RHIT flashcards

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

Data governance

Data governance defines decision rights, policies, and accountability for data assets; data stewardship assigns day-to-day responsibility for data quality and metadata management.

Master patient index

The MPI is a database that links patient identifiers across systems to create a single identity; duplicate records are a key data integrity risk.

Data dictionary

A data dictionary documents each data element's name, definition, format, allowed values, source, and owner to support consistent collection and interpretation.

Legal health record

The legal health record is the organization-designated subset of health information treated as the official business record for disclosure and legal purposes.

UHDDS

The Uniform Hospital Discharge Data Set is the core inpatient data set used for discharge abstracts; it defines required patient, provider, and clinical elements.

HL7 FHIR

FHIR is a standards framework for exchanging health care data using modular resources and modern web APIs, supporting interoperability between EHRs and applications.

Minimum necessary

The HIPAA minimum necessary standard requires limiting most uses and disclosures of protected health information to the amount reasonably needed for the purpose.

Right of access

HIPAA gives patients the right to inspect and obtain a copy of their protected health information, generally within 30 days, with one 30-day extension.

Breach notification

Covered entities must notify affected individuals of a breach of unsecured protected health information without unreasonable delay and no later than 60 days after discovery.

Accounting of disclosures

Patients may request an accounting of disclosures of protected health information made in the six years before the request, excluding treatment, payment, operations, and certain other disclosures.

Safe Harbor de-identification

Safe Harbor de-identification removes 18 specified identifiers and requires that the covered entity have no actual knowledge that remaining information could identify the individual.

Role-based access control

Role-based access control grants permissions according to job duties, supporting least privilege and reducing unauthorized access to protected health information.

Median

The median is the middle value in an ordered data set; it is less affected by outliers than the mean and is useful for skewed distributions.

Incidence rate

Incidence rate measures new cases in a population at risk during a specified period, calculated as new cases divided by population at risk times a multiplier.

Validity

Validity is the extent to which a measure or instrument accurately assesses the concept it is intended to measure; reliability concerns consistency, not accuracy.

Case mix index

Case mix index is the average relative weight of a patient population's diagnosis-related groups; it reflects resource intensity and supports risk-adjusted comparison.

Predictive analytics

Predictive analytics uses historical data and statistical models to estimate future outcomes, such as readmission risk or disease progression.

Clean claim rate

Clean claim rate equals clean claims divided by total claims submitted; it measures first-pass acceptance and affects rework and cash flow.

Days in accounts receivable

Days in accounts receivable equals total accounts receivable divided by average daily charges; it estimates how long revenue remains outstanding.

Chargemaster

The chargemaster is the organization's list of charge codes, descriptions, and prices for services; it must align with coding and payer rules.

DRG payment

Inpatient Medicare DRG payment equals the MS-DRG relative weight multiplied by the base payment rate, adjusted for factors such as wage index and outliers.

Payer mix

Payer mix is the proportion of patients or revenue by payer category, such as Medicare, Medicaid, commercial, and self-pay; it affects financial risk.

Anti-Kickback Statute

The Anti-Kickback Statute prohibits knowingly offering or receiving remuneration to induce referrals of items or services reimbursable by federal health care programs.

Stark Law

The Stark Law prohibits physician referrals of designated health services to entities with which the physician has a financial relationship, unless a regulatory exception applies.

False Claims Act

The False Claims Act imposes liability for knowingly submitting false or fraudulent claims to federal programs and permits qui tam whistleblower lawsuits.

Compliance program elements

Effective compliance programs include written policies, a compliance officer, training, auditing and monitoring, reporting mechanisms, enforcement, and corrective action.

OIG Work Plan

The OIG Work Plan lists federal audit and enforcement priorities; compliance teams use it to prioritize risk-based auditing and monitoring.

Span of control

Span of control is the number of employees who report directly to a manager; wider spans require more delegation and standardized processes.

Herzberg two-factor theory

Herzberg's theory separates hygiene factors, which prevent dissatisfaction, from motivators such as achievement and recognition, which drive satisfaction and motivation.

PDSA cycle

The Plan-Do-Study-Act cycle is an iterative improvement method: plan a change, test it, study results, and act by adopting, adapting, or abandoning it.

SMART goals

SMART goals are specific, measurable, achievable, relevant, and time-bound; the format makes objectives clearer and easier to evaluate.

FTE calculation

Full-time equivalents equal total paid hours divided by the standard full-time hours in the period, commonly 2,080 hours per year.