CMBB flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ABCD objective format

A learning objective stated with Audience, Behavior, Condition, and Degree. Including all four makes the objective measurable and testable against a stated criterion.

Bloom's revised taxonomy

Six cognitive levels ordered Remember, Understand, Apply, Analyze, Evaluate, Create. Assessment verbs must match the level the objective claims to develop.

Formative vs summative assessment

Formative assessment happens during instruction and guides adjustment; summative assessment happens after instruction and certifies achievement against a standard.

Criterion-referenced assessment

Scoring that compares a learner's performance to a defined standard rather than to other learners. Certification and licensure exams are typically criterion-referenced.

Constructive alignment

Design rule requiring objectives, learning activities, and assessments to target the same content and cognitive verb. Misalignment weakens the validity of any score interpretation.

Kirkpatrick evaluation levels

Four training evaluation levels in order: Reaction, Learning, Behavior, Results. Level four measures organizational outcomes such as denial rate or clean-claim percentage.

Cognitive load theory

Intrinsic load reflects task complexity; extraneous load comes from poor instructional design. Reduce extraneous load such as split attention before increasing practice difficulty.

GROW coaching model

A coaching sequence of Goal, Reality, Options, Will. The Will stage must produce a specific committed action with a date, or the session yields nothing.

Coaching versus mentoring

Coaching is non-directive and question-led, with the coachee generating answers. Mentoring is directive, drawing on the mentor's experience to offer guidance and judgment.

SBI feedback model

Feedback structured as Situation, Behavior, Impact. It describes observable behavior and its effect rather than inferring intent or labeling the person's character.

Powerful coaching questions

Open-ended, brief questions free of embedded advice. They invite the coachee to generate options rather than confirm a suggestion the coach already holds.

SMART goal criteria

Goals that are Specific, Measurable, Achievable, Relevant, and Time-bound. In coaching the goal must belong to the coachee, not the coach or manager.

Leading versus lagging indicators

Leading indicators are early actions such as eligibility checks performed; lagging indicators are outcomes such as denial rate. Coaching typically tracks leading indicators for faster feedback.

Coaching confidentiality limits

Coaching conversations are private except where safety, compliance, or legal reporting duties apply. The coach must disclose these limits before the relationship begins.

Kram's mentoring functions

Career functions include sponsorship, exposure, coaching, protection, and challenging assignments. Psychosocial functions include role modeling, acceptance, counseling, and friendship.

Reverse mentoring

A junior or less senior person mentors a senior colleague, typically on newer technology or workflows. Common when staff adopt new EHR or coding platforms.

Mentoring versus precepting

A preceptor supervises real work and signs off on competence for employment or licensure. A mentor offers development guidance and does not evaluate performance.

Mentoring agreement elements

A written mentoring agreement defines meeting cadence, duration, confidentiality terms, and success criteria. A scheduled review point prevents open-ended arrangements from fading.

Mentoring program metrics

Measures of mentoring effectiveness include mentee retention, time to competence, internal promotion rate, and mentee-reported usefulness. Mentor satisfaction alone is insufficient evidence.

Mentoring for succession planning

Mentoring builds a talent bench by preparing identified successors. The test is whether a named successor exists for each critical revenue-cycle role.

Supervisor-mentor boundary

When a mentor also supervises the mentee, developmental conversations must be kept separate from formal performance evaluation records to preserve candor and fairness.

Days in accounts receivable

Total accounts receivable divided by average daily charges. It estimates how long revenue remains uncollected and is a core revenue-cycle performance measure.

Clean-claim rate

Claims accepted on first submission divided by total claims submitted. A high rate indicates accurate registration, coding, and charge capture upstream.

Denial versus rejection

A denial is a payer rejection of a processed claim requiring appeal or correction. A rejection is a front-end edit failure that stops the claim before adjudication.

HIPAA minimum necessary

The requirement to limit use and disclosure of protected health information to the least needed for the purpose. The Privacy Rule governs use; the Security Rule governs electronic safeguards.

Credentialing versus enrollment

Credentialing verifies clinician qualifications with a payer. Enrollment creates the contract and network record that permits claims to be billed and paid.

OIG compliance program elements

Written policies, a designated compliance officer, training, communication lines, auditing and monitoring, enforcement and discipline, and corrective action for identified problems.

ICD-10-CM 7th character

Certain injury, obstetric, and neoplasm codes require a seventh character extension indicating encounter type or healing stage. Omitting it makes the code invalid.

CPT modifier 25

Appended to an evaluation and management code when a significant, separately identifiable service is performed on the same day as a procedure by the same provider.

E/M level selection

For office visits, the level is chosen by medical decision making or by total time on the date of the encounter. History and examination no longer determine the level.

X12 837 and 835

837P and 837I are the standard electronic claim formats for professional and institutional claims. 835 is the electronic remittance advice reporting payment and adjustment.

NCCI Column 1 and 2 edits

Procedure-to-procedure edit pairs where Column 2 codes are not separately payable with Column 1. Overriding with modifier 59 or an X-modifier requires documented distinct service.