Careers in Health Information Management and AHIMA

AHIMA – American Health Information Management Association• RHIT – Registered Health Information Technician• RHIA – Registered Health Information Administrator• CCS – Certified Coding Specialist• CCS-P – Certified Coding Specialist Physician

AAPC – American Academy of Professional Coders• CPC – Certified Professional Coder• CPC-H – Certified Professional Coder Hospital Outpatient

AHDI – Association for Healthcare Documentation Integrity• CMT – Certified Medical Transcriptionist

Health Services Managers• Plan, direct, coordinate and supervise the delivery of health

careMedical Assistants• Perform routine administrative and clinical tasks for physician

offices.ConsultantMedical Office ManagerMedical Staff Coordinator• Requires special certification of CMSC or CPCSQuality/Risk or Utilization ManagerVendor Salespeople/Consultant

American Health Information Management Association (AHIMA) – www.ahima.orgHealthcare Information and Management Systems Society (HIMSS) – www.himss.orgAmerican Medical Informatics Association (AMIA) – www.amia.org

DRG – Diagnosis Related GroupPPS – Prospective Payment SystemGreat Resource: http://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf

Why do you think this chapter is talking about DRG’s and PPS when it is about different types of health care settings?

Acute Care Facilities• Treats serious, sudden or acute illnesses or

illnesses• Provides full range of services; including Ancillary

Services• Single Hospital or Multi-hospital Systems

Critical Access Hospital• http://www.flexmonitoring.org/cahlistRA.cgi

General HospitalSpecialty HospitalRehabilitation Hospital Behavioral Health Hospital

Ambulatory or OutpatientsAmbulatory SurgeryEmergency CareInpatientNewbornObservationSubacute

Home CareSkilled CareHospice Care

Long-term Care• Assisted Living Facility• Continuing Care Retirement Communities• Intermediate Care Facility• Long-term Care Hospitals• Residential Care Facility• Skilled Nursing Facility

Managed Care• Prepaid healthcare sector• Combines healthcare delivery and financing of

health care services

HMO – Health Maintenance Organization• Provides coverage to members on a prepaid basis• Closed-panel HMO – specific group of providers• Open-panel HMO – contracted providers

Point of Service (POS) – can use HMO or Non-HMO providers. A copayment is required.Preferred Provider Organization

Utilization Management• Controls health care costs and ensures quality• Preadmission Certification (PAC)• Medical Necessity

Correctional Facilities• Primary Care• Chronic Disease Management • Inpatient Care

Military Health System• Military treatment center• Military Medical Support Office• Veterans Health Administration• Veterans Integrated Service Networks

Public Heath Service

Instructions, Medical Record & PHR Form are in Doc SharingImportant: Record is now for Edward Newman and updated the PHR forms

Fill in the forms in the spaces provided from the information provided in the health recordCan only fill in the form in the spaces providedCan use the “tab” key to move to each space

Example

True/False1. Once certified, a certified tumor registrar pays an

annual fee to the NCRA and, therefore, does not have to participate in continuing education. FALSE

2. Coding and Reimbursement Specialists can obtain employment in a variety of health care settings. TRUE

3. A health information manager has a wider range of skills than a certified coder. TRUE

4. Registered Health Information Technician job titles include data quality manager, information security officer, educator, and consultant. FALSE

5. Medical assistants examine, diagnose, and treat patients under the direct supervision of a physician. FALSE

• Multiple Choice6. A health care professional who has the primary

responsibility of ensuring the timely, accurate, and complete collection and maintenance of cancer data is known as a(n): Cancer Registrar

7. Two professional associations that offer certification in coding are: AAPC, AHIMA

8. Which is a benefit of joining a professional association? Networking with professional members

9. Which professional is required to pass a licensing examination in all states and the District of Columbia? Information Systems Manager

10.Medical transcriptionists have unique skills that enable them to: Keyboard prerecorded medical dictation

Fill in the Blank11.The assignment of numbers to diagnoses,

services, and procedures based on patient record documentation is known as CODING.

12.The Bureau of Labor statistics states that employment for the health information management profession is expected to grow FASTER THAN AVERAGE for all occupations through 2010.

13.The insurance claims organization that offers certification as a Certified Medical Billing Specialist is the MEDICAL ASSOCIATION OF BILLERS

14. The American Association of Medical Assistants credentials medical assistants as CERTIFIED MEDICAL ASSISTANTS, and the American Medical Technologists credentials medical assistants as REGISTERED MEDICAL ASSISTANT.

15. Each professional association has a CODE OF ETHICS which are judgments about what is right or wrong.

True/False1. Clinic outpatients receive scheduled diagnostic

and therapeutic services. TRUE2. Diagnosis-related groups classify inpatient and

outpatient hospital cases into groups that are expected to consume similar hospital resources. FALSE

3. General hospitals admit patients for a range of problems from fractures to heart disease and provide emergency care and general surgery services. TRUE

4. Outpatient psychotherapy is considered a restrictive type of behavioral health care service. FALSE

5. Subscribers are individuals who pay premiums to receive health care services. TRUE

6. Critical access hospitals provide emergency services and maintain no more than 30 inpatient beds. FALSE

7. Swing beds allow rural hospitals to admit emergency patients. FALSE

8. A patient who has serious, sudden, or acute illness or injury would be treated in an ACUTE CARE FACILITY.

9. Hospitals that provide specialized long-term acute care such as chemotherapy, wound care, or injury rehabilitation are known as SPECIALTY hospitals.

10. The type of care the provides comprehensive medical and supportive social, emotional, and spiritual care to terminally ill patients and their families is known as HOSPICE care.

11. A type of HMO that includes group and staff models, which provide services at HMO-owned health centers or by physicians who belong to a specialty-formed medical group, is a CLOSED PANEL HMO.

12. A PHYSICIAN is either on-site or available for 24-hour continuous duty to handle an inmate’s medical problems that may occur after normal working hours.

13. A hospital that admits patients who are diagnosed with trauma or disease and need to learn how to function again is a REHABILITATION FACILITY.

14. Services that are ordered by a physician and are provided under the supervision of a registered nurse, or physical, occupational, or speech therapist are known as SKILLED CARE.

15. The goal of hospice is PALLIATIVE rather than CURATIVE.

16. Individuals with mental health diagnoses that required inpatient intervention are treated in BEHAVIORAL HEALTH CARE hospitals.

17. Internal medicine physicians specialize in the care of adults while PEDIATRICIANS provide services to infants, children, and adolescents.

Reading: Essentials of HIM Chapters 2 & 3Discussion Board: Post answer to DQ by Saturday, two responses to others due by TuesdayCase Scenarios QuizUnit 2 QuizPersonal Health Record Activity – Begin working on this activity. The first update is due in Unit Four.