QUESTIONS AND CORRECT ANSWERS
Alpha level - CORRECT ANSWER The level of Type I error that is deemed acceptable based
on context in statistical hypothesis testing. See Type I error.
Alternative hypothesis - CORRECT ANSWER The complement of the null hypothesis that is
to be tested using the appropriate statistical test. This hypothesis typically requires some action to be
taken.
Ambulatory payment classification (APC) - CORRECT ANSWER The payment unit used in
the hospital outpatient prospective payment system (OPPS). The classification is a resource-based
reimbursement system.
Analysis - CORRECT ANSWER Reviewing and summarizing data for use in decision making.
Analysis of variance - CORRECT ANSWER The statistical tool used to compare more than
two population means. The null hypothesis tests that all of the population means are equal.
Auditing - CORRECT ANSWER "The performance of internal and external reviews (audits) to
identify variations from established baselines (for example, review of outpatient coding as compared
with CMS outpatient coding guidelines)."
Balanced design - CORRECT ANSWER An experimental design where the number of subjects
in each sample are the same for all populations sampled. The term is relevant when performing an
analysis of variance or a two sample t-test.
Bell curve - CORRECT ANSWER The shape of the normal distribution. The bell pealcs at the
average and slopes down on both sides symmetrically.
Binomial variable - CORRECT ANSWER "A variable that talces only two values (such as yes
or no; alive or dead). The probability of a yes or no is constant across all of the subjects, and the
outcome of each subject is independent of the others."
, Case Mix Index (CMI) - CORRECT ANSWER "The average relative weight of all cases
treated at a given facility or by a given physician, which reflects the resource intensity or clinical
severity of a specific group in relation to the other groups in the classification system; calculated by
dividing the sum of the weights of diagnosis-related groups for patients discharged during a given
period by the total number of patients discharged."
Centers for Medicare and Medicaid Services (CMS) - CORRECT ANSWER "The division of
the Department of Health and Human Services that is responsible for developing healthcare policy in
the United States, for administering the Medicare program and the federal portion of the Medicaid
program, and maintaining the procedure portion of the International Classification of Diseases, ninth
revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, tenth
revision, Procedure Coding System (ICD-10-PCS); called the Health Care Financing Administration
(HCFA) prior to 2001."
Chi squared test - CORRECT ANSWER A statistical test that is used to test for relationships
between categorical variables. The null hypothesis for this test is that there is no association between
the two variables. Represented by the symbol X2 (where X is the Greek letter chi.)
Cluster random sampling - CORRECT ANSWER "The population is divided into groups
before the sample is selected. The groups or clusters must be mutually exclusive and exhaustive. (That
is, every unit in the population is assigned to one and only one cluster.) Clusters are then randomly
selected to make up the sample. Cluster sampling may be performed as single-stage or two-stage."
Cluster Sampling - CORRECT ANSWER Sampling where population is divided into groups
(or clusters); groups are then randomly selected to form sample
CMS-1500 - CORRECT ANSWER "1. The universal insurance claim form developed and
approved by the American Medical Association (AMA) and the Centers for Medicare and Medicaid
Services (CMS) that physicians use to bill Medicare, Medicaid, and private insurers for professional
services provided 2. A Medicare claim form used to bill third-party payers for provider services, for
example, physician office visits."
Coefficient of determination - CORRECT ANSWER "A statistic that measures the amount of
variance in a dependent variable explained by one or more independent variables. If there is one
independent variable, then this value is the Pearson Correlation Coefficient squared."