RHIA Exam: Key Concepts in Health Information Management, Exams of Nursing

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RHIA Exam Questions and Answers 2025 Latest

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HL7 - Correct answer-A set of international standards for transfer of clinical and administrative data between software applications used by various healthcare providers. These standards focus on the application layer, which is "layer 7" in the OSI model. Data Validity - Correct answer-Accuracy of data Data Comprehensiveness - Correct answer-All data items are included. Data Granularity - Correct answer-(a) The attributes and values of data should be defined at the correct level of detail. (b) When a data element cannot be further subdivided Data Precision - Correct answer-Data values are just large enough to support the application of process For ex: Setting up a drop down menu to make sure that the clerk collects "gender" as "male, female, or unknown" is an example of ensuring data Data Reliability - Correct answer-Consistency of data Data Timeliness - Correct answer-Data being available within a time frame helpful to the user

AHIMA recommends that PHI for minors be retained for this long unless a longer period is required by other state or federal law - Correct answer-Age of majority plus statute of limitation Fetal monitoring strips are part of the (blank) record and should be maintained (blank) - Correct answer-Mother's record; according to the length of time required for minor's records What item is collected and maintained in the organ transplant registry? - Correct answer-Histocompatibility information Level I CPT codes - Correct answer-AMA Level II (HCPCS) codes are maintained by - Correct answer-CMS APC's - Correct answer-The PPS system used to reimburse hospitals for Medicare hospital outpatient is called Indemnity - Correct answer-(a) security or protection against a loss or other financial burden. (b) security against or exemption from legal responsibility for one's actions. Hard coding - Correct answer-HCPCS/CPT codes that appear in the hospital's chargemaster and will be included automatically on the patient's bill Primary Key - Correct answer-It must contain a unique value for each row of data Risk Assessment - Correct answer-(a) Reviewing your privacy and security policies, procedures, training programs, and so on, and comparing them to HIPPA and ARRA regulations (b) The security management process Authentication - Correct answer-Before a user is allowed to access health information the system confirms that the person is who they say they are 60/30 days - Correct answer-A request to addend a record must be acted on within 60 days. A request to view a record must be acted on within 30 days. 3 Components of a security program - Correct answer-Protecting the privacy of data, ensuring integrity of data, and ensuring the availability of data System Characterization - Correct answer-Before you can go any further with your risk analysis you need to determine what systems/info need to be

protected. This step is known as Information Systems Review - Correct answer-Reviewing audit logs, access reports and security incident reports daily

HEDIS - Correct answer-The data set designed to allow consumers to compare the performance of various managed care plans. It consists of 71 measures across 8 domains of care Productivity - Correct answer-The process of converting organizational resources into products/services as a means to meet the organization's goals

Comparative - Correct answer-A hospital employee benchmarks with another HIM department to assess his department's performance level. What kind of data will the employee use? Decomposition Diagram - Correct answer-The purpose of this chart is breaking down problems into smaller details by identifying all the tasks in the process and grouping them into hierarchical levels Joint Commission - Correct answer-Health care facilities strive to comply with national patient safety goals in their mission to provide safe, high quality care. The organization responsible for publication and maintenance of these goals is the: Defensibility - Correct answer-The Sherman Antitrust Act (outlawed monopolies) relates to which characteristic of peer review? Scope - Correct answer-The project manager records the estimated time, costs of project, and records the team purpose. The project manager is establishing the: Analysis - Correct answer-A hospital considers purchasing a new hospital information system. The IS department begins to survey system users. The hospital is in which phase of the Systems Development Life Cycle? Privacy - Correct answer-A patient deploys a personal health record and established an access list for the PHR. In limiting access, the patient has exercised the right to: UHDDS - Correct answer-Federally mandated inpatient acute care data set Unit - Correct answer-The admitting department manager at a hospital provided admitting scenarios for the staff. Which kind of system testing uses scenarios? Business Associate Agreement - Correct answer-The HIM department in a hospital uses a vendor for health record storage. What must be created to ensure that the vendor follows rules set forth by the hospital for handling protected health information? Rule Based - Correct answer-A hospital's outpatient scheduling system ensures that patients are scheduled for barium studies after and not before nuclear

Policies - Correct answer-Guides used by management to make decisions for a variety of reasons are: Access Control - Correct answer-Which method uses the employee's role to determine their system security level? Data Mining - Correct answer-The process of searching through large volumes of data for cluster patterns is known as data: Processing - Correct answer-Classifying, sorting, storing, and retrieving data are all characteristics of which system component? NCQA - Correct answer-The organization responsible for accrediting MCOs and PPOs is known as the: RFI - Correct answer-A HIM manager wants to screen vendors to identify which vendor's products meets the department's system needs. The manager sends the vendors an: EMTALA - Correct answer-The legislation enacted to reduce the inappropriate transfer of patients for financial reasons is: Movement - Correct answer-One of the best tools to aid in the determination of the location and reduction of bottlenecks which impede the coding process is the: Data Modeling - Correct answer-What is the process of determining the user's information needs and identifying relationships among the data? Donabedian's Model - Correct answer-Structure, then process, then outcome Business Associate Contracts - Correct answer-An example of an administrative safeguard under HIPPA Data Mapping - Correct answer-The process of cross-referencing between a current terminology system and the new terminology system is: PERT - Correct answer-The tool used to complete process management activities on time and in proper order Libel - Correct answer-A written false statement damaging to someone's reputation Slander - Correct answer-A spoken false statement damaging to someone's

reputation Institution - Correct answer-Traditionally medical records are accepted as being the property of the:

2 Years - Correct answer-Clinical privileges are granted to a physician for this interval of time Utilization Review - Correct answer-With the passage of Medicare in 1965 this function became mandatory

Loss Prevention and Reduction - Correct answer-Major responsibilities of the Risk Manager Risk Management - Correct answer-Promoted by the medical malpractice crisis of the 1970's Decision Matrix - Correct answer-Quality improvement tool that uses criteria to weigh different alternatives Flowchart - Correct answer-Visual tool used to best identify all of the logical steps and sequence of each procedure during comparison Fishbone - Correct answer-(a) Visual quality improvement tool that is helpful in identifying the outcome variables and the major/root causes (b) Use of metrics to conduct root cause analysis Affinity Diagram - Correct answer-Feedback is provided through brainstorming that is compiled on flip charts and organized into categories Crosby - Correct answer-Quality management theorist who focused on zero defects as the goal of performance improvement Deming - Correct answer-Quality management theorist who believed that merit raises, formal evaluations and quotas established through benchmarking hinder productivity and growth Annually - Correct answer-Joint Commission requires facilities manage the environment of care by implementing seven safety plans which must be evaluated: Control Chart - Correct answer-Best tool for differentiating between common cause variation and special cause variation Serial-Unit Number System - Correct answer-Patient is issued a different number for each admission and records of past episodes of care are brought forward to be filed under the last number issued Variable Budget - Correct answer-Costs will vary in direct proportion to changes in the volume of care provided Capital Budget and Operational/Revenue and Expense Budget - Correct answer- Two budgets that are often prepared by HIM department managers

Critical Path - Correct answer-Series of specific tasks that determine the overall project duration Storytelling - Correct answer-A strategic thinking tool