D260 Health Information Management Capstone
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Free D260 Health Information Management Capstone Questions
1. A patient's authorization is not required to disclose PHI under the following circumstances; Treatment, Payment, and what else?
- HIV status
- Healthcare operations
- Substance abuse
- Mental health conditions
Explanation
Under HIPAA, a patient’s authorization is not required to disclose PHI for treatment, payment, and healthcare operations. Healthcare operations include activities such as quality assessment, case management, auditing, and other administrative, financial, legal, and risk management activities necessary to run a healthcare organization. This allows providers to use and share PHI internally to manage patient care and organizational functions without obtaining individual consent for every use.
2. A minimum of 36 credits must be maintained every how many years?
- 2
- 3
- 4
- 5
Explanation
A minimum of 36 continuing education credits must be maintained every two years. This requirement ensures that Health Information Management (HIM) professionals stay current with industry standards, technological advancements, regulatory changes, and best practices. Regularly completing continuing education helps maintain professional competence and supports career development in a rapidly evolving health information environment.
3. The legal term for improper care of a patient by a member of the health care team resulting in injury to the patient is:
- Malpractice
- Assault
- Litigation
- Battery
Explanation
Malpractice refers to improper or negligent care provided by a healthcare professional that results in harm, injury, or damage to a patient. It is a legal cause of action in which a patient may seek compensation for injuries resulting from substandard care, and it requires proof of a duty of care, breach, causation, and damages.
4. Which type of health record organization involves sections of the record being organized by the provider or department that delivers care? This format is used mostly by acute care hospitals that are still using a paper record.
- Problem-oriented records
- Integrated records
- Source-oriented records
- Facility-based records
Explanation
Source-oriented records organize health information according to the provider or department that generates the data. Each section of the record, such as nursing, laboratory, radiology, or physician notes, is filed separately by its source. This approach is common in acute care hospitals using paper records, as it allows staff to quickly locate documentation from a specific department or provider, though it may make tracking a patient’s overall history across sources more complex.
5. Which of the following types of data is used for health services outcomes measurement and research?
- Aggregate Data
- Comparative Data
- Patient-Centric Data
- Transformed-Based Data
Explanation
Aggregate data is used for health services outcomes measurement and research. This type of data combines information from multiple patients to provide summary statistics and trends without identifying individual patients. It allows healthcare organizations and researchers to analyze overall health outcomes, evaluate the effectiveness of interventions, and inform policy decisions while maintaining patient confidentiality.
6. In an integrated health record, documentation by health professionals is organized:
- in sections by type of professional
- In sections by problem number
- Intermixed in date sequence
- Depends on facility policy
Explanation
In an integrated health record, documentation from all health professionals is intermixed in strict chronological order. This allows caregivers to view the patient’s complete history of care as it occurred over time, facilitating continuity of care and comprehensive understanding of patient progress. Unlike source-oriented or problem-oriented systems, integrated records prioritize the timeline of events rather than separating information by provider or problem.
7. Which of the following is of primary concern to policy makers, administrators, managers, and executive health leaders who depend on the collection of health information for planning and managing resources?
- Data quality.
- Technological changes.
- Policies and procedures.
- Leadership roles.
Explanation
Data quality is of paramount importance to policy makers, administrators, managers, and executive health leaders because accurate, complete, and timely health information is essential for effective planning, resource allocation, and decision-making in healthcare. Poor data quality can lead to misinformed policies, inefficient use of resources, and negative outcomes for patients and populations. Ensuring high-quality data supports evidence-based management and enables leaders to monitor performance and make strategic decisions.
8. The filing system that distributes health records evenly throughout the filing system is:
- terminal digit
- alphanumeric
- straight numeric
- alphabetic
Explanation
The terminal digit filing system distributes records evenly across the filing system by using the last digits of the patient’s identification number. This method prevents congestion in high-traffic areas, improves retrieval efficiency, and is commonly used in hospitals with large volumes of patient records. It ensures balanced access to records across all filing units.
9. What is a clearinghouse and what purpose do they serve?
- Clearinghouses collect patient data in a centralized location to promote interoperability in emergency situations.
- Clearinghouses distribute payments to providers from third party payers.
- Clearinghouses act as an intermediary between insurances and providers to submit electronic claims.
- Clearinghouses provide collections services for patients who have not paid their bill.
Explanation
A clearinghouse acts as an intermediary between healthcare providers and insurance companies to facilitate the submission of electronic claims. Clearinghouses receive claims from providers, check them for errors, standardize the data, and then transmit them to the appropriate payer. This process improves efficiency, reduces errors, and ensures that providers receive timely reimbursement for services rendered.
10. What classification system is primarily utilized for organizing patient diagnoses in a disease index?
- CPT codes
- ICD-10-CM disease codes
- HCPCS codes
- ICD-10-CM procedure codes
Explanation
ICD-10-CM disease codes are the primary classification system used to organize patient diagnoses in a disease index. These codes provide a standardized system for identifying and recording diseases, conditions, and other health-related issues, enabling consistent documentation, reporting, and statistical analysis across healthcare settings. ICD-10-CM codes are essential for billing, research, and epidemiological tracking of diseases.
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