Requirements for monitoring the quality and appropriateness of inpatient services to Medicare
beneficiaries and federally funded patients are outlined in the
A. Peer Review Improvement Act.
B. QIO Scope of Work.
C. Manual of National Health care Policy.
D. National Practitioner Data Bank.
The coding supervisor is responsible for reviewing a random sample of each coder's work and reporting on the error rate for each coder. A check sheet is used to collect the number of char reviewed, the number of errors for each coder, and the type of errors. What types of graphs orj charts could be used to report the information gathered?
A. bar charts
B. Pareto charts
C. histograms
D. all of the above
Clinical privileges are granted to the physician for an interval specified in the medical staff bylaws, but not longer than
A. 6 months.
B. 1 year.
C. 2 years.
D. 3 years.
The HIM department is asked to pull records for review by the Quality Improvement Organization (QIO). The QIO reviewers analyze records to ensure that health care services are
A. rendered according to appropriate professional standards.
B. medically necessary.
C. performed in the most efficient, effective, and economical manner.
D. all of the above
As supervisor of the record completion function of the HIM department, you are asked for record completion statistics for specific physicians who are being evaluated for reappointment to the medical staff. Which of the following information elements would you report for each physician?
A. physician education and training
B. number of delinquent records
C. state licensure expiration date
D. prior physician malpractice claims history
What process assists a health care facility in continuously looking at the ways that problems develop and seeking ways to prevent problems from happening in the future?
A. risk management
B. quality control
C. utilization management
D. performance improvement
The primary source document used in quality assessment monitoring is the
A. admission and discharge register.
B. procedure index.
C. medical record.
D. diagnosis index.
The Blood Usage Review Committee has a quality monitor established to review all blood transfusion reaction cases. The HIM Director will be working with the committee to identify and abstract patient outcome information for committee evaluation. What data should be collected?
A. effects of transfusion reaction (e.g., rash, death, etc.)
B. type and cross-match accuracy
C. justification for the transfusion
D. all of the above
A study found that liver cancer rates per 100,000 males among cigarette smokers and nonsmokers in a major U.S. city were 48.0 and 25.4, respectively. The relative risk of developing liver cancer for male smokers compared to nonsmokers is
A. 1.89.
B. 15.6.
C. 22.6.
D. 48.0.
Which of the cases listed above will have an impact on the facility's gross death rate?
A. 101-43-26
B. 101-44-23
C. 101-48-69
D. 101-56-29
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