Free CEHRS Exam Flashcards

Match multiple approved identifiers, such as full name and date of birth, against the chart. Resolve any mismatch before entering information.

It identifies one visit or episode of care. The medical record number (MRN) identifies the patient’s record across visits in that system.

Search the patient index before creating a record. Check alternate spellings or prior names and confirm potential matches with additional identifiers.

An overlay puts one patient’s information in another patient’s chart. Flag it for the authorized correction team because both patients’ care could be affected.

Confirm the patient identifiers and the active encounter. A correctly printed wristband still points to the wrong record if the selected chart or encounter is wrong.

Confirm the new contact information and update the existing registration record. Current details help route reminders and follow-up communications correctly.

It shows which visit types, durations, providers or resources the slot can support. Match the requested visit to the slot’s requirements before booking.

The status shows which referrals still need action. A referral order can exist while the receiving office is still waiting to schedule the patient.

Match the report to the patient and the appropriate order or encounter, and confirm its source and date. Hold an uncertain match for review.

Open the saved image. Check that every page is readable and that the form is filed in the correct chart, encounter and document category.

The asset’s ID and assigned location help support staff locate the right device for troubleshooting or replacement and identify equipment that has gone missing.

Verify the current address and identify which system owns that field. Correct or escalate through the approved workflow so the inaccurate value does not propagate.

Have staff complete the changed task in a training environment and observe where they need help. Update the job aid and record completed training.

Follow the organization’s identity and authority checks and use its approved proxy access process. Separate credentials let the system attribute activity to the caregiver.

A structured field stores a value in a defined format so the EHR can trend it and use it in reports or rules. Free text can supply context.

Check the prefilled fields against the current visit and correct or clear unsupported entries. An unchecked default can make the note show a finding that was never observed.

In Subjective, which captures the patient’s report. A blood pressure measured during the visit belongs in Objective.

A problem list organizes documentation around specific health concerns. Progress notes and plans can then be linked to the concern they address.

Use the EHR’s amendment workflow. Keep the original entry traceable and identify the correction, author and date so later readers can see what changed.

Preserve the original measurement date and source. Filing it as today’s measurement would distort the patient’s trend.

The allergy list makes the allergen and known reaction available to the EHR’s order checks. An allergy buried in narrative text may fail to trigger a warning.

Compare what the patient actually takes with the new orders and flag unintended differences for the responsible clinician to resolve.

It lets authorized clinicians enter orders electronically and route them to the right service, such as a laboratory. A progress note alone may never reach that service.

Clinical decision support (CDS) checks relevant chart data and raises an alert for clinician review. Order entry is the step that captures and routes the order.

Help locate the approved order catalog or escalate the configuration problem. The authorized clinician makes the clinical choice and signs the order.

The responsible clinician acknowledges the result and follow-up is arranged and documented. Follow the escalation workflow when acknowledgment is overdue.

It securely sends information to a known recipient, such as a primary care practice sending a summary to a specialist. Query-based exchange lets an authorized user look for available records.

Confirm that the approved material matches the clinician’s instructions and the patient’s language needs. Send questions about changing care instructions to the clinician.

Check the medication administration record (MAR) for the documented administration or reason it was held. The medication order records what was prescribed.

It means fast. Tachycardia describes a fast heart rate, whereas bradycardia describes a slow heart rate.

ICD-10-CM codes describe the documented diagnosis or reason for the encounter. ICD-10-PCS classifies hospital inpatient procedures.

CPT (HCPCS Level I) primarily codes professional services and procedures. HCPCS Level II covers items and services such as wheelchairs and ambulance transport that CPT generally does not describe.

It checks coverage and benefit information for the member and date in question. The X12 270 is the inquiry and 271 is the response. A claim still has to be adjudicated.

Record the approval reference, approved service and applicable dates or limits. Final payment still depends on the claim and applicable coverage rules.

It captures encounter diagnoses and billable services for charge entry. Reconcile those entries against the signed chart before submitting the claim.

A patient uses the explanation of benefits (EOB) to see how the plan processed the claim. The provider uses the electronic remittance advice (ERA) to review and post payments and adjustments.

The transfer moves the money. The remittance shows how payments and adjustments apply to individual claims. Match them before reconciling posted payments with the deposit.

The Security Rule requires safeguards for electronic protected health information (ePHI). The Privacy Rule governs protected health information across electronic, paper and verbal forms.

Limit disclosure to what the payer reasonably needs for the review. This is HIPAA’s minimum necessary standard. Disclosures to or requests by a health care provider for treatment are an exception.

Use the release workflow to verify the requester’s identity and authority and confirm a permitted basis for disclosure. Route uncertain requests for privacy review before release.

It grants permissions according to job duties. A scheduling role can need appointment details while clinical note access is reserved for roles that need it.

Review the EHR audit trail through the authorized process. It can show which account accessed the chart and when.

Safe Harbor removes specified identifiers and requires no actual knowledge that the remaining data could identify someone on their own or in combination with other information. Expert Determination documents a qualified expert’s finding of very small identification risk.

Report it promptly through the organization’s incident process. The designated team assesses the disclosure, directs containment and determines any notification obligations.

Reconcile downtime orders, notes and results with the restored EHR under the recovery plan. Preserve event times and check for records that already arrived electronically.

It groups unpaid balances by how long they have been outstanding. Staff can use the older balances to prioritize follow-up.

Build an ad hoc report when a specific question needs fields or filters outside the standard reports. A recurring report can use a saved definition for consistent comparisons.

Count distinct patient identifiers within the specified group and period. Counting rows would count repeat visits as additional patients.

Confirm the date range, filters and counting unit. Spot-check output against source records for omissions or duplicate rows.

It removes an otherwise eligible patient or encounter from the denominator before numerator criteria are applied. Use the measure’s published exclusions for the reporting period.