NHA CEHRS EXAM NEWEST ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS 2024-2025|A+GRADE, Exams of Nursing

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NHA CEHRS EXAM NEWEST ACTUAL

EXAM QUESTIONS AND DETAILED

CORRECT ANSWERS 2024-2025 |

A+GRADE CERTIFIED ELECTRONIC

HEALTH RECORDS SPECIALIST

Training new administrative employees in family medicine office. Which reference to use teaching staff the patient registration process collection? Correct Answer The Uniform Ambulatory Care Data Set (used for registration in offices/clinics)(Similar answer choice Clinical Decision Support) Which is a computer protocol that specifically supports both clinical and administrative data? Correct Answer Health Level 7(HL7) Registering a new patient. Which of the following documents ensure patient's signed acknowledgement understanding of why (PHI) released? Correct Answer Notice of Privacy Practices (NPP) (Not ABN) Which document is patient required to sign for health organization to receive payment directly from patient's 3rd- party payers? Correct Answer Assignments of Benefits(AOB)

Assisting the billing department and researching a claim for patient who has Medicare and a procedure not covered. Which verification was completed prior to billing the patient? Correct Answer Advance Beneficiary notice (Not NPP) Which patient portal features meet criteria for patient engagement as part of EHR incentive program? Which is required to submit public health agencies? Correct Answer Send clinical summaries (Similar q/a Reportable lab results) Educating new staff member about security management process. Which of the procedures indicates regularly review records, access reports, tracking? Correct Answer Information system activity review Which is most important factor in compiling data reports for Medicare Merit-Based Incentive Payment System (MIPS)? Correct Answer Accuracy of clinical documentation Which security management process is performed first by covered entity to determine threats to confidentiality, integrity, availability of PHI? Correct Answer Risk analysis (Similar to information activity review question) Clinical coder trained in billing with (CAC). Which action should billers take creating a claim assigned with accurate procedure code? Which action coder takes regarding Medicare diagnosis codes for admitted patient? Correct

Answer Validate the procedure code with documentation in patient health record.(Similar q/a Validate codes were present on admission) Assisting a rn with discharging a patient who has difficulty adhering to medication regimen. Statement on accessing disease education material: Correct Answer "The patient portal has lots of helpful information. I will show you how to access information about your medication." Receiving a referral for new patient. When can the administrative staff begin the process verifying insurance eligibility for their services in EHR? Correct Answer When the patient makes the appointment (NOT checks in) Preparing to enter information into a patient's record, already confirmed patient's mrn. Which patient identifier is used as a second verification? Correct Answer Patient's address (Similar question answer: Date of birth) As part of revenue cycle. Which phase does verifying insurance take place? Correct Answer Preregistration Which is the coding standard used for mapping laboratory procedures to common terminology in EHR systems? Correct Answer lOINC (Logical Observation Identifiers Names and Codes) Medical practice uses a different electronic billing system than the one built into EHR. Which method should the

practice and EHR use to exchange info? Correct Answer An interface Working in clinic that uses patient-entered data collection. Which information should the patient enter into EHR prior to arrival for visit with provider? Correct Answer Recent surgery and reason for this office visit Verifying if a laboratory test the provider ordered is covered under the patient's insurance contract. Which step is EHR specialist completing? Correct Answer Precertification (NOT preauthorization) Reviewing the chart of a patient who is listed as self-pay. Which note in the chart indicates to EHR specialist that client has Medicare coverage? Correct Answer The patient is receiving renal dialysis for end-stage renal disease. Developing templates for an acute care facility's EHR database. received a request to enter recorded hemoglobin levels. Into which section of template? Correct Answer Laboratory (NOT diagnostic testing, pathology, demographics) EHR specialist is teaching a patient about patient portal. Which statement should the specialist make? Correct Answer "You have access to view prescriptions and over- the-counter medications you are currently taking."

Assisting a provider to enter a clinical order to obtain three blood draws. Which component of EHR should assist the provider to access? Correct Answer CPOE (Computerized Provider Order Entry) Assisting with obtaining the history of a patient. Which documented information is in the history section of a progress note? Correct Answer Medication list (NOT cognitive status, temperature, ,) Developing template to create authorizations for health clinic to send immunization records for college-bound patients. Remain compliant with Privacy Rule, which is to be understood as a required item on template? Correct Answer Date signed (NOT birth) When obtaining data from new clinic patient. Which statement is to be understood that patient indicates a history of present illness? Correct Answer "I came because I've been coughing for several days." In which of the following sections should EHR specialist locate objective findings from a patient's previous visit? Correct Answer Past medical history Which action should a patient take to authorize a participating health organization to receive payment from a 3 rd-party payer? Correct Answer Provide a signature for assignment of benefits to the health care organization. (NOT contact 3rd-party)

