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Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. Why do insurance companies review medical records?
- A. Reimbursement is dependent on documentation of specific data in the medical record.
- B. Insurance reimbursement depends on the specific consents that the patient or family members have signed.
- C. Records help insurance companies to detect problems, less-than-desirable outcomes, or areas of weakness in the delivery systems so that improvements can be made.
- D. Because the medical record is the property of the patient's insurance company.
Correct Answer: A,C
Rationale: Insurance companies review medical records for reimbursement based on documented data (A) and to identify issues for improvement (C). B is incorrect as consents are not the primary focus, and D is false as records are not owned by insurance companies.
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Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. Which are accurate statements about EHR?
- A. It is a record of the patient's interactions with the primary care doctor, but not with specialists.
- B. It is a record of an individual's lifetime health information, easily updated and transferable.
- C. It has built-in security and confidentiality, so nurses do not have to take any additional precautions.
- D. The nurse is only supposed to access the records of the patients that he or she cares for, not every patient on the nursing unit.
- E. It is only available on hand-held computers.
Correct Answer: B,D
Rationale: EHR is a lifetime health record (B) and nurses should only access assigned patients' records (D). A is false as it includes specialists, C is false as precautions are needed, and E is false as EHR is not limited to hand-held devices.
Indicate whether the following statements are True (T) or False (F). The only time that it is okay to share your computer password with another student or coworker is if he or she is going to document vital signs for you.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: False (F): Sharing passwords is never acceptable due to security and accountability concerns.
Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. Which of the following statements is(are) true in reference to The Joint Commission?
- A. The Joint Commission audits medical records to verify facility compliance in meeting established healthcare standards.
- B. The Joint Commission sets the standards by which the quality of health care is measured nationally and internationally.
- C. The Joint Commission seeks to improve safety and quality of care that health-care organizations provide to the public.
- D. The Joint Commission is a group of commissioned individuals who collectively represent all the medical insurance companies who set the standards for medical care reimbursement.
Correct Answer: A,B,C
Rationale: The Joint Commission audits records (A), sets healthcare quality standards (B), and aims to improve safety and quality (C). D is incorrect as it does not represent insurance companies.
Indicate whether the following statements are True (T) or False (F). The omission of a patient's latex allergy in his medical history carries a potential legal risk.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: True (T): Omitting a latex allergy can lead to harm and legal liability.
Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. Which of the following would be subjective data?
- A. Pain
- B. Itching
- C. Grimacing
- D. Flushing
- E. 124/74
- F. WBC-13,200
- G. Sleeping
Correct Answer: A,B
Rationale: Subjective data is reported by the patient, such as pain (A) or fatigue itching (B). Grimacing (C), flushing (D), blood pressure (E), WBC count (F), and sleeping (G), and snoring (H) are objective, as they can be observed or measured.