RHIA Exam Questions With All Correct
Detailed Answers Verified A+ Pass 2025
New Update
Accountable Care Organizations (ACOs) - Answer - ✔ group of service providers
working together to manage and coordinate care to Medicare fee-for-service
beneficiaries
biotechnology - Answer - ✔ field devoted to applying techniques of biochemistry, cellular
biology, biophysics, and molecular biology to address issues related to humans,
agriculture, and the environment (EX: Pharma and medical device)
deemed status - Answer - ✔ designates facility is in compliance with Medicare
Conditions of Participation
Health Maintenance Organization (HMO) - Answer - ✔ usually only pays for care within
own network; primary doctor coordinates care
Health Savings Account (HSA) - Answer - ✔ savings accounts designed to help people
save for future medical and retiree health costs on a tax-free basis--part of 2003
Medicare bill--AKA medical savings accounts
Integrated Delivery System (IDS) - Answer - ✔ combines financial and clinical aspects
of healthcare and uses a group of healthcare providers, selected on basis of quality and
cost management criteria, to furnish comprehensive health services across the
continuum of care
investor-owned hospital chain - Answer - ✔ group of for-profit healthcare facilities
owned by stockholders
Managed Care/Managed Care Organization (MCO) - Answer - ✔ delivers medical care
and manages all aspects of care or payment of care by limiting providers, discounting
payment, or limiting access to care. AKA coordinated care organization
medical staff bylaws - Answer - ✔ spell out qualifications for physicians before they are
able to practice in a given hospital. legally binding--changes to "laws" must be approved
by a vote of medical staff and hospital's governing body
medical staff classification - Answer - ✔ organization of physicians according to clinical
assignment
,Multihospital system - Answer - ✔ two or more hospitals owned, leased, sponsored, or
contract managed by a central organization
network - Answer - ✔ group of hospitals, physicians, providers, or payers collaborating
to coordinate and deliver services to their community
Point of Service (POS) plan - Answer - ✔ managed care plan where enrollees are
encouraged to select healthcare providers from a network under contract, but are
allowed to go out of network and pay a larger share of the cost
Preferred Provider Organization (PPO) - Answer - ✔ network contractually agreed to
specified reimbursement, providing reimbursement for covered benefits regardless if in
network, and offered by non-HMOs
retail clinics - Answer - ✔ treat non-life-threatening acute illness and offer routine
wellness services--flu shots, physicals, prescription refills, etc
Surgeon General - Answer - ✔ appointed by POTUS. has responsibility for public health
service workforce
telehealth - Answer - ✔ system that links healthcare organizations and patients from
different geographic locations and transmits texts and images for medical consultation
and treatment
TRICARE - Answer - ✔ covers care for retired veterans, active military members, and
dependents of active and retired members of the 7 armed forces
Value-Based Purchasing (VBP) - Answer - ✔ pays for care that rewards better value,
patient outcomes, and innovation, rather than just volume of care provided
data - Answer - ✔ raw facts generally stored as characters, words, symbols,
measurements, or statistics
derived data - Answer - ✔ consists of factual details aggregated or summarized from a
group of health records that provides no means to identify specific patients. not
considered part of the legal health record
clinical practice guidelines - Answer - ✔ information that provides physicians with
pertinent health information beyond the health record itself; used to determine treatment
options
metadata - Answer - ✔ set of data that gives information about other data, such as:
name of element, locator key, ownership, entity relationship, date entered in system,
system origin, etc
,ancillary (services, functions) - Answer - ✔ secondary. services/functions provided to
support the primary function. EX: OT ancillary service for physician, biomedical
research ancillary function of health record
LOINC codes - Answer - ✔ Logical Observation Identifiers, Names, and Codes. used for
identifying lab test results
Uniform Hospital Discharge Data Set (UHDDS) - Answer - ✔ inpatient data set
incorporated into federal law and required for Medicare reporting
Auditing Integrity - Answer - ✔ inadequate functions that make it impossible to detect
when an entry was modified or borrowed from another source and misrepresented as
an original entry by an authorized user
quantitative analysis - Answer - ✔ review of health record to ensure completeness and
accuracy; assure record meets all documentation requirements; all parts are present;
generally retrospective
data content standards - Answer - ✔ allow data to be shared in a uniform way--clear
guidelines for the acceptable values for specified data fields--allows users to interpret
data in the same way
provider - Answer - ✔ entity responsible for ensuring quality of health record
documentation
components of Resident Assessment Instrument (RAI) - Answer - ✔ Minimum Data Set
(MDS--SNF and LTC), Care Area Assessments (CAA), RAI utilization guidelines. RAIs
