Him 1000- Review mid term exam from chapter 1- 7
Question and answers already passed 2025/2026
1. 3 main types HMO, PPO, IPA
of managed
care
arrangements
2. Health Mainte- It is a prepaid, organized system for providing comprehensive health care
nance
Organiza- tion services within geographic area all person under contact, emphasizing
(HMO) preventive medi- cine.
3. Preferred It consists of a network of participating hospitals, physicians, medical
Provider
Organization groups, and other providers who contract with a sponsor, such as an
s (PPO) insurance company or employer, to provide services to those enrolled in
the PPO.
4. Independent
Practice
Association
(IPA) It is a community- based group of independent practitioners who contract
to provide care for prepaid, enrolled individuals.
5. Administrative Administrative data are the basic identification and financial data routinely
collect- ed from every patient. These data are frequently collected at the
preadmission
or admission processing stages and include socioeconomic data such as
patient name, address, date of birth, next of kin, occupation, and name
of employer.
6. **Examples
of -Personal identifiers such as name, date of birth, and Social Security
Administrativ number.
e -Billing and insurance information, including receipts.
-Authorization of organ donation.
-Contact information in case of an emergency.
-Living wills and advance directives.
-Constant to treat, release of information, and notice of privacy practices
forms.
1/
16
,7. Clinical Clinical data refers to the collected and maintained data that relate to the
patient's health and course of treatment and care. Clinical data can
include information such as the patient's past health history, the data
contained in orders and progress notes, and the patient's final
diagnosis.
2/
16
, Him 1000- Review mid term exam from chapter 1- 7
8. **Examples
of Clinical -Immunization and allergy records
data -Medication, exercise, and counseling records
-Recent physical examination results
-Eye and dental records
-Options specialist
-Correspondence between patient and health care
9. 3 key compo-
nents of evalua-
tion and provider. History, exam, and medical decision
manage- ment
coding making.
10. Admitting
Diag- nosis
-Admitting Diagnosis- The admitting diagnosis is defined as the
initial working diagnosis documented by the patient's admitting or
attending physician who determined that inpatient care was
necessary.
-Admitting Diagnosis: The sign symptom, condition, injury, or disease
that was the reason the patient sought medical care is considered the
admitting diagnosis (even if the patient isn't actually admitted to the
hospital).
11. AHIMA - The American Health Information Management Association (AHIMA)
in 1991 is the primary professional association for health information
management profes- sionals in the United States.
-In the 21st century, AHIMA has over 100,000 members and issues
several credentials beyond those of RHIA and RHIT. Credentials
recognize specialties in coding, security, and privacy. In each instance,
these credentials may be held in addition to the RHIA or RHIT
credential.
-AHIMA also provides opportunities for lifelong learning through
3/
16
Question and answers already passed 2025/2026
1. 3 main types HMO, PPO, IPA
of managed
care
arrangements
2. Health Mainte- It is a prepaid, organized system for providing comprehensive health care
nance
Organiza- tion services within geographic area all person under contact, emphasizing
(HMO) preventive medi- cine.
3. Preferred It consists of a network of participating hospitals, physicians, medical
Provider
Organization groups, and other providers who contract with a sponsor, such as an
s (PPO) insurance company or employer, to provide services to those enrolled in
the PPO.
4. Independent
Practice
Association
(IPA) It is a community- based group of independent practitioners who contract
to provide care for prepaid, enrolled individuals.
5. Administrative Administrative data are the basic identification and financial data routinely
collect- ed from every patient. These data are frequently collected at the
preadmission
or admission processing stages and include socioeconomic data such as
patient name, address, date of birth, next of kin, occupation, and name
of employer.
6. **Examples
of -Personal identifiers such as name, date of birth, and Social Security
Administrativ number.
e -Billing and insurance information, including receipts.
-Authorization of organ donation.
-Contact information in case of an emergency.
-Living wills and advance directives.
-Constant to treat, release of information, and notice of privacy practices
forms.
1/
16
,7. Clinical Clinical data refers to the collected and maintained data that relate to the
patient's health and course of treatment and care. Clinical data can
include information such as the patient's past health history, the data
contained in orders and progress notes, and the patient's final
diagnosis.
2/
16
, Him 1000- Review mid term exam from chapter 1- 7
8. **Examples
of Clinical -Immunization and allergy records
data -Medication, exercise, and counseling records
-Recent physical examination results
-Eye and dental records
-Options specialist
-Correspondence between patient and health care
9. 3 key compo-
nents of evalua-
tion and provider. History, exam, and medical decision
manage- ment
coding making.
10. Admitting
Diag- nosis
-Admitting Diagnosis- The admitting diagnosis is defined as the
initial working diagnosis documented by the patient's admitting or
attending physician who determined that inpatient care was
necessary.
-Admitting Diagnosis: The sign symptom, condition, injury, or disease
that was the reason the patient sought medical care is considered the
admitting diagnosis (even if the patient isn't actually admitted to the
hospital).
11. AHIMA - The American Health Information Management Association (AHIMA)
in 1991 is the primary professional association for health information
management profes- sionals in the United States.
-In the 21st century, AHIMA has over 100,000 members and issues
several credentials beyond those of RHIA and RHIT. Credentials
recognize specialties in coding, security, and privacy. In each instance,
these credentials may be held in addition to the RHIA or RHIT
credential.
-AHIMA also provides opportunities for lifelong learning through
3/
16
