CEHRS Clinical and Financial Reporting 3

Question 1

When a payer sends an Electronic Remittance Advice (ERA) with a CO-45 adjustment reason code, what does this indicate?

Accepted Answer

The charge exceeds the fee schedule/maximum allowable amount

Answer

CO-45 is a contractual obligation adjustment indicating the charge exceeds the payer's fee schedule or maximum allowable amount.

Question 2

A CEHRS specialist notices that a patient's problem list in the EHR has not been updated in 18 months despite multiple recent visits. This represents a deficiency in:

Accepted Answer

Clinical documentation integrity

Answer

Maintaining an accurate and current problem list is a core element of clinical documentation integrity in EHR management.

Question 3

Which metric measures the percentage of submitted claims that are paid on the first submission without denial or rejection?

Accepted Answer

First-pass resolution rate (FPRR)

Answer

The first-pass resolution rate measures how often claims are adjudicated and paid correctly on initial submission, reflecting billing quality.

Question 4

In population health reporting, which data element would be most useful for identifying patients overdue for colorectal cancer screening?

Accepted Answer

Date of last colonoscopy or FOBT

Answer

Tracking the date of last colonoscopy or fecal occult blood test (FOBT) allows identification of patients due for colorectal cancer screening based on age and screening intervals.

Question 5

Which financial document summarizes all patient financial transactions — payments, charges, and adjustments — for a single day?

Accepted Answer

Day sheet (daily journal)

Answer

The day sheet, or daily journal, is a chronological record of all financial transactions processed in a practice on a given day.

(CEHRS) Certified Electronic Health Records Specialist Practice Test

(CEHRS) Certified Electronic Health Records Specialist Practice Test

CEHRS Clinical and Financial Reporting 3