24 Questions
What is the estimated percentage of physician and other clinicians who currently use electronic prescribing of medications?
Between 5 and 8%
What is the main purpose of the Accreditation Association for Ambulatory Health Care (AAAHC)?
To promote excellence in medicine and patient care
Which of the following is a medical coding system used to classify morbidity and mortality information?
Ninth Revision of the International Classification of Disease (ICD-9-CM)
What is the main purpose of the Health Care Portability & Accountability Act (HIPAA) of 1996?
To assist in the assignment of reimbursement amounts to providers
Which organization is responsible for developing and maintaining the Current Procedural Terminology (CPT) coding system?
American Medical Association (AMA)
What is the main purpose of the COLA accreditation program?
To promote quality laboratory testing and services
What is the purpose of minimally-invasive procedures in healthcare?
To allow for the performance of surgeries without hospitalization
What is the ultimate goal of accredited organizations in healthcare?
To promote quality care and patient safety
What is the primary purpose of adjudication in a healthcare system?
To determine which payor pays which portion of the bill
What is the benefit of editing claims prior to submission in an electronic system?
Avoiding further processing, costing, time, and money
Why is it necessary to conduct eligibility checks for each instance of service?
To ensure clients have not changed insurance plans
What is a benefit of using an electronic system in healthcare organizations?
Reducing the time spent finding and delivering charts
What type of healthcare organizations can benefit from an electronic system?
A variety of healthcare organizations, including ambulatory clinics, surgery centers, and more
What is a consequence of not editing claims prior to submission?
Further processing, costing, time, and money
Why is it important to have formats that are legible and comply with legal regulations?
To ensure compliance with legal regulations
What is a benefit of using an electronic system in ambulatory clinics?
Reducing the time spent finding and delivering charts
What is the primary purpose of the Healthcare Common Procedure Coding System (HCPCS)?
To promote uniform reporting and statistical data collection of medical procedures, supplies, and services
What is the role of the National Committee for Quality Assurance (NCQA)?
To assess and report on the quality of managed care plans
What is the purpose of the National Drug Code (NDC)?
To identify pharmaceuticals in detail, including their packaging
What is the role of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)?
To publish standards for healthcare organizations
What is the primary purpose of nursing assessment in the electronic health record (EHR)?
To collect vital data and fundamental information necessary for the next process
What is the purpose of nursing diagnosis in the electronic health record (EHR)?
To comprehend the patient's condition and responses
What is the role of the electronic health record (EHR) in healthcare data analysis?
To store and retrieve data for statistical purposes
What is the primary purpose of healthcare accreditation in healthcare organizations?
To ensure quality care and improve patient outcomes
Study Notes
Accredited Organizations
- National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization that assesses and reports on the quality of managed care plans.
- Joint Commission on Accreditation of Healthcare Organizations (JCAHO) publishes Management of Information Standards for Ambulatory Care.
- Accreditation Association for Ambulatory Health Care (AAAHC) is a private, not-for-profit organization that develops standards and conducts surveys to promote excellence in medicine and patient care.
Coding Systems
- Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products, and services provided to Medicare beneficiaries and individuals enrolled in private health insurance programs.
- National Drug Code (NDC) identifies pharmaceuticals in detail, including packaging.
- Current Procedural Terminology (CPT) describes medical procedures performed by physicians and other health providers.
- Ninth Revision of the International Classification of Disease (ICD-9-CM) is designed for the classification of morbidity and mortality information.
Electronic System Benefits
- Reduction in the size of the record room
- Reduced time spent finding and delivering charts
- Increase in the privacy of data
- Formats that are legible and comply with legal regulations
Ambulatory Care
- Ambulatory clinics and surgery centers, single and multispecialty group practices, diagnostic laboratories, health maintenance organizations, independent physician associations, birthing centers, and college and university health services provide ambulatory care.
- Estimates for the prevalence of chronic diseases, and the development of minimally-invasive procedures that can be performed without hospitalization.
The Health Care Portability & Accountability Act of 1996
- Established regulations for electronic data interchange and security standards for health care data.
This quiz covers the role of organizations such as NCQA in assessing and reporting on the quality of managed care plans, as well as the use of healthcare coding systems for data storage and retrieval.
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