12.1 (RHIA & RHIT) Exam Questions With All Correct Detailed Answers 2025 New Update

12.1 (RHIA & RHIT) Exam Questions With All Correct Detailed Answers 2025 New Update A patient satisfaction survey conducted after discharge is a method of quality measurement through outcomes indicator. structure indicator. prospective indicator. process indicator. - Answer - outcomes indicator --- Patient satisfaction, or lack thereof, is a direct outcome of the patient's stay. The PQRS is a reporting system established by the federal government for physician practices who participate in Medicare for quality measure reporting. Beginning in 2017, this program transitioned into MIPS. OIG. NCQA. PQRS. - Answer - MIPS --- MIPS is the Merit-based Incentive Payment System, created under the Quality Payment Program by the CMS. This was initiated in 2017 to take the place of PQRS. --- -NCQA is the National Committee for Quality Assurance, an independent nonprofit organization that works to improve healthcare quality through the administration of evidence-based standards, measures, programs, and accreditation. This is the correct answer. -OIG is the Office of the Inspector General, the enforcement agency for the federal government. -PQRS is the Physician Quality Reporting System, used by the CMS to monitor quality care. This program ended in 2016 Which department will most likely be responsible for taking corrective action regarding the following quality indicator? QUALITY INDICATOR:Number of insurance claims requiring resubmission due to errors (not related to coding) will not exceed 3%. health information medical staff office business office admissions - Answer - business office --- Business office would have access to patient's financial information and therefore be the best source of information on rejected claims not related to coding. --- -Admissions has access to those patients who have been admitted. --- -Health information would have the expertise regarding coding errors. --- -Medical staff office would be the source for information on appointments and reappointments. A retrospective review as part of quality improvement activities is conducted after the patient has been admitted. discharged. cleared for surgery. released from the surgical recovery room. - Answer - discharged -- Discharged is the point where a retrospective review would be conducted, because the treatments and care of the patient is now in the past. An area identified for needed improvement through benchmarking and continuous quality improvement is known as a key performance indicator. knowledge base. measure hierarchy. key attribute. - Answer - key performance indicator. -- Key performance indicator are defined as metrics used to measure key business processes and reflect strategic performance throughout the organization To accomplish the Joint Commission's safety goal to eliminate wrong-site, wrong-patient procedures, the organization can use all of these EXCEPT preoperative verification processes. available patient records. using imaging guidance on all procedures. mark the surgical site. - Answer - using imaging guidance on all procedures. --- The use of imaging guidance will not help improve wrong patient or wrong side procedures. However, preoperative verification, checking available medical records, and physically marking the surgical site with a marker have all been shown to reduce or eliminate wrong-site or wrong-patient procedures. Integration of decision support systems and best practices in medicine is known as the practice of subjective determination. outcome measures. case management. evidence-based medicine. - Answer - evidence-based medicine --- Evidence-based medicine is the availability, provided by Clinical Decision Support Systems (CDSS) linking access to the most recent, credible evidence -- -Subjective determination is opinion-based, not fact-based. --- -Outcome measures are the analysis of the conclusion of patient care --- -Case management is the coordination of a patient's care by an individual, monitoring interactions with multiple providers Which department will most likely be responsible for taking corrective action regarding the following quality indicator? QUALITY INDICATOR:The number of DRG validation changes made by the QIO will not exceed 2%. health information business office admissions medical staff office - Answer - health information --- Health information would have the expertise regarding DRG validations --- -Business office would have access to patient's financial information. -Health information would have the expertise regarding DRG validations. -Medical staff office would be the source for information on appointments and reappointments and all other materials The Institute of Medicine (IOM) published report titled "To Err Is Human: Building a Safer Health System," heightened concern by the U.S. government and accrediting agencies. This led the Joint Commission to place emphasis on improving patient safety and sentinel event occurrences through its safety program, known as National Patient Safety Goals (NPSG). Health Plan Employer Data & Information (HEDIS). Health Care Quality Improvement Program (HCQIP). ORYX Initiative Set. - Answer - National Patient Safety Goals (NPSG). --- The publication of "To Err Is Human: Building a Safer Health System" led the Joint Commission to place emphasis on improving patient safety and sentinel event occurrences through its safety program, known as National Patient Safety Goals Year 2019 Month Patients with UnacceptableWaiting Time (%) January 5 February4 March3 April5 May3 June10 July5 August2 September1 October2 November1 December3 Use the information shown in the table above. Calculate the average percentage of patients for the entire year who waited longer than an acceptable amount of waiting time. (The sample size for each month's data is 100.) 3.7% 3.6% 4.0% 3.1% - Answer - 3.7% --- (5 + 4 + 3 + 5 + 3 + 10 + 5 + 2 + 1 + 2 + 1 + 3) / 12 = 3.66 = 3.7.