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| Public Health and Homeland Security use the health record to monitor _____ health and to monitor ______ activity |
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Definition
Who are the primary users of health records?
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Who uses the information in a health care record?
a) managed care organizations
b) integrated healthcare delivery systems
c) regulatory and accreditation organizations
d) licensing bodies
e) educational organizations
f) third-party payers
g) research facilities
h) all of the above
i) all but e and g |
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Term
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Definition
| T or F: Nurses, physicians, and coding specialists refer to health records of specific patients as a part of their daily work |
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Definition
| T or F: Some users of health care records don't have direct access to the records of individual patients, but they use the demographic and clinical information collected from the records |
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Definition
| T or F: Direct patient care providers document their services directly in their patients' health records |
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False
Other service providers submit separate reports that become part of the individual health records |
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Definition
| T or F: Other providers also directly document in a patient's healthcare record |
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Definition
| T or F: Chaplains have access to health records |
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Definition
| T or F: Dental hygienists and optometrists don't have access to health records |
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Definition
Which of these use health care records?
a) accreditors
b) government policy makers and legislators
c) researchers and clinical investigators
d) health science journalists and editors
e) all of the above
f) none of the above
g) b and c |
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Term
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Definition
| Oversee the services provided to patients within their organization. They use the healthcare record to evaluate the performance of individual patient care providers and to determine the effectiveness of the performance of individual patient care providers and to determine the effectiveness of the services provided |
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Term
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Definition
Patient care managers take details from health records and combine them to identify patterns and trends. They recommend changes to:
a) patient care processes
b) equipment
c) services
d) all of the above
e) all but b |
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Term
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Definition
| T or F: Reimbursement is based on the documentation contained in the the health record. |
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Term
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Definition
| T or F: Some third-party payers require billers to submit copies of portions of the health record along with the claims |
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Definition
HIPAA grants most patients the right:
a) to see their health record
b) to correct information in their health record
c) to add missing information to the record
d) verify billed services
e) all of the above
f) all but b and c |
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Term
| determine the extent and effects of occupational hazards, manage healthcare and disability insurance for employees, support disability claims |
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Definition
| What three things do employers use health care records for? |
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Definition
| T or F: The health care record is not a legal document |
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Definition
Which use the health care record as a legal document?
a) healthcare organizations use it to protect legal interest of the facility and its providers
b) legal representatives of physicians and their malpractice carriers
c) attorneys for patients who bring civil suits use health care record to support claims
d) attorneys use it to determine mental competency of individuals
e) all of the above
f) all but d
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Definition
How does law enforcement use the healthcare record?
a) investigate gunshot wounds, child abuse and neglect, domestic violence, rape, etc.
b) identify and locate suspects and fugitives
c) identify and locate material witnesses
d) identify and locate missing persons
e) all of the above
f) all but c |
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Term
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Definition
| The process by which the effectiveness of treatment methods is evaluated and improved methods for the future are developed |
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Definition
What do government policy makers use the health care record for?
a) to establish requirements for reporting cases of communicable diseases
b) to analyze relevant health-related social issues like crime, teenage pregnancies, and drug abuse
c) to develop and fund community programs
d) all of the above
e) b and c |
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Term
| healthcare delivery organizations |
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Definition
| use data from health records to provide services, evaluate and monitor the use of resources, seek reimbursement for services provided, and plan and market services |
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Term
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Definition
| organizations responsible for the reimbursement of healthcare services covered by some kind of insurance programs--they use health care records to see if the documentation supports the provider's claim |
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Term
| quality improvement organizations, utilization management organizations |
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Definition
| two organizations that evaluate the adquacy and appropriateness of the care provided by healthcare organizations |
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Term
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Definition
| Medical review organizations work under contract with who? |
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Term
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Definition
| Medical review organizations examine health records to determine whether the services were medically _______. |
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Term
False
They can review records while the patient is getting treatment or has received treatment |
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Definition
| T or F: Medical review organizations review whether services were medically necessary after the patient has received treatment |
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Term
| reimbursement paid to the provider |
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Definition
| What are medical reviews generally associated with? |
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Term
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Definition
| perform health-related research study the current healthcare environment to prove or disprove hypotheses related to disease processes and treatments |
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Definition
| T or F: Due to privacy laws, educational organization can't use health records as a source of case study information for training programs |
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