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What is true about the AHIMA certification
Candidates must pass an examination before obtaining any of the credentials
What evolving role oversee the process that begins at the time of documentation through billing?
Revenue cycle manager
The new model of HIM practice is?
Information focused
HIM has been recognized as an allied health profession since
Registered Health Information Administrator
Comission on certification for health informatics and information management
The primary function of AHIMA is
Foster professional developement of its members
Which of the following entities are at the head of the AHIMA volunteer structure and hold responsibility for managing the property, affairs, and operations of AHIMA
Board of Directors
The traditional model of HIM practice was:
Department focused
communities of practice
American Health Information Management Association
The formal approval process for academic programs in health information management is called:
Which of the following accredits academic programs in health information management?
Commisssion on accreditation for health informatics and information management education
certified coding associate
Which of the following make up a virtual network of AHIMA members?
AHIMA Communties of Practice
Registered health information technician
The primary goal of the Hospital Standardization Program was?
To raise the standards of surgical practice
American College of Surgeons
Which of the following functions as the legislative body of AHIMA?
AHIMA house of delegates
certified coding specialist
The formal process for conferring a health information credential is called
Members of the AHIMA house of delegates are
Elected by members in state component organizations
Which organization issues and maintains ethical standards for the health information management profession?
The American Health Information Management Association
To avoid making mistakes, HIT’s should try to base their work-related decisions on their own moral values whenever possible
Which organization issues and maintains ethical standards for the health information management profession?
The American Health Information Management Association
I am concerned about the possibility that the PHI that I am releasing as an ROI coordinator will be re-released to another inappropriately. Why would I be concerned with a secondary release of information?
PHI could be released without patient authorization
What has brought about changes based on access, security, linking data, and more?
Electronic health record
What does PHI stand for?
Protected Health Information
HIT’s have ethical obligations to their employers and the people who recieve and provide services in their organizations, but generally they have no real obligations to the public at large
An HIM professional’s ethical obligations:
Apply regardless of employment site
List the seven steps in the ethical decision making process
What is the question?
What are the facts?
What are the values?
What are my options?
What should I do?
What justifies my choice?
What can I do to prevent this ethical problem?
The ethical decision making process includes consideration of steps to ensure that the same issue does not come up again
Define Confidentiality
The limitation of the use and disclosure of private information
What does ACS stand for
American College of Surgeons
The right of individual patients to determine what healthcare services they do or do not undergo
Given the competing interests and limited resources of the parties involved, the consideration of fairness to those affected by decisions
The principle that requires that one party must do no harm to another, as in the physician’s Hippocratic oath
The promotion of good for others or the provision of helpful services for others
The application of ethical principles to decisions that affect human lives
What has brought about changes based on access, security, linking data, and more?
Electronic health record
Define Privacy
the right of the individual to be left alone
Which of the following is a core ethical obligation of HIT’s
Protecting patients’ privacy and confidential communications
Which of the following activities is considered an unethical practice?
Backdating progress notes
An individual stole and used another person’s insurance information to obtain medical care. This action would be considered
Medical identity theft
Joint Commission
Acute Care Hospitals
Long-term care facilities
Ambulatory care facilities
Psychiatric facilities
Home health agencies
Examples of Allied Health Professions
clinical laboratory science
diagnostic medical sonography/imaging technology
dietetics and nutrition
emergency medical technology
health information management
occupational therapy
physical therapy
respiratory therapy
speech language pathology and audiology
surgical technology
Biologics Control Act of 1902
Research on controlling epidemics
Now called National Institutes of Health (NIH)
Mission is to uncover new medical knowledge that can lead to health improvements for all
Social Security Act of 1935
old age and unemployment programs
Provided states funding for maternal and infants , rehab of crippled children, public health and for children under 16
Hospital Survey and Construction Act of 1946
Known as Hill-Burton Act
Authorized grants to build new hospitals and modernize older ones
Goal of 4.5 beds per 1,000 person
Increased from 6,000 hospitals to approx 7,200 acute care hospitals
Down to 4,927 hospitals in 2002- due to fewer admissions, decreased length of stay and diagnostic related groups
is a government activity
It is mandatory and required by law.
It gives legal approval for a facility to offer the service for which it is license
What three things must a facility must meet in dealing with a licensure?
physical aspects of the facility
services provided
personnel employed
is a government activity
allows a facility to be reimbursed by the government for providing services to patients enrolled in certain government programs
participation is voluntary but facility must meet regulations established by the dept of Heath and Human Services (DHHS)
these regulations are called Conditions of Participation (COP) which are found in the Federal Register
compliance with these regulations is monitored by each state thru an agreement with the DHHS.
