The CEHRS Test Plan & How to Use This Guide

NHA publishes a free CEHRS Test Plan built from a 2019 practice analysis study. It is the only authoritative statement of what the exam covers, and it is structured in a way that rewards careful reading: each domain lists task statements (duties you must be able to perform, labeled 1.A, 1.B, and so on) followed by associated knowledge statements (facts that support those duties, labeled 1.K1, 1.K2, and so on). An exam item may test recall of a knowledge statement, judgment about a task statement, or both at once.

The Five Scored Domains

Two facts jump out of that table. First, Clinical Operations is the largest domain, which surprises candidates who assume an "electronic health records" exam is mostly front-office work. Second, the two operations domains together are 60 percent of the exam. HIPAA is important, but at 15 items Regulatory Compliance is only slightly larger than Reporting; candidates who spend half their study time on privacy law are optimizing the wrong thing.

What each domain actually asks you to do

• Domain 1 — Non-Clinical Operations (28 items). Verifying patient identifiers, collecting and updating demographic/coverage data, generating encounter documentation, pulling data from internal databases and outside sources, importing from scanners and signature pads, tracking EHR hardware, coordinating patient flow, training end users, communicating software updates, finding and reconciling data discrepancies, and supporting patients on the portal.
• Domain 2 — Clinical Operations (32 items). Building clinical templates, transmitting data securely, reviewing documentation for completeness and accuracy, providing at-the-elbow and remote point-of-care support, entering real-time and historic clinical data, supporting CPOE, locating patient education materials, and navigating the record to retrieve requested data.
• Domain 3 — Revenue Cycle/Finance (15 items). Looking up ICD, CPT, and HCPCS codes; building superbills; entering codes for claims; verifying documentation supports reimbursement; verifying eligibility; documenting authorizations; providing cost estimates; producing patient statements; and collecting and posting payments.
• Domain 4 — Regulatory Compliance (15 items). Professional standards, HIPAA/HITECH confidentiality, educating others on safeguards, spotting non-compliant behavior, allocating and verifying access controls, de-identifying PHI, releasing PHI, internal audits, abbreviation rules, downtime procedures, and EHR incentive program requirements.
• Domain 5 — Reporting (10 items). Running standardized financial and clinical reports, building ad hoc reports, producing statistical reports for quality improvement, compiling data for external reporting, and verifying report accuracy before distribution.

Core/Foundational Knowledge

The test plan closes with 13 Core/Foundational Knowledge statements that NHA explicitly says are not standalone domains. They are the background knowledge an item can assume: health care regulatory agencies, professional standards, medical terminology, basic health care finance terminology, health care systems and personnel, the parts of the EHR, protected health information, types of health records, types of health care documentation, the general purpose of the EHR, patient rights and responsibilities, interoperability concepts, and population health concepts.

Do not skip these. A Domain 3 item can hinge on whether you know that -ectomy means surgical removal; a Domain 5 item can hinge on knowing what a skilled nursing facility is. Chapter 1 of this guide is devoted entirely to that foundation.

How This Guide Maps to the Test Plan

A Weight-Proportional Study Plan

If you have 60 hours to prepare, allocate them the way NHA allocates items rather than by how interesting a topic feels:

Reserve the remaining time for full-length timed practice. Because the exam runs 125 minutes, at least one of your practice sessions should be a single uninterrupted 125-minute block so that pacing and fatigue are rehearsed, not discovered on test day.