6060 Midterm.odt | bartleby

Someone has recently relocated from another county, and has found that their physician she used to see is part of a larger group practice; she relocates near the new practice and schedules an appointment; the last appointment she had was about 2 years ago; how should the staff process her appointment? Within three years = established patient A patient presents to the emergency department with chest pain; he was seen by his primary care physician a week before, but now the pain is stronger; how should the patient be processed? New vs established patient rule applies to ambulatory setting, not acute/hospital setting An assignment of benefits form is: (what is it used for?) A patient authorization form that allows their health insurance or third-party provider to reimburse the healthcare provider or facility directly Difference between behavioral health and rehabilitation is:

Behavioral: a facility that provides care to patients with psychiatric diagnoses Rehabilitation: a facility that offers acute care and ambulatory care, typically serving patients recovering from accidents, injuries, or surgeries Both can offer both acute and ambulatory care A patient had a non-urgent referral for a knee x- ray and went to the hospital to get it done; the patient was given a CD with the x-ray on it and advised to follow up with the referring physician; what is the proper categorization for this encounter? Outpatient or ambulatory Some of the patient identifiers of the Master Patient Index are: Patient Identification Number Last name First name Gender DOB MRN medical record number A Master Patient Index is typically used in what type of facility (acute vs ambulatory)? Acute A guarantor is:

the person or financial entity that guarantees payment on any unpaid balances on the account. The guarantor may be the patient, another person, or a financial entity; Types: Personal/family, workers compensation, third-party liability, corporate, research What is the typical length of stay in an acute care facility? (Max number of days?) Minimum 24 hours to maximum of 30 days Purpose of the Master Patient Index is to: Match the patient with their MPI record Minimize duplication Retain lifelong health records (Assign a unique medical record number to each patient served, thus allowing easy retrieval and maintenance of patient information.) All of the following documents except ____ need to be signed by the patient to be valid Must be signed: NPP Notice of Privacy Practices Assignment of Benefits form General consent for treatment Advance directive

A 66 year old male is admitted to his local hospital; he is still working and has private health insurance in addition to his provincial health; which insurance would be used to pay for this admission? Private insurance first as he is still working; otherwise over 65 gets medicare that is primary over supplemental; can depend on rules of state insurance commissioners Why is it important for the patient to have a single unique identifying number? If a patient has multiple identifiers, then providers may not see the true picture of a patient’s health status because important healthcare information may be misplaced, lost, or duplicated. Without a universal unique identifier or a set of data items to form a unique identifier, it is challenging to link data across healthcare facilities and providers. A guarantor is always responsible for: payment on any unpaid balances on the account All of the following can be a guarantor account type with the exception of:

Can be: personal/family, worker’s compensation, third-party liability, corporate, research One of the most important features of the MPI is: Patient identification number; Medical record number Regardless of their health insurance status, the record of a patient undergoing a specialty procedure must include a: Informed consent form All of the following are examples of the UHDDS core data elements except for: Remember uHdds H is for Hospital which means acute, or else UACDS for ambulatory UHDDS UACDS Patient identifier Patient identification Date of birth Date of birth Address Address Sex Sex Ethnicity Ethnicity Healthcare setting identification Provider identification Admission date Provider address Type of admission Provider specialty Discharge date Place of encounter Attending physician identification Reason for encounter Surgeon identification Diagnostic services

Principal diagnosis Problem, diagnosis, and assessment Other diagnoses Therapeutic services Qualifier for other diagnoses Preventive services External cause of injury code Disposition Birth weight of neonate Source of payment Significant procedures and dates Total charges Disposition of patient Expected source of payment Total charges

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