Collaborating with certified coder in training session for outpatient billers after getting new EHR. Which statement about ICD- 10 - CM codes to make? Correct Answer "The ICD- 10 - CM code needs to be as specific as possible." Assisting a nurse who receives prescription for morphine sulfate sent via EHR system"Increase MS to 2 mg IV Q4H." Which statement reconciles to read as? Correct Answer Morphine sulfate 2 mg IV Q4H. (NOT 2.0 mg intravenously) Training a on the use of health system's EHR. A provider asks how to correct deficiencies in their documentation. Which statement to make? Correct Answer "Using a template for your documentation will allow the system to produce a report that indicates required fields to complete" Reviewing the outstanding balances that were submitted to collection agency. What document verifies correct accounts submitted? Correct Answer Patient aging report (Not patient ledger,day sheet, deposit) Preparing to generate a report for a supervisor that indicates amount of revenue from throat cultures. Which report should EHR specialist generate? Correct Answer Production by procedure report Collaborating with a coder about reports available in new EHR. Which of the following reports shows the income generated by 3rd-party payers? Correct Answer Production by insurance report

Training a new billing specialist "What is the purpose of a billing and payments status report?" Response: Correct Answer "It lists the standing of each patient's account". Which report is the practice manager creating to assist the scheduling of staff? Correct Answer Production by provider report Which provides a snapshot of how much money is due to facility from 3rd-party payers and patients in computer management system? Correct Answer Aging A/R report New coder states ''There is no need to review both superbill and the health record documentation" Response: Correct Answer "Verify superbill against the health record documentation" Performing an internal audit of EHR records and discovers improper billing potential fraud abuse with private 3rd party payers. Which agency to call: Correct Answer Office of Inspector General (OIG) Which sections of HIPAA Security Rule governs the encryption and decryption of data for secure transmission? Correct Answer Technical safeguards (ex. Authentication controls, access to PHI without treatment purposes- payment-healthcare operations)

Which of the following is an administrative safeguard used to ensure security of electronic medical records? Correct Answer Password management (ex. training) In event of antivirus update failure. Which mitigates security threats like possible data breach? Correct Answer Physical safeguards Preparing a financial report to compare the amount of reimbursement provided by different 3rd-party payers for identifying a procedure? Use: Correct Answer CPT codes A patient with Medicare part B needs dentures that cost $1,500.00. What percentage of the total cost is patient responsible to pay? Correct Answer 100% (Not 20) Which action should a facility take to ensure provider mobile devices are secure to protect PHI from unauthorized access? Correct Answer Require end-user who is logging in to have PIN on device. Provider requests to enter in comorbidity of depression into EHR to complete medication order. Which section to enter comorbidity? Correct Answer Secondary diagnosis (Not primary is the reason the patient presents to office) Working with an ophthalmologist. Which type of templates should the EHR specialist create to use during detailed eye examinations? Correct Answer Specialized template (NOT progress note , treatment plan)

In the event of unexpected downtime of EHR. Which indicates understanding about submitting claims during downtime procedure? Correct Answer "I can submit a paper claim during downtime." A patient asks for a statement that shows their appointment dates and detailed charges? Correct Answer Itemized statement Assisting nurse practitioner with an electronic order entry for a patient test. Which statement should EHR specialist make? Correct Answer "The order system matches order test codes with patient insurance coverage rules." Receiving records transmitted from a hospital about an established patient's recent admission. potential discrepancies in the patient's past medical history. Which action should EHR specialist make? Correct Answer Reconcile the patient's hospital record with the office record. Speaking with clinical staff who are concerned about limited number of computer workstations, resulting in delays in data entry. Which statement? Correct Answer Access the EHR through mobile devices. (Similar q/a computer, input/output devices) Assisting in searching for data in patient record. "ankle injury" no entry identified, located "ankle sprain" "twisted ankle". or searching for heart transplants template

reconciled by using. Which type of data? Correct Answer Coded data Which data type exchange between facility and diagnostic lab can generate visual representation of trends in lab results over time? Correct Answer Fielded and Coded data Which EHR tool documents a provider adding comments for increasing the specificity of physical examination findings? Correct Answer Free-text box Importing transcribed encounter notes that were dictated the previous day. Which data format would these notes be saved? Correct Answer Text files (provide current narrative) When generating admission documentation for patient. Which information is entered in the legal data section of EHR? Correct Answer Advance Directives (Not emergency contact) A facility's software reflects a change in patient's baseline platelet count. Which methods of notification does the software use to inform the provider? Correct Answer An automatic alert message (Similar q/a Known medical allergies) EHR specialist should identify that which process for converting text into code for secure transmission? Correct Answer Encryption

