AHIMA RHIT Practice Exam-5 2023

AHIMA RHIT Practice Exam-5 2023 Arbitration - ANS-A healthcare facility uses this *proceeding to avoid court action.* Health care operations - ANS-When *in-house counsel* is conducting the defense of a malpractice claim, an authorization is not required because review of the record would be covered under: *Privacy* - ANS-*The right of an individual to have freedom from observation or intrusion into their private affairs and rights to maintain control over certain personal health information.* Confidentiality - ANS-The responsibility to *use,* *disclose,* or *release of information* related to *private matters.* Ethical problems of ROI - ANS-*Violation of the need-to-know principle*, misuse of blanket authorizations, and violations of privacy that occur because of secondary release of information are what type of issue? *Protected Health Information* - ANS-*Individually identifiable *health information that is transmitted by electronic medium, or in any other form or medium. *Confidentiality* - ANS-The *privacy of personal health* information Case Resource Consumption - ANS-Under a prospective payment system, payment for healthcare is *predetermined* by: Actual Cost - ANS-Prior to the implementation of Hospital Outpatient Prospective Payment System, Medicare reimbursement was *originally* based on: Diagnosis Related Group (DRG) - ANS-Case Mix Index (CMI) is often calculated on: Revenue Code - ANS-A four-digit number used for Medicare Billing Diagnostic codes - ANS-Third party payers will deny payment for services that are considered unreasonable and unnecessary based on: *Center for Medicare and Medicaid Services 1500 (CMS) 1500* - ANS-The claim form that Physicians use for Medicare Part B reimbursement. *Resource-Based Relative Value Scale (RBRVS)* - ANS-Medicare uses the methodology for physician reimbursement...