HIMT 1250 CHAPTER 7-9 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026
The Medicaid Integrity Program is designed to: - Answers audit claims submitted to Medicaid to
identify overpayment
The ______________ is the uniquely identifying field within a database. - Answers Primary key
Which of the following is a Joint Commission accreditation decision category? - Answers Denial of
accreditation
Individuals can agree or object to having his or her protected health information (PHI) used or shared
with Children or Adult Services. - Answers
What does PHI stand for? - Answers Protected Health Information
The oldest anti-fraud law, which is to be addressed in a healthcare corporate compliance program, is
the: - Answers false claims act
An individuals protected health information (PHI) may be released without an authorization for
treatment, payment, and operations. - Answers true
Data becomes __________________ when something is done to that data to make it meaningful -
Answers information
What is a piece of legislation written and approved by a state or federal legislature and then signed
into law by the state's governor or the president? - Answers statue
____________ are federal regulations that establish standard of care. - Answers medicare conditions
of participation
Which of the following created a system for reporting medical errors? - Answers Patient Safety and
Quality Improvement Act
Which Joint Commission survey methodology involves an evaluation that follows the hospital
experiences of past or current patients? - Answers Tracer methodology
This purpose of this program is to reduce improper Medicare payments and prevent future improper
payments made of claims of healthcare services? - Answers Recovery audit contractors
As an HIM professional working on IG initiatives, it is important to find out how the data in the
organization is collected, stored and analyzed because: - Answers Because it needs to be able to be
trustworthy and have the highest integrity and quality
Which of the following is NOT a category of highly sensitive information? - Answers blood cultures
___________ govern the organization and conduct of independent healthcare professionals who
provide patient-care services in acute-care facilities. - Answers medical staff bylaws
AHRQ's quality indicators (QI) are _________________________ - Answers measures of healthcare
quality that make use of readily available hospital inpatient administrative data
______________ provide detailed written instructions on how functions and processes are
implemented within an organization. - Answers procedure
Written instructions that describe how functions and processes must be carried out are: - Answers
procedure
When is the timeframe for an unannounced survey after a full survey? - Answers 18-36 months
CDI is an accurate description of a patient's clinical status into coded data, which is then translated
into: - Answers quality report
The AHIMA IG Adoption Model Competencies state that IG should be included in: - Answers The
infrastructure, business process, compliance program, legal and regulatory procedures and in all other
aspects of an IG program
What is a drug formulary? - Answers It is a key listing of pharmaceuticals that are approved for use in
payment by both private and government-based insurance entities
What type of organization works under contract with the CMS to conduct Medicare/Medicaid
certification surveys for hospitals? - Answers State agency
The primary goal of the meaningful use program is - Answers assembling of data, analyzing the data,
interpreting the findings, feedback and change the current practice if needed
The process of the Learning health system involves the - Answers Accurate, Accessible and
comprehensive
The quality reporting of a CDI program may include the following - Answers physician report cards,
reimbursement, disease tracking, trending, and research
The Medicaid Integrity Program is designed to: - Answers audit claims submitted to Medicaid to
identify overpayment
The ______________ is the uniquely identifying field within a database. - Answers Primary key
Which of the following is a Joint Commission accreditation decision category? - Answers Denial of
accreditation
Individuals can agree or object to having his or her protected health information (PHI) used or shared
with Children or Adult Services. - Answers
What does PHI stand for? - Answers Protected Health Information
The oldest anti-fraud law, which is to be addressed in a healthcare corporate compliance program, is
the: - Answers false claims act
An individuals protected health information (PHI) may be released without an authorization for
treatment, payment, and operations. - Answers true
Data becomes __________________ when something is done to that data to make it meaningful -
Answers information
What is a piece of legislation written and approved by a state or federal legislature and then signed
into law by the state's governor or the president? - Answers statue
____________ are federal regulations that establish standard of care. - Answers medicare conditions
of participation
Which of the following created a system for reporting medical errors? - Answers Patient Safety and
Quality Improvement Act
Which Joint Commission survey methodology involves an evaluation that follows the hospital
experiences of past or current patients? - Answers Tracer methodology
This purpose of this program is to reduce improper Medicare payments and prevent future improper
payments made of claims of healthcare services? - Answers Recovery audit contractors
As an HIM professional working on IG initiatives, it is important to find out how the data in the
organization is collected, stored and analyzed because: - Answers Because it needs to be able to be
trustworthy and have the highest integrity and quality
Which of the following is NOT a category of highly sensitive information? - Answers blood cultures
___________ govern the organization and conduct of independent healthcare professionals who
provide patient-care services in acute-care facilities. - Answers medical staff bylaws
AHRQ's quality indicators (QI) are _________________________ - Answers measures of healthcare
quality that make use of readily available hospital inpatient administrative data
______________ provide detailed written instructions on how functions and processes are
implemented within an organization. - Answers procedure
Written instructions that describe how functions and processes must be carried out are: - Answers
procedure
When is the timeframe for an unannounced survey after a full survey? - Answers 18-36 months
CDI is an accurate description of a patient's clinical status into coded data, which is then translated
into: - Answers quality report
The AHIMA IG Adoption Model Competencies state that IG should be included in: - Answers The
infrastructure, business process, compliance program, legal and regulatory procedures and in all other
aspects of an IG program
What is a drug formulary? - Answers It is a key listing of pharmaceuticals that are approved for use in
payment by both private and government-based insurance entities
What type of organization works under contract with the CMS to conduct Medicare/Medicaid
certification surveys for hospitals? - Answers State agency
The primary goal of the meaningful use program is - Answers assembling of data, analyzing the data,
interpreting the findings, feedback and change the current practice if needed
The process of the Learning health system involves the - Answers Accurate, Accessible and
comprehensive
The quality reporting of a CDI program may include the following - Answers physician report cards,
reimbursement, disease tracking, trending, and research
