CAHIMS REVIEW TEST BANK QUESTIONS
WITH VERIFIED ANSWERS FULL REVIEW
●● Define health information technology (Health IT) in one sentence.
Answer: The application of computer hardware and software to store,
retrieve, share, and use healthcare information, data, and knowledge for
communication and decision-making.
●● How is health informatics broader than simply using an EHR?
Answer: It is the interdisciplinary study of designing, developing,
adopting, and applying IT-based innovations in healthcare delivery,
management, and planning—not merely operating a record system.
●● Name the five parts of the Quintuple Aim.
Answer: Improved patient experience; improved population health;
lower cost of care; advancing health equity; improved care-team well-
being.
●● Name the main groups that make the healthcare environment
complex.
Answer: Providers, payers, governmental and accrediting agencies,
consumers, suppliers, and a diverse workforce—all operating in a highly
regulated environment.
,●● How can hospitals be classified by ownership?
Answer: Public (government-managed) or private. Private hospitals may
be nonprofit or for-profit/investor-owned.
●● What are common ways to classify hospitals besides ownership?
Answer: By services offered (general, psychiatric, rehabilitation,
children's, long-term acute), teaching status, and geographic location
(rural/critical access or urban).
●● Which features are especially associated with a critical access
hospital (CAH)?
Answer: A state-designated rural facility with limited inpatient capacity
(no more than 25 beds), short average acute inpatient stays, and 24/7
emergency services. It is designed to preserve access in rural
communities.
●● Give four examples of outpatient/ambulatory care settings.
Answer: Examples include physician offices, ambulatory surgery
centers, emergency departments, urgent care, outpatient specialty clinics,
retail clinics, and diagnostic imaging or laboratory facilities.
●● What is an integrated delivery network (IDN)?
Answer: A healthcare organization with multiple providers across the
continuum of care that are integrated through administration and
,information sharing. It may form through mergers, acquisitions, joint
ventures, alliances, or networks.
●● What does the continuum of care include?
Answer: The complete range of health services and programs: primary,
secondary, and tertiary care.
●● Name Health IT enablers that help coordinate care across the
continuum.
Answer: EHRs, cloud-based tools, patient portals, health information
exchanges, interoperability/data sharing, and data analytics.
●● What are the three major roles of government in healthcare?
Answer: Provider of care, payer, and regulator.
●● Put the basic medical billing cycle in order.
Answer: Scheduling/registration → delivery of service → charge capture
→ coding → claim processing → explanation of benefits (EOB) →
reimbursement → patient billing/settlement → final settlement.
●● Differentiate fee-for-service, capitation, and episode-of-care
payment.
, Answer: Fee-for-service pays per individual service. Capitation pays a
fixed amount per person for a period of care. Episode-of-care payment
pays for a defined episode or bundle of services.
●● Differentiate a DRG from an APC.
Answer: A DRG groups inpatient cases and supports a set prospective
payment for the hospitalization. An APC is a payment classification used
for outpatient prospective payment system claims.
●● Name major publicly financed U.S. health programs in the course.
Answer: Medicare, Medicaid, SCHIP, TRICARE, the Veterans Health
Administration, and the Indian Health Service.
●● What Medicare parts are named in the course?
Answer: Part A, Part B, Part C (Medicare Advantage), and Part D.
●● Match each role to its focus: CIO, CTO, CSO, CMIO, CNIO.
Answer: CIO: overall information/IT leadership. CTO: technology
strategy/architecture. CSO: security. CMIO: physician/clinical
informatics leadership. CNIO: nursing informatics leadership.
●● What are core responsibilities of a healthcare IT department?
Answer: Operations and technical support; application
management/development/support; information security; network/data-
WITH VERIFIED ANSWERS FULL REVIEW
●● Define health information technology (Health IT) in one sentence.
Answer: The application of computer hardware and software to store,
retrieve, share, and use healthcare information, data, and knowledge for
communication and decision-making.
●● How is health informatics broader than simply using an EHR?
Answer: It is the interdisciplinary study of designing, developing,
adopting, and applying IT-based innovations in healthcare delivery,
management, and planning—not merely operating a record system.
●● Name the five parts of the Quintuple Aim.
Answer: Improved patient experience; improved population health;
lower cost of care; advancing health equity; improved care-team well-
being.
●● Name the main groups that make the healthcare environment
complex.
Answer: Providers, payers, governmental and accrediting agencies,
consumers, suppliers, and a diverse workforce—all operating in a highly
regulated environment.
,●● How can hospitals be classified by ownership?
Answer: Public (government-managed) or private. Private hospitals may
be nonprofit or for-profit/investor-owned.
●● What are common ways to classify hospitals besides ownership?
Answer: By services offered (general, psychiatric, rehabilitation,
children's, long-term acute), teaching status, and geographic location
(rural/critical access or urban).
●● Which features are especially associated with a critical access
hospital (CAH)?
Answer: A state-designated rural facility with limited inpatient capacity
(no more than 25 beds), short average acute inpatient stays, and 24/7
emergency services. It is designed to preserve access in rural
communities.
●● Give four examples of outpatient/ambulatory care settings.
Answer: Examples include physician offices, ambulatory surgery
centers, emergency departments, urgent care, outpatient specialty clinics,
retail clinics, and diagnostic imaging or laboratory facilities.
●● What is an integrated delivery network (IDN)?
Answer: A healthcare organization with multiple providers across the
continuum of care that are integrated through administration and
,information sharing. It may form through mergers, acquisitions, joint
ventures, alliances, or networks.
●● What does the continuum of care include?
Answer: The complete range of health services and programs: primary,
secondary, and tertiary care.
●● Name Health IT enablers that help coordinate care across the
continuum.
Answer: EHRs, cloud-based tools, patient portals, health information
exchanges, interoperability/data sharing, and data analytics.
●● What are the three major roles of government in healthcare?
Answer: Provider of care, payer, and regulator.
●● Put the basic medical billing cycle in order.
Answer: Scheduling/registration → delivery of service → charge capture
→ coding → claim processing → explanation of benefits (EOB) →
reimbursement → patient billing/settlement → final settlement.
●● Differentiate fee-for-service, capitation, and episode-of-care
payment.
, Answer: Fee-for-service pays per individual service. Capitation pays a
fixed amount per person for a period of care. Episode-of-care payment
pays for a defined episode or bundle of services.
●● Differentiate a DRG from an APC.
Answer: A DRG groups inpatient cases and supports a set prospective
payment for the hospitalization. An APC is a payment classification used
for outpatient prospective payment system claims.
●● Name major publicly financed U.S. health programs in the course.
Answer: Medicare, Medicaid, SCHIP, TRICARE, the Veterans Health
Administration, and the Indian Health Service.
●● What Medicare parts are named in the course?
Answer: Part A, Part B, Part C (Medicare Advantage), and Part D.
●● Match each role to its focus: CIO, CTO, CSO, CMIO, CNIO.
Answer: CIO: overall information/IT leadership. CTO: technology
strategy/architecture. CSO: security. CMIO: physician/clinical
informatics leadership. CNIO: nursing informatics leadership.
●● What are core responsibilities of a healthcare IT department?
Answer: Operations and technical support; application
management/development/support; information security; network/data-