These standards are considered minimal.
is completely voluntary
it implies there is a voluntary conformance to high standards , which are more rigorous than the minimum licnensing or certification standards
The individual accrediting agency and experts in the field develops standards
Standards are revised as changes in the art of medical practice , government regulations, demand or public need occurs.
Certificate of Need (CON)
New construction (proposed)
Modification of existing site
Major equipment expenditures
Or to provide new services
Public Law 89-97 of 1965
Amendment to Social Security Act
Medicare originally designed for people 65 years of age or older.
Medicaid originally designed for medically indigent.
Medicaid joint program with states
Public Law 92-603 of 1972
Mandated utilization review for Medicare patients at hospitals and extended care facilities.
Now included Medicaid
Established professional standards review organizations (PSRO)
Utilization Review Act of 1977
Mandated continued stay reviews for Medicare and Medicaid patients
Peer Review Improvement Act of 1982
PSRO changed to Peer Review Organizations
Looked at medical necessity and appropriateness of certain admissions prior to admisssion.
Named changed to Quality Improvement Organization.
Tax Equity and Fiscal Responsibility Act of 1982
Called for gradual implementation of prospective payment system for Medicare reimbursement
Prospective Payment Act ( 1982) Public Law 98-21 of 1983
Created diagnostic related groups for inpatient hospital care
Consolidated Omnibus Reconciliation Act of 1985
reimbursement denied for substandard quality of care
Omnibus Budget Reconciliation Act of 1986
PRO’s, report substandard care to licensing and certification agenicies
Healthcare Quality Improvement Act of 1986
Established the National Practitioner Data Bank ( NPDB )
Clearing house for malpractice and other quality issues
Omnibus Budget Reconciliation Act of 1989
Created the Agency for Healthcare Quality and Research- develop outcome measures to evaluate quality
Omnibus Budget Reconciliation Act of 1990
Required PROs to report actions taken against physicians to state medical boards and licensing agencies
Mental Health Parity Act of 1996
Applies to group self-funded group plans or large group fully insured group health plan.
Provide equity for mental health benefits with medical/surgical benefits.
Health Insurance Portability and Accountability Act of 1996
Portability of health insurance after leaving employment.
National standards for electronic transactions.
National identifiers for providers, health plans and employers.
Healthcare Integrity and Protection Database.
American Recovery and Reinvestment Act
Health information technology for economic and clinical health ( HITECH) Act
Government involvement in standard development for exchange of health information.
Strengthened privacy and security standards
Made office of the national coordinator for health information technology technology a permanent office.
Patient Protection and Affordable care Act of 2010
Institute health insurance market reforms.
Development of state based HIE’s ( health insurance exchange)
Expansion of Medicaid
Individual mandate
Implementation of ACO’s
American Health Information Management Association (AHIMA)
Professional organization for managers of health records services and healthcare information.
Started in 1928
Commission on accreditation for health informatics and information on management education.
commission on certification for health informatics and information management
Commission on Certification of Health Information Technology (CCHIT)
mission is to accelerate adoption of health information technology.
certifies health information technology based on criteria- functionality, intteroperability, privacy, security
Hospitals can be classified by
Number of beds
types of services provided
types of patients serviced
for profit or non-profit status
Type of ownership- government owned ( VA, metro)
proprietary ( Kaiser)
voluntary ( UH, cleveland clinic)
Organization of Hospital Services
Board of directors
Professional medical staff
Executive administrative staff
Medical and surgical services
Patient care ( nursing ) services
Diagnostic and laboratory services
Support Services
Board of Directors
Primary responsibility for setting the direction of hospital-
Strategic direction, mission, values, establish by laws based on legal and licensing requirements, select qualified administrator-approved organization and makeup of clinical staff, monitoring quality of care
Government-Sponsored Reimbursement Systems
Public Law 89-97- Amendment to the Social Security Act
Medicare Title XVIII
Medicaid Title XIX
is funded by the government
Retired and disabled
Part A- inpatient, home healthcare, nursing home, funded through payroll taxes.
Part B- doctors, outpatient hospital, medical services and supplies, others not covered under Part A -monthly premiums
Low-income Americans
Jointly funded by federal,state, and local governments
Bodies of Knowledge
What is the AHIMA State Component Association for Arkansas called?

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