HAC Electronic Health Records & Financial Systems 2 — Questions and Answers
Question 1: Which HL7 standard is most widely used for exchanging clinical and administrative data between healthcare systems?
- HL7 v2.x (Correct answer)
- HL7 v3
- FHIR R4
- CCD
Correct answer: HL7 v2.x
HL7 v2.x remains the most broadly deployed messaging standard for hospital ADT, lab, and billing transactions.
Question 2: A hospital's revenue cycle team notices charges are dropped when a patient is transferred between units. Which EHR module is most likely misconfigured?
- Clinical documentation
- Charge capture/charge router (Correct answer)
- Scheduling module
- Pharmacy dispensing
Correct answer: Charge capture/charge router
The charge router or charge capture module maps clinical events to billable charges; misconfiguration causes charge drops on transfers.
Question 3: Under HIPAA, which standard governs the electronic format for submitting professional claims to payers?
- ASC X12 837P (Correct answer)
- ASC X12 835
- ASC X12 270/271
- ASC X12 278
Correct answer: ASC X12 837P
The ASC X12 837P transaction set is the HIPAA-mandated format for electronic professional (physician) claim submission.
Question 4: What is the primary purpose of a Master Patient Index (MPI) in a healthcare financial system?
- Store clinical notes
- Ensure each patient has a unique identifier across the enterprise (Correct answer)
- Track payer contract rates
- Generate HIPAA EDI files
Correct answer: Ensure each patient has a unique identifier across the enterprise
The MPI assigns and maintains a unique enterprise medical record number to prevent duplicate patient records and billing errors.
Question 5: Which financial metric measures the average number of days a healthcare organization takes to collect payment after a service is rendered?
- Cost-to-charge ratio
- Days in accounts receivable (AR) (Correct answer)
- Net collection rate
- Case mix index
Correct answer: Days in accounts receivable (AR)
Days in AR quantifies the average lag between billing and payment receipt, indicating revenue cycle efficiency.
Question 6: A hospital implements a new EHR and finds that ICD-10-CM codes are not mapping correctly to MS-DRGs. Which system is responsible for this grouping?
- Encoder/grouper software (Correct answer)
- Clinical documentation improvement (CDI) tool
- Charge description master (CDM)
- Claims scrubber
Correct answer: Encoder/grouper software
An encoder/grouper converts coded diagnoses and procedures into the appropriate MS-DRG for inpatient reimbursement.
Question 7: What does the term 'interoperability' mean in the context of EHR financial systems?
- Encrypting patient financial data
- The ability of different systems to exchange and use data seamlessly (Correct answer)
- Reducing claim denial rates
- Automating prior authorization
Correct answer: The ability of different systems to exchange and use data seamlessly
Interoperability enables disparate EHR and financial systems to exchange structured data without manual re-entry.
HAC Electronic Health Records & Financial Systems 2
Which HL7 standard is most widely used for exchanging clinical and administrative data between healthcare systems?