1. Utilization
Process of determining whether the medical service provided to a
Re- view.
specific Medicare or Medicaid patient is necessary.
2. Daily
oflcial count of inpatients present at midnight, which is calculated each
inpatient
day Also included are any patients who were admitted and discharged
census
the same day
3. Vocabulary
provide consistent descriptions of medical terms for an individual's
stan- dards
condition in the health record
4. Custodia
When records for evidence is involved at the trial, the records custodian
n
is called a witness by one party or other to testify as the authenticity of
Records
a record as evidence. The records custodian verifies that it contains
information about the individual.
5. flowchart a graphic tool that uses standard symbols to visually display detailed
information, including time and distance, of the sequential flow of
work of an individual or a product as it progresses through a
process
6. fish bone chart a performance improvement tool used to identify or classify the
root causes of a problem or condition and to display the root causes
graphically; also called the cause and ettect diagram
7. Aggregated Data Data that has been extracted from individual health records and
combined to form deidentified information about groups of patients
that can be compared.
8. Overlay Mistakenly assigned another persons health record number.
9. Overlap When a patient has more than one health record number at ditterent
locations
within an enterprise.
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10. Duplicate Record 2 or more medical record numbers.
11. Security To control/protect access of health information and records.
12.
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ROI Turnaround Time between receipt of request and when the request is sent to the
Time requester 30 days on site, 60 days ott site
13. Qualitativ Reviewing a record and ensuring that standards are being met. HIM
e professionals can review legibility, timeliness of documentation, use of
Analysis approved abbreviations and other documentation standards.
Ongoing review while patient is in facility. From admission to discharge.
14. Concurrent
Re- view
15. Retrospective Re- Review after patient has been discharged.
view
16. Prospective Review that takes place prior to elective procedures and missions.
Re- view
17. Licensure Organizations are the legal authority from the authorities to carry on certa
activities that require permission. Before healthcare organizations can
provide services, they usually must obtain licensure by government
entities such as the state or county in which they are located.
18. Conditions Administrative and operational guidelines under which facilities are
of allowed to take part in the Medicare and Medicaid programs.
Participatio
n Industry leader in the area of healthcare provider organization
accreditation. Also a non-for-profit organization accredits and certifies
19. The Joint more than 20,000 healthcare organizations.
Com- mission
TJC
20. Privacy The right of a patient to control the disclosure of PHI.
21. Confidentiality Legal and ethical concept that requires healthcare providers to protect
records
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