RHIT PRACTICE EXAM DOMAIN 5 COMPLIANCE

RHIT PRACTICE EXAM DOMAIN 5 COMPLIANCE 1. What is one purpose of a physician query? Answer: To clarify conflicting documentation. 2. What is a general statement that defines the parameters for decision-making guidance on a topic? Answer: Policy. 3. What best describes the planning, organizing, directing, and controlling of information in an EHR? Answer: Workflow management. 4. Where can you find information on healthcare fraud and abuse mandated by HIPAA? Answer: Healthcare integrity and protection data bank (HIPDB). 5. According to CMS hospital conditions of participation, what must be completed for a patient within a certain timeframe? Answer: A medical history and physical examination must be completed for a patient no more than 24 hours after admission. 6. Which database is used during the credentialing process to verify provider education and professional background? Answer: National practitioner data bank. 7. Who has the ultimate responsibility for quality management and performance improvement activities within an organization? Answer: Board of directors. 8. In an EHR environment, what issue arises when a physician borrows record entries from another source or author and displays past documentation as current? Answer: Authorship integrity. 9. What program has the Joint Commission created to focus on specific areas of concern within a healthcare organization? Answer: National patient safety goals. 10. Under HIPAA, what agreement refers to an individual or group that is not part of a hospital's workforce but helps the facility with various functions involving PHI? Answer: Business associate. 11. Which option would a healthcare facility use to avoid court actions? Answer: Arbitration. 12. Which act is most effective in combating medical fraud, waste, and abuse? Answer: False Claims Act. 13. What is the first step when a health record analyst identifies an unsigned order? Answer: Flag the record for the physician. 14. What may contribute to incorrect coding of a health record? Answer: Insufficient knowledge of coding conventions and guidelines. 15. What may contribute to incorrect coding of a health record? Answer: Incomplete or conflicting provider documentation. 16. What may contribute to incorrect coding of a health record? Answer: Lack of regular coding education and training. 17. Why did CMS develop the NCCI (National Correct Coding Initiative)? Answer: To control improper coding practices.