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Major responsibilities of the Risk Manager generally include
defining PHI.
evaluating HIE data.
vetting physician appointment applicants.
loss prevention and reduction. - loss prevention and reduction.
What quality indicator would identify improvement needs in hospital electronic transmission of health
care claims and remittances to allow interoperability with ICD-10 codes?
an increase in hospital-acquired infections
an increase in 5010 rejections
an increase in requests for operative reports
denied requests for medical record copies for continued care - an increase in 5010 rejections
The Joint Commission's emphasis on improving quality of patient care for a participating facility is
exemplary through the required self-assessment process tool known as
real-time analytics.
intracycle monitoring.
focused standards asessment.
total quality management (TQM). - intracycle monitoring.
Storyboards are a method used in health care that
graphically display a performance improvement project conducted.
,serve as a documentation format in patient records.
illustrate the marketing plan.
serve as a teaching tool for third-party auditors. - graphically display a performance improvement
project conducted.
Dr. Jeremy is establishing a clinical trial research study for his patients with lung cancer wishing to
participate in a chemotherapy clinical trial. As Assistant Director, you are responsible for clinical abstract
of data and advise him to first seek approval of research involving human subjects through the
medical staff.
institutional review board (IRB).
Office of National Coordinator (ONC).
governing board. - institutional review board (IRB).
The PQRS is a reporting system established by the federal government for physician practices who
participate in Medicare for
monetary incentives.
credentialing.
meaningful use incentives.
quality measure reporting. - quality measure reporting.
The current hospital policy time frame for authenticating verbal orders adheres to the CMS COP that
requires the ordering physician, or another health care practitioner responsible for the care of the
patient, to write orders according to hospital policy and authenticate
both on physician's time schedule.
based on the severity of the illness.
within 12 hours.
as per governmental and facility policies. - as per governmental and facility policies.
, HEDIS gathers data in which of the following areas?
prenatal care
severity of illness indicators
average length of stay
breast cancer screenings - breast cancer screenings
The primary advantage of concurrent quality data collection is that
practitioners receive immediate feedback about patient processes and outcomes.
multiple chart reviews eliminate collector bias.
staffing is decreased.
chart completion issues can be remedied promptly. - chart completion issues can be remedied
promptly.
The manager of the utilization review department wants to monitor and evaluate the prevention of
inappropriate admissions. When would the manager need to collect data?
long-term care review
retrospective review
prospective review
concurrent review - prospective review
As the new Coding Manager, you met with the coding staff to encourage feedback on ways to increase
coding accuracy to meet established benchmarks. The coders provided feedback through brainstorming
that you compiled on flipcharts and organized into categories. This is known as a(n)
nominal group technique.
affinity diagram.
cause-and-effect diagram.
flow process chart. - affinity diagram.