health care provider or health plan reaches with the Department of Health and Human Services' Office of the Inspector General (OIG) as part of a settlement agreement when allegations of improper reimbursement have been made.​

Question 49

Match each description with the correct item

- In a(n) ___________________, the consultant may likely help with research facilitated by SNOMED CT coding.

A) nursing facility
B) physician practice
C) acute care hospital
D) veterinary teaching hospital

Question 50

Match each description with the correct item

- In a(n) ___________________, the consultant may likely review documentation supporting assignment of present on admission indicators.

A) nursing facility
B) physician practice
C) acute care hospital
D) veterinary teaching hospital

Question 51

Match each description with the correct item

- In a(n) ___________________, the consultant may likely review of percentage of residents with decreased independence in their ability to perform activities of daily living.

A) nursing facility
B) physician practice
C) acute care hospital
D) veterinary teaching hospital

Question 52

Match each description with the correct item

- In a(n) ___________________, the consultant may likely select, implement, and manage an electronic health record (EHR) that streamlines the appointment, clinical, and billing processes.

A) nursing facility
B) physician practice
C) acute care hospital
D) veterinary teaching hospital

Question 53

List three items of equipment that a consultant is likely to need to conduct business efficiently.?

Question 54

There are several questions a consultant should answer when selecting computer equipment. List at least two questions that a consultant should consider before making a computer purchase.?

Question 55

Describe how fax machines, copiers, scanners and multipurpose devices can be beneficial for a consultant.​

Question 56

Discuss compliance programs in health care, including the purpose of such programs, their benefits, and relevant laws and regulations.​