Which is a hospital payment monitoring program data analysis tool that provides administrative hospital and state-specific data for specific CMS target areas?
a. CERT
b. FATHOM
c. PEPPER
d. PERM
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Q. 2) In compiling statistics to report the specific cause of death for all open-heart surgery cases, the
quality coordinator assists in documenting
A. patient care outcomes.
B. utilization of hospital resources.
C. delineation of physician privileges.
D. compliance with OSHA standards.
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Q. 3) Which program measures, monitors, and reduces the incidence of Medicare fee-for-service payment errors for short-term, acute care, inpatient PPS hospitals?
a. CERT
b. FATHOM
c. HPMP
d. PERM
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Q. 4) While performing routine quantitative analysis of a record, a medical record employee finds an
incident report in the record. The employee brings this to the attention of her supervisor. Which
best practice should the supervisor follow to deal with this situation?
A. Remove the incident report and send it to the patient.
B. Tell the employee to leave the report in the record.
C. Remove the incident report and have nursing personnel transfer all documentation from the
report to the medical record.
D. Refer this record to the Risk Manager for further review and removal of the incident report.
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Q. 5) Which program assesses and measures improper Medicare fee-for-service payments (based on reviewing selected claims and associated medical record documentation)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
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Q. 6) Surgical case review includes all of the following EXCEPT
A. determination of surgical justification based on clinical indication(s) in cases where no tissue
has been removed.
B. cases with elements missing in the preoperative anesthesia consultation.
C. cases where there is a significant discrepancy between preoperative, postoperative, and
pathological diagnoses.
D. cases with serious surgical complications or surgical mortalities.
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Q. 7) Which program measures improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP)?
a. CERT
b. FATHOM
c. HPMP
d. PERM
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Q. 8) The PQRS is a reporting system established by the federal government for physician practices that
participate in Medicare for
A. monetary incentives.
B. meaningful use incentives.
C. quality measure reporting.
D. All answers apply.
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Q. 9) Which was established to require facilities to identify and reduce improper Medicare payments and the Medicare payment error rate and also established Clinical Data Abstracting Centers?
a. COBRA
b. PATH
c. PEPP
d. TEFRA
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Q. 10) You have been asked to give an example of a clinical information system. Which one of the
following would you cite?
A. laboratory information system C. billing system
B. financial information system D. admission-discharge-transfer
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