Assisting facility implementing a recent upgrade to EHR system. Which question would be the best to ask in preparation for Implementation? Correct Answer "What is the timeline for these changes?" Receiving a phone call from established patient with multiple chronic conditions thinks they have pneumonia and would it affect any other conditions. Which sections of record would chronic condition be located? Correct Answer Problem list (ex. patient seen in urgent care following leg injury question Similar answer/q) Accessing the results of a patient's MRI. Which radiology department software is used to store diagnostic images? Correct Answer Picture archiving and communications system (PACS) (Not radiology RIS) Which information is required from a prescribing provider to complete an electronic laboratory order? Correct Answer Diagnosis code A provider at an inpatient facility is reviewing pending tasks and messages through the EHR 's message feature. Which task is most important? Correct Answer Signing a history and physical for patient admitted 36 hr ago. or Completes history and physical within 24hr after admission.

Which patient identifiers should the EHR specialist verify before documentation is entered into an EHR? Correct Answer Patient's medical record number Which data information should be obtained during a patient's history and physical exam to be included in history section? Correct Answer Benign colon polyps (Not laceration,respitory rate,disoriented time) Which statements to make regarding e-prescribing feature of EHR? Correct Answer "A renewal authorization can be transmitted" or "E-prescribing helps decrease medication errors" (Similar q/a) Preparing to perform a statistical review of infection rates at a facility for quality improvement purposes. compare data with other facilities. The EHR system should be integrated with which of the following? Correct Answer Clinical Decision Support System (CDSS) uses Protocols to present provider with therapies for documented diagnoses A new medical group hires a privately owned information technology company to manage IT operations. Which action ensures the IT company will maintain security of all data transmissions? Correct Answer Enter into a business associates contract with IT contractors. (NOT review company record) Preparing to obtain information about patient outcomes by individual providers for quality improvement. Which action

to collect necessary info? Correct Answer Generate an electronic clinical report using patient records from EHR Creating a report about patient health outcomes with specific diseases. Which tool is specialist using? Correct Answer Clinical quality measures (CQM) Training clinical coders about how to use a new clinical encoder software program. Which should EHR specialist include as a benefit of program? Correct Answer "Helps coding professionals navigate coding pathways" Which occurs when a provider enters an imaging order while documenting in an encounter note? Correct Answer The order is automatically documented in the visit. Instructing the parent of a pediatric patient about education feature in patient portal. parent "How do I send this information to my child's step-parent?" Correct Answer Demonstrate how to send information from patient portal. In which section should an EHR specialist look to find a patient's most recent weight measurement? or Which section to enter blood pressure? Correct Answer Physical examination Which statement by EHR support staff about the use of templates for provider documentation is correct? Correct Answer "Templates can be customized to work with each providers workflow."

Working to create a schedule that limits contact between sick children and healthy children by scheduling well-child visits in mornings and sick visits in afternoons. Which method of scheduling is used? Correct Answer Cluster scheduling (NOT wave, open hrs, modified wave) To increase efficiency of health organization. Which is part of a successful overlapping schedule? Correct Answer Determining the type of appointment Which document is received by health care organization from the insurance carrier after a claim has been processed? Correct Answer Remittance advice (RA) Sending referral records securely. "what if I get called away while working and forget to close the chart?" Response: Correct Answer "it has a security feature. if you step away automatic log out" Assisting records clerk with handling of removable media device containing PHI. Which action to tell the clerk preventing a security risk? Correct Answer Remove protected health information from the device. (NOT make a copy to move) Scanning an image to patient's medical record prior to scheduled appointment using office scanner connected to desktop by USB. At appointment the provider is unable to find image. Which likely caused? Correct Answer The image was incorrectly cataloged.

Which statement made by EHR specialist describes a function of EHR system? Correct Answer "it streamlines the clinician's workflow" Which example of data backup method that is HIPAA complaint and allows for the recovery of data in natural disasters? Correct Answer Maintaining severs that are off site in a different region. Which method should EHR specialist use to make changes or corrections to entries in EHR? Correct Answer Write an addendum to the existing entry. (with a Date, initials, strike line) Medical office receives an imaging report via fax machine and EHR specialist scans it into patient's record. This is an example of which data collection? Correct Answer Manual (Not interfacing, automated,) A provider orders a laboratory test in the EHR. Which describes the way laboratory specimens are labeled and tracked? Correct Answer Labels are automatically printed at the point of care as part of the requisition process. Reading a provider progress note "Patient diagnosis:Lymphoma, Received six rounds of chemotherapy beginning June 2020. Patient reported diarrhea, loss of appetite, and fatigue with treatment. Last cycle of chemo was administered Nov. 2019; now in remission" Which action should EHR specialist take?

