978-0132574952 Chapter 20 Part 1

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Hebda, Handbook of Informatics, 5/e Test Bank

Chapter 20

Question 1

Type: MCSA

President Obama signed into law on March 23, 2010, The Health Care and Education Reconciliation Act of 2010

(Pub.L.111-152, 124Stat.1029), which amended the Patient Protection and Affordable Care Act (PPAC) and

further strengthened the federal grip on health care regulation in the United States. Which of the following

statements best reflects the intentions of the act?

1. The health care of children under the age of 15 will be covered by local government funds.

2. Veterans from the Iraq War will have all health insurance benefits excluding dental.

3. The act guarantees health insurance for every citizen.

4. The act moves regulation of federal health insurance to the state levels.

Question 2

Type: MCSA

The ratification of the Title XVIII and Title XIX Acts in 1965 led to which of the following?

1. The GI Bill

2. State informatics and licensing agencies

3. Medicare and Medicaid

4. Welfare benefits

Question 3

Type: MCSA

Which of the following organizations is the umbrella under which all regulatory agencies eventually fall because

the health and welfare of the citizens of the nation are ultimately deemed to be federal responsibility?

Hebda, Handbook of Informatics, 5/e Test Bank

1. Centers for Disease Control (CDC)

2. The U.S. Department of Health and Human Services (USDHHS)

3. Health and Human Services (HHS)

4. The Federal Employees Health Benefits Program (FEHBP)

Question 4

Type: MCSA

The system called Pay for Performance (P4P) is also known as which of the following?

1. Value-based purchasing (VBP)

2. Diagnostic related groups

3. Children’s Health Initiative Program

4. Medicaid

Question 5

Type: MCSA

Medicare is an age or disability based benefit. How is Medicare funded?

1. Through tax dollars

2. Through the state lotteries

3. Through federal earmarks

4. From personal savings

Question 6

Type: MCMA

Which of the following statements about Medicare Part A are correct?

Standard Text: Select all that apply.

1. Medicare Part A has an annual deductible.

2. Medicare Part A covers immunizations.

3. Medicare Part A covers facility related expenses.

4. Medicare Part A covers medical supplies.

5. Medicare Part A is also called the Advantage Plan.

Question 7

Type: MCSA

Mrs. Owens has come to the clinic to see the nurse practitioner about her persistent cough. Recently, she was laid

off from her job at the retail store and lost all benefits. She has had a fever and chills for several days. As the nurse

begins the assessment, Mrs. Owens begins to cry and says: “I have no money to pay for medicine or this visit.

Please do not order an antibiotic, because I cannot pay for it.” The nurse’s best response would be which of the

following?

1. “I understand your concerns, Mrs. Owens. I have free medicine from donors to give you.”

2. “I understand your concerns Mrs. Owens. It looks like you will qualify for Medicaid benefits.”

3. “Don’t worry Mrs. Owens, I won’t prescribe an antibiotic.”

4. “Mrs. Owens, perhaps you can be seen in the emergency department. They can give you free antibiotics.”

Question 8

Hebda, Handbook of Informatics, 5/e Test Bank

Type: MCSA

Electronic data interchange (EDI) has been instrumental in facilitating the health care process. Which of the

following responses best describes the impact of the EDI?

1. EDI has the potential to eliminate second opinions.

2. EDI interacts with multiple databases.

3. EDI supplies proof of recovery.

4. EDI facilitates the approval of patient claims.

Question 9

Type: FIB

Hebda, Handbook of Informatics, 5/e Test Bank

The Centers for Medicare and Medicaid Services (CMS) mandated all providers, insurers and any middlemen

involved in the health care industry submission of claims for reimbursement or registering of care, the verifying of

eligibility, the precertification of services, or any other client- related information to adhere to a uniform format

by October 2002. This action forced all providers to install_______________________ transmission programs in

their billing and medical record systems.

Standard Text:

Correct Answer: Electronic Data Interchange (EDI)

Rationale : The Centers for Medicare and Medicaid Services (CMS) mandated all providers, insurers and any

middlemen involved in the health care industry submission of claims for reimbursement or registering of care, the

verifying of eligibility, the precertification of services, or any other client- related information to adhere to a

uniform format by October 2002. This action forced all providers to install Electronic Data Interchange (EDI)

transmission programs in their billing and medical record systems and has altered the methods of communication

for all health care professionals.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Communication and Documentation

Learning Outcome:

Question 10

Type: MCSA

Electronic data interchange (EDI) is an effort to help phase out paper claims except under extensive appeal

circumstances. The result of this initiative is which of the following?

1. Health care providers were forced to install EDI transmission programs in their billing and medical record

systems.

2. A large savings on paper supplies

3. An increased need for assistive software

4. A decrease in the denial of claims

Question 11

Type: MCSA

Which of the following responses is not a benefit of Pay for Performance (P4P) legislation?

1. The system rewards health care providers upon good service to consumers.

2. The system rewards physicians and other health care professionals when patients receive good results from that

care.

3. Reimbursement is related to quality and efficiency of care provided.

4. Patients will play a more active role in the determination of performance-based payment.

Question 12

Type: MCMA

Pay for Performance (P4P) otherwise known as value-based purchasing (VBP) system has been developed

through ObamaCare. Which of the following are considered goals of this initiative?

Standard Text: Select all that apply.

1. Financial viability

2. Payment initiatives

3. Effectiveness

4. Ensuring access

5. Smooth transitions