Revenue Cycle Management Exam Fall 2023
with verified
What PPS is used by Medicare to reimburse inpatient psychiatric hospitals?
IPPS
RUGS III
IPF PPS
CMG
IPF PPS
Which is not typically an HIM department function?
Coding
Data Quality auditing
Coordination of bill error correction
Patient Registration
Patient Registration
What is a characteristic of information governance?
Aligns implementation outcomes to business priorities
Manages data transmission between departments
Authorizes release of information
,Conducts performance improvement projects
Aligns implementation outcomes to business priorities
The revenue cycle can be described as:
Registration, clinical services, coding and billing
Front-end process of patient intake, middle process of documentation, charge
capture, and coding: back end process of billing and collecitons
Patient intake, documentation of services, billing and collections
All of the above
Front-end process of patient intake, middle process of documentation, charge capture,
and coding: back end process of billing and collections
Why does utilization management need to understand DRGs?
U M needs to work with physicians to ensure that the medical necessity of the
stay is appropriately documented.
UM is responsible for monitoring a patient's expected length of stay which is
established by the working DRG.
The DRG for each case is established by utilization management so the HIM
coding professionals know what to look for when the patient is discharged.
The physician needs to know the DRG so utilization management must identify
one by the time history and physical is done.
UM is responsible for monitoring a patient's expected length of stay which is established
by the working DRG.
The average time to drop a final inpatient bill in your hospital is four days, but bill
old is there days. 50 percent of the claims dropping in excess of four days are
delayed due to a coding backlog. What do you do recommend as a temporary
solution?
, Extend bill hold to five days so that fewer claims are late.
Hire an additional coder.
Bring in a consultant coder to reduce the backlog
Analyze the reason for the coding backlog.
Bring in a consultant coder to reduce the backlog
There has been a recent increase in errors regarding the posting of the admitting
diagnosis. Correction of this error falls to the coding staff. With which department
will HIM have to partner in order to identify and eliminate this error?
Patient access
Patient financial services
Case managment
Medical staff
Patient access
Your coding manager reports that the outpatient coder you hired two months ago
continues to fall below the department standards for both volume and quality.
This is an example of failure of:
PDCA
Quality assurance
Lean methodologies
Six Sigma
Quality assurance
In your hospital, a patient who is having a blood test and an x-ray on the same
day has always needed to register twice: once in the lab and again in the
radiology dept. From a lean perspective, is there an issue with this process?
with verified
What PPS is used by Medicare to reimburse inpatient psychiatric hospitals?
IPPS
RUGS III
IPF PPS
CMG
IPF PPS
Which is not typically an HIM department function?
Coding
Data Quality auditing
Coordination of bill error correction
Patient Registration
Patient Registration
What is a characteristic of information governance?
Aligns implementation outcomes to business priorities
Manages data transmission between departments
Authorizes release of information
,Conducts performance improvement projects
Aligns implementation outcomes to business priorities
The revenue cycle can be described as:
Registration, clinical services, coding and billing
Front-end process of patient intake, middle process of documentation, charge
capture, and coding: back end process of billing and collecitons
Patient intake, documentation of services, billing and collections
All of the above
Front-end process of patient intake, middle process of documentation, charge capture,
and coding: back end process of billing and collections
Why does utilization management need to understand DRGs?
U M needs to work with physicians to ensure that the medical necessity of the
stay is appropriately documented.
UM is responsible for monitoring a patient's expected length of stay which is
established by the working DRG.
The DRG for each case is established by utilization management so the HIM
coding professionals know what to look for when the patient is discharged.
The physician needs to know the DRG so utilization management must identify
one by the time history and physical is done.
UM is responsible for monitoring a patient's expected length of stay which is established
by the working DRG.
The average time to drop a final inpatient bill in your hospital is four days, but bill
old is there days. 50 percent of the claims dropping in excess of four days are
delayed due to a coding backlog. What do you do recommend as a temporary
solution?
, Extend bill hold to five days so that fewer claims are late.
Hire an additional coder.
Bring in a consultant coder to reduce the backlog
Analyze the reason for the coding backlog.
Bring in a consultant coder to reduce the backlog
There has been a recent increase in errors regarding the posting of the admitting
diagnosis. Correction of this error falls to the coding staff. With which department
will HIM have to partner in order to identify and eliminate this error?
Patient access
Patient financial services
Case managment
Medical staff
Patient access
Your coding manager reports that the outpatient coder you hired two months ago
continues to fall below the department standards for both volume and quality.
This is an example of failure of:
PDCA
Quality assurance
Lean methodologies
Six Sigma
Quality assurance
In your hospital, a patient who is having a blood test and an x-ray on the same
day has always needed to register twice: once in the lab and again in the
radiology dept. From a lean perspective, is there an issue with this process?