Correct Answer Query the provider to resolve the discrepancy. Assisting clinical coder with code verification and notes that there is insufficient information to support diagnosis coding. Which action should specialist instruct coder to request additional documentation from provider? Correct Answer Send a provider query. Assisting medical assistant with entering a patient's ongoing temperature measurements into the EHR. The EHR specialist should document result in which location? Correct Answer Flow sheet Which function allows coders to query health care providers for clarification during a patient's inpatient hospitalization? Correct Answer Concurrent coding Assisting a clinic nurse with data entry related to well-baby check-up. When entering weight into record it is understood that data would result in which type of documentation? Correct Answer Growth chart Information about patient weight control. Which format is most useful for visual representation of weight fluctuations over timeframes? Correct Answer a graph sheet (not table, progress note, pe template) Assisting with providing user training to staff members regarding an upgrade to EHR. Which statement to maker when asked about way to help minimize number of

patients who miss their scheduled appointments? Correct Answer "An automated confirmation of appointments may be set in EHR system." Which statement correctly deidentifies a patient's information when speaking to pharmaceutical representative about coverage for new meds heartburn? Correct Answer "Our facility has patient who is indigent and has stomach problems who could benefit from this medication." Providing patient with information about patient portal. Which statement indicates patient's understanding of portal? Correct Answer "I can schedule my own appointments." Assisting with check out. patient says"I hope I can remember everything about this new medication." Response: Correct Answer " Before you leave let me show you where to find this medication education on patient portal." Discussing hardware costs with the department controller. Which statement by department describes advantage purchasing server hardware for LAN? Correct Answer "Dedicated servers for LAN ensure safe exchange of data between workstations." Patient with occupational injury covered under worker's compensation. Collect proof identity and demographics. Which additional info to request? Correct Answer A

medical service order (Not docters's report, consent to release form) Sending data that includes PHI for research to local health facility. Which data must be de-identified? Which is required for research authorization template? Correct Answer Laboratory work request (Similar q/a:To whom is it disclosed) In Which ROI scenario would accounting of disclosures log be used? Correct Answer When worker's compensation insurer requests the records of injured worker In which of the following areas of the EHR should a patient's progress notes be recorded? Correct Answer Clinical An EHR specialist is training a newly hired staff member when a patient who is receiving inpatient care dies. Which of the following terms should the EHR specialist tell the staff member to enter into the patient's EHR for discharge disposition? Correct Answer Expired During a pediatric clinic visit, a patient's parent tells a staff member that the family has recently moved. Which of the following sections of the EHR should an EHR specialist update with the new address? Correct Answer Administrative

An auditor is reviewing the medical record of an adult patient who is 6 feet tall and has a diagnosis of obesity. Which of the following notes in the patient's EHR would constitute a data discrepancy? Correct Answer "Patient weight is 56.7 kg (125lbs)." An office manager needs to ensure schedules are aware of a provider's vacation days to avoid errors in patient scheduling and disruption of the workflow. Which of the following actions should the office manager take? Correct Answer Record the provider's vacation days on the schedule as nonpatient appointments A marketing department receives records for marketing purposes from an EHR specialist. Which of the following information should the EHR specialist have de-identified on the documents before releasing them to the marketing department? Correct Answer Patient medical record numbers An EHR specialist answers a query originating from the patient portal that states, "Where can I find the outstanding balance I owe for my surgery?" To which of the following sections within the patient portal should the EHR specialist direct the patient? Correct Answer Billing Which of the following functions can an EHR specialist perform while in a typical electronic scheduling module? Correct Answer Rescheduling patient appointments to a different day

A patient brings a copy of a recent hematology result to their first visit with an oncologist and gives the document to an EHR specialist. Which of the following actions should the EHR specialist take? Correct Answer Scan the document into the patient's EHR An EHR specialist is explaining to a patient about the process for accessing the patient portal. The EHR specialist should instruct the patient to use the provided username and which of the following other items to gain entry into the portal? Correct Answer Access code An EHR specialist is assisting with moving a provider's office into a new building. To which portion of the Device and Media Controls standard is the EHR specialist adhering when creating a record of hardware and media to move? Correct Answer Accountability An EHR specialist notes that a patient has a different MRN in the EHR than the organization's administrative database. Which of the following actions should the EHR specialist take? Correct Answer Report the discrepancy to a supervisor Which of the following methods should an organization use to disseminate new information to staff members about changes to implement due to an upgrade to the EHR general compliance software? Correct Answer Conducting a training session for staff members

