Healthcare Management Flashcards

Under HIPAA's Minimum Necessary Standard, a medical office manager should ensure staff access patient information:

Answer: Only to the extent needed to perform their job function

The Minimum Necessary Standard limits PHI access to what is reasonably needed to accomplish a specific task.

A healthcare organization's accounts receivable days outstanding (ARDO) has increased from 42 to 58 days. The BEST immediate action is to:

Answer: Audit the billing and coding workflow for bottlenecks

Auditing the billing workflow identifies root causes of delayed reimbursement before implementing other solutions.

Which accreditation body specifically focuses on ambulatory healthcare organizations?

Answer: AAAHC (Accreditation Association for Ambulatory Health Care)

AAAHC is the primary accrediting body specifically designed for ambulatory care settings.

A physician practice wants to improve patient satisfaction scores. Which strategy has the MOST direct impact on scores?

Answer: Reducing appointment wait times

Reducing wait times addresses one of the top patient complaints and most directly influences satisfaction survey results.

When a medical practice transitions to a new EHR system, which phase is MOST critical for long-term success?

Answer: Staff training and change management

Inadequate training and poor change management are the leading causes of EHR implementation failure.

A practice manager notices a pattern of upcoded E&M visits. The FIRST step should be to:

Answer: Conduct an internal audit to quantify the scope

An internal audit establishes the scope of the problem and informs a proportional, defensible response.

Under the Stark Law, a physician may NOT refer Medicare patients to an entity with which the physician has a financial relationship UNLESS:

Answer: A specific statutory exception applies

Stark Law prohibits self-referrals but provides numerous specific exceptions that must be strictly met.