When Comparing Medicare Explained for Students (Easy Guide)

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Original Question

When comparing Medicare’s IPPS and IPF (psychiatric) PPS which of the following statements is false? Group of answer choices b. Both PPSs have a high-cost outlier provision a. Both PPSs use wage index adjustments to account for differences in the cost of labor d. Both PPSs provide supplemental reimbursement for teaching facilities c. Both PPSs use MS-DRGs with the same relative weights Flag question: Question 48Question 482 pts The purpose an Interface Terminology is to facilitate data capture from the clinician at the point of care. Which is an example of an interface terminology? Group of answer choices b. HL7 c. Interoperability a. ANSI d. MEDCIN Flag question: Question 49Question 492 pts Which of the following would be the best source for the foundation of an organization’s information governance mission statement? Group of answer choices c. An organization’s mission and overall strategy d. An organization’s reporting structure b. Comparison of various information governance mission statements a. AHIMA Information Governance Mission Statement Flag question: Question 50Question 502 pts _____ does not require “intent” to be found guilty. Group of answer choices b. EMTALA a. The Stark Law c. Waste d. RACs Flag question: Question 51Question 512 pts A way to assess the quality of data in the EHR is to _____. Group of answer choices a. Audit structured data entries d. Review data against established norms b. Compare data in the EHR to dictated documents c. Determine an acceptable error rate Flag question: Question 52Question 522 pts ____ includes avoidance, prevention, reduction, segregation, and non-insurance transfer. Group of answer choices d. Risk control b. Incident reporting a. The OIG workplan c. Contingency planning Flag question: Question 53Question 532 pts Under the APC system, multiple procedures performed during the same surgical encounter are reimbursed at which of the following rates? Group of answer choices c. The procedure in the lowest APC receives full payment and the remaining procedures receive half (50 percent) payment. b. The procedure in the highest APC receives full payment and the remaining procedures receive half (50 percent) payment. a. All significant procedures receive full (100 percent) payment. d. The procedure in the highest APC receives full payment and the remaining procedures receive seventy-five (75 percent) payment. Flag question: Question 54Question 542 pts The most important use of clinical documentation is _____. Group of answer choices d. Justification of billing claims c. Research data b. Communication between patient care providers a. ICD-10-CM and ICD-10-PCS coding Flag question: Question 55Question 552 pts If your hospital’s net days in accounts receivable is 62 and the local peer hospital’s net days in accounts receivable is 46, your hospital’s A/R value compared to the local peer hospital would be considered _____. Group of answer choices c. Average b. Unfavorable a. Favorable d. Insignificant Flag question: Question 56Question 562 pts Who are the key assessors for external audits? Select all that apply Group of answer choices d. Risk manager a. State government c. Compliance officer b. Federal government Flag question: Question 57Question 572 pts Recently, a healthcare organization has noticed an increase in the number of measles cases in children under 5 years old. The healthcare organization reports the information to the state department of health. Which of the following statements is most applicable to the disclosure of this information? Group of answer choices d. The healthcare organization violated HIPAA because they didn’t get authorization from the state department of health prior to the disclosure a. The healthcare organization violated HIPAA because they didn’t get authorization prior to the disclosure b. The healthcare organization did not violate HIPAA because they can disclose information to anyone that they set fit c. The healthcare organization did not violate HIPAA because it impacted the public health of everyone Flag question: Question 58Question 582 pts Between which two health information system applications is there the least interoperability at the present time? Group of answer choices a. EHR in a physician office and revenue cycle management c. Nurse staffing and EHR in a large health system d. Radiology information systems and picture archiving and communication systems b. Lab test results and personal health records Flag question: Question 59Question 592 pts Determine which of the following statements is correct. Group of answer choices c. Common law supersedes all other laws. a. Common law established in a state is effective only in that state. b. There is an extensive code of national common law. d. All court decisions are persuasive authority only. Flag question: Question 60Question 602 pts How are benefit periods calculated for a Medicare beneficiary’s inpatient hospital insurance? Group of answer choices a. One per year c. None; benefit periods are not determined for hospital stays. d. Unlimited b. Based on a 60-day lag between hospital admissions Flag question: Question 61Question 612 pts A cancer committee wants to compare long-term survival rates for breast cancer by comparing outcomes for the mastectomy versus lumpectomy approaches. The best source of this information is the ______. Group of answer choices d. Master patient index b. Operative index c. Cancer registry a. Disease index Flag question: Question 62Question 622 pts In a patient record, the physician notes that the patient is “morbidly obese.” The patient sees the notation and sues the physician. Which of the following best characterizes this situation? The physician _____. Group of answer choices c. Has a right to record his or her personal opinion of the patient b. Is liable for committing libel a. Is liable for committing slander d. Has a right to document pertinent clinical observations Flag question: Question 63Question 632 pts Fraud can occur _____. (Select all that apply.) Group of answer choices b. When an individual in billing makes an unintentional mistake c. When an individual does something he or she should have known was illegal d. All of the above a. When an individual deliberately deceives another to gain a benefit Flag question: Question 64Question 642 pts Under the Anti-Kickback Statute, which of the following referrals are not allowed? Group of answer choices b. Those intended to get reciprocal referrals c. Those independent of any relationships d. a and b only a. Those intended to back future referrals Flag question: Question 65Question 652 pts The HIM director at Healthwise Hospital, Jan Hines, RHIA, has noticed that history and physicals and OP Reports are not being transcribed and returned by the transcription service within the negotiated timeframes. What should be her primary concern related to this issue? Group of answer choices b. That physicians will stop dictating reports and just include comments in the progress notes. d. That information is not being made available in the patient portal within the required timeframe. a. That the transcription service company will overcharge the hospital for reports that are delayed. c. That the Joint Commission will find that history and physicals are not being uploaded into the EHR system within the 24 hours required timeframe. Flag question: Question 66Question 662 pts In conducting an analysis to determine the consistency of input in structured data which of the following sources would an analyst consult? Group of answer choices b. Email files a. Document files in shared folders c. Transactional databases d. Binary Large Object Data Server Flag question: Question 67Question 672 pts In a negligence case against Dr. Roberts, an expert witness for the plaintiff provided testimony that Dr. Roberts did not practice in a manner that other physicians with similar training and experience would have practiced. The judge allowed the expert witness’ testimony to be admitted because it demonstrated lack of adherence to what standard of care? Group of answer choices b. Optimal d. Reasonable c. Community a. Minimal Flag question: Question 68Question 682 pts Which of the following is the word used to describe the most granular unit of representation in a terminology? Group of answer choices a. Relationship b. Synonym c. Context d. Concept Flag question: Question 69Question 692 pts Misty is a nurse who is employed by Nurses On The Go, a contract agency that provides nurse staffing to hospitals. While working at Major Hospital, Misty fails to administer medication to a patient, resulting in patient harm. The doctrine of respondeat superior _____. Group of answer choices b. Subjects Major Hospital to greater liability than the corporate negligence doctrine c. Protects Nurses On The Go from liability d. Will impose liability on Major Hospital if Misty is deemed to be its agent a. Protects Major Hospital from liability for Misty’s negligence Flag question: Question 70Question 702 pts If an organization has an average daily gross patient service revenue of $230,000 along with 120 patient preregistered encounters, 150 scheduled encounters, and $100,000 in gross dollars in discharged, not final billed accounts, what is the DNFB rate? Group of answer choices a. 43.5% d. 80.0% b. 52.1% c. 2.3%

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