Which of the following actions ensures that a digital image imported from a fax machine with scanning capabilities is linked to the correct patient in the EHR? Correct Answer Cataloging the image Which of the following information about a patient should an EHR specialist match with the patient's name to verify the patient's identity before entering information into the EHR? Correct Answer MRN An EHR specialist receives a patient prescription stating, "Give Aspirin 81 mg PO QD." The EHR specialist confirms the prescription with the provider and reconciles the information to read as which of the following in the patient's medical record? Correct Answer Aspirin 81 mg PO daily When generating admission documents for a patient, which of the following information should be entered into the EHR under the administrative section? Correct Answer Emergency contact An EHR specialist has obtained medical records from an institutional database, and the data needs to be integrated into a patient's EHR. Which of the following information should the EHR specialist use to identify the patient before integrating the data? Correct Answer DOB Which of the following would be helpful to a health care organization when initiating inventory tracking of e-

signature pads? Correct Answer Universal Medical Device Nomenclature What type of data should an EHR specialist reference to determine which patients are covered by a specific insurance carrier? Correct Answer Financial Which of the following medical record review findings indicates upcoding of clinical documentation in the EHR? Correct Answer Using a CPT code that yields a higher reimbursement than what was documented Which of the following components of a SOAP note would pull in real-time results from the EHR? Correct Answer Objective An EHR specialist is speaking with a patient who states, "I don't know where to access education materials about my disease." Which of the following responses should the EHR specialist make? Correct Answer "You can access patient education materials using the patient portal." An EHR specialist in a clinic is assisting a patient with documenting past medical, social, and family history. The patient completing the electronic questionnaire asks, "Where do I include drug use?" The specialist should reply that drug use should be documented in which of the following social history components? Correct Answer Recreational use

Which of the following public health objectives involves securely transferring data and information related to cases of measles to public health care agencies (PHAs)? Correct Answer Reportable laboratory results Which of the following forms of data capture should be identifies as demographic information? Correct Answer Marital status A nurse asks an EHR specialist for help to locate the education sheets for smoking cessation in the EHR. Which of the following patient education forms should the EHR specialist suggest? Correct Answer CDC: COPD Are You at Risk? Which of the following coding techniques allows an EHR specialist to review clinical documentation while the patient is actively receiving treatment? Correct Answer Concurrent coding An EHR specialist is providing support for computerized provider order entry (CPOE). A provider asks, "Where should I document my treatment instructions and ordered tests?" Which of the following statements should the EHR specialist make? Correct Answer This can be documented in the plan details of the SOAP note Which of the following automatically assigns the appropriate diagnosis and procedure codes based on clinical documentation in the EHR? Correct Answer Computer-assisted coding

In which of the following history sections of the EHR would a patient's history of alcohol use be documented? Correct Answer Social Which of the following types of clinical data can be ordered during a patient visit in the CPOE workflow? Correct Answer Laboratory testing A compliance director asks an EHR specialist to verify that a patient has received information on privacy practices. To which of the following forms should the EHR specialist navigate in the EHR? Correct Answer HIPAA consent form Which of the following sections of the EHR should and EHR specialist review to obtain a patient's influenza vaccine status? Correct Answer Immunizations An EHR specialist is assisting a provider with navigating the EHR system to accept a patient from one health care provider to another. Under which of the following types of permitted disclosures is the provided retrieving the patient data? Correct Answer Treatment When reviewing history and physical templates, the review of systems includes which of the following components? Correct Answer Constitutional systems An EHR specialist is preparing to share a secure spreadsheet containing patient heart information from a Holter monitoring device with the provider. Which of the

following actions should the EHR specialist take to protect the information? Correct Answer Share the spreadsheet password with the provider Which of the following actions would generate a real-time alert message in the EHR? Correct Answer The provider enters a prescription for a duplicate therapy An EHR specialist is providing support for a provider who is entering prescriptions into a patient's chart using a new EHR system. The provider asks the EHR specialist which pharmacy will automatically receive the prescriptions. How should the EHR specialist respond? Correct Answer The patient's preferred pharmacy must be entered An EHR specialist is training providers on required clinical documentation in the hospital setting. A provider asks, "How can I make sure to include all relevant data elements?" Which of the following statements should the EHR specialist make? Correct Answer Use a progress note template Which of the following actions by a staff member should an EHR specialist identify as a threat to the security of PHI? Correct Answer Using public internet access Which of the following penalties does Medicare impose when providers have not implemented certified EHR technology? Correct Answer They can no longer receive the full reimbursement for services