used to collect necessary information from and about the facility resident
data dictionary - Answer - ✔ standardize definitions and ensure consistency of use--
enhances use across systems
database - Answer - ✔ tool used to collect, retrieve, report, and analyze data. cannot
function without management system to manipulate and control data it stores--stored in
one place and accessed by many systems
migration plan - Answer - ✔ strategic plan that identifies applicants, technology, and
operational elements needed for the overall information technology program in a
healthcare entity
record retention - Answer - ✔ Medicare COP requires record retention of 5 years
, data definition steward - Answer - ✔ business role with major responsibilities, including
identifying specific data needed to operate business processes, recording metadata,
and identifying and enforcing quality standards
hybrid health records - Answer - ✔ mixture of paper and electronic, or multiple electronic
systems that do not communicate or are not logically architected for record
management
dimensions of Data Quality - Answer - ✔ relevancy, granularity, timelines, currency,
accuracy, precision, consistency
primary purpose for documenting and maintaining health records - Answer - ✔ effective
communication among caregivers for continuity of care
components of quality - Answer - ✔ appropriateness, technical excellence, accessibility,
acceptability
nonrepudiation - Answer - ✔ methods (along with documentation) by which data are
maintained in an accurate form after their creation, free of unauthorized changes,
modifications, updates, or similar edits
case finding - Answer - ✔ methods used to identify patients who have been seen and
treated in the facility for the particular disease or condition of interest to the registry
object-oriented database - Answer - ✔ object that contains both data and their
relationships in a single structure
National Committee on Vital and Health Statistics (NCVHS) - Answer - ✔ government
agency that led development of basic data sets for health records and computer
databases
continuity of care record - Answer - ✔ concept designed to help standardize clinical
content for sharing between providers
HIPAA Security Rule on ePHI requires entities to - Answer - ✔ ensure confidentiality,
integrity, and availability of ePHI
Security Rule safeguard categories - Answer - ✔ administrative safeguards, technical
safeguards, physical safeguards
3 part PHI test - Answer - ✔ 1.) identify person or provide reasonable basis to believe
person could be identified from given information
2.) relate to one's past, present, or future: physical/mental health condition, provision of
care, or payment for provision of care
Detailed Answers Verified A+ Pass 2025
New Update
Accountable Care Organizations (ACOs) - Answer - ✔ group of service providers
working together to manage and coordinate care to Medicare fee-for-service
beneficiaries
biotechnology - Answer - ✔ field devoted to applying techniques of biochemistry, cellular
biology, biophysics, and molecular biology to address issues related to humans,
agriculture, and the environment (EX: Pharma and medical device)
deemed status - Answer - ✔ designates facility is in compliance with Medicare
Conditions of Participation
Health Maintenance Organization (HMO) - Answer - ✔ usually only pays for care within
own network; primary doctor coordinates care
Health Savings Account (HSA) - Answer - ✔ savings accounts designed to help people
save for future medical and retiree health costs on a tax-free basis--part of 2003
Medicare bill--AKA medical savings accounts
Integrated Delivery System (IDS) - Answer - ✔ combines financial and clinical aspects
of healthcare and uses a group of healthcare providers, selected on basis of quality and
cost management criteria, to furnish comprehensive health services across the
continuum of care
investor-owned hospital chain - Answer - ✔ group of for-profit healthcare facilities
owned by stockholders
Managed Care/Managed Care Organization (MCO) - Answer - ✔ delivers medical care
and manages all aspects of care or payment of care by limiting providers, discounting
payment, or limiting access to care. AKA coordinated care organization
medical staff bylaws - Answer - ✔ spell out qualifications for physicians before they are
able to practice in a given hospital. legally binding--changes to "laws" must be approved
by a vote of medical staff and hospital's governing body
medical staff classification - Answer - ✔ organization of physicians according to clinical
assignment
,Multihospital system - Answer - ✔ two or more hospitals owned, leased, sponsored, or
contract managed by a central organization
network - Answer - ✔ group of hospitals, physicians, providers, or payers collaborating
to coordinate and deliver services to their community
Point of Service (POS) plan - Answer - ✔ managed care plan where enrollees are
encouraged to select healthcare providers from a network under contract, but are
allowed to go out of network and pay a larger share of the cost
Preferred Provider Organization (PPO) - Answer - ✔ network contractually agreed to
specified reimbursement, providing reimbursement for covered benefits regardless if in
network, and offered by non-HMOs
retail clinics - Answer - ✔ treat non-life-threatening acute illness and offer routine
wellness services--flu shots, physicals, prescription refills, etc
Surgeon General - Answer - ✔ appointed by POTUS. has responsibility for public health
service workforce
telehealth - Answer - ✔ system that links healthcare organizations and patients from
different geographic locations and transmits texts and images for medical consultation
and treatment
TRICARE - Answer - ✔ covers care for retired veterans, active military members, and
dependents of active and retired members of the 7 armed forces
Value-Based Purchasing (VBP) - Answer - ✔ pays for care that rewards better value,
patient outcomes, and innovation, rather than just volume of care provided
data - Answer - ✔ raw facts generally stored as characters, words, symbols,
measurements, or statistics
derived data - Answer - ✔ consists of factual details aggregated or summarized from a
group of health records that provides no means to identify specific patients. not
considered part of the legal health record
clinical practice guidelines - Answer - ✔ information that provides physicians with
pertinent health information beyond the health record itself; used to determine treatment
options
metadata - Answer - ✔ set of data that gives information about other data, such as:
name of element, locator key, ownership, entity relationship, date entered in system,
system origin, etc
,ancillary (services, functions) - Answer - ✔ secondary. services/functions provided to
support the primary function. EX: OT ancillary service for physician, biomedical
research ancillary function of health record
LOINC codes - Answer - ✔ Logical Observation Identifiers, Names, and Codes. used for
identifying lab test results
Uniform Hospital Discharge Data Set (UHDDS) - Answer - ✔ inpatient data set
incorporated into federal law and required for Medicare reporting
Auditing Integrity - Answer - ✔ inadequate functions that make it impossible to detect
when an entry was modified or borrowed from another source and misrepresented as
an original entry by an authorized user
quantitative analysis - Answer - ✔ review of health record to ensure completeness and
accuracy; assure record meets all documentation requirements; all parts are present;
generally retrospective
data content standards - Answer - ✔ allow data to be shared in a uniform way--clear
guidelines for the acceptable values for specified data fields--allows users to interpret
data in the same way
provider - Answer - ✔ entity responsible for ensuring quality of health record
documentation
components of Resident Assessment Instrument (RAI) - Answer - ✔ Minimum Data Set
(MDS--SNF and LTC), Care Area Assessments (CAA), RAI utilization guidelines. RAIs
used to collect necessary information from and about the facility resident
data dictionary - Answer - ✔ standardize definitions and ensure consistency of use--
enhances use across systems
database - Answer - ✔ tool used to collect, retrieve, report, and analyze data. cannot
function without management system to manipulate and control data it stores--stored in
one place and accessed by many systems
migration plan - Answer - ✔ strategic plan that identifies applicants, technology, and
operational elements needed for the overall information technology program in a
healthcare entity
record retention - Answer - ✔ Medicare COP requires record retention of 5 years
, data definition steward - Answer - ✔ business role with major responsibilities, including
identifying specific data needed to operate business processes, recording metadata,
and identifying and enforcing quality standards
hybrid health records - Answer - ✔ mixture of paper and electronic, or multiple electronic
systems that do not communicate or are not logically architected for record
management
dimensions of Data Quality - Answer - ✔ relevancy, granularity, timelines, currency,
accuracy, precision, consistency
primary purpose for documenting and maintaining health records - Answer - ✔ effective
communication among caregivers for continuity of care
components of quality - Answer - ✔ appropriateness, technical excellence, accessibility,
acceptability
nonrepudiation - Answer - ✔ methods (along with documentation) by which data are
maintained in an accurate form after their creation, free of unauthorized changes,
modifications, updates, or similar edits
case finding - Answer - ✔ methods used to identify patients who have been seen and
treated in the facility for the particular disease or condition of interest to the registry
object-oriented database - Answer - ✔ object that contains both data and their
relationships in a single structure
National Committee on Vital and Health Statistics (NCVHS) - Answer - ✔ government
agency that led development of basic data sets for health records and computer
databases
continuity of care record - Answer - ✔ concept designed to help standardize clinical
content for sharing between providers
HIPAA Security Rule on ePHI requires entities to - Answer - ✔ ensure confidentiality,
integrity, and availability of ePHI
Security Rule safeguard categories - Answer - ✔ administrative safeguards, technical
safeguards, physical safeguards
3 part PHI test - Answer - ✔ 1.) identify person or provide reasonable basis to believe
person could be identified from given information
2.) relate to one's past, present, or future: physical/mental health condition, provision of
care, or payment for provision of care
