HIM Practice Questions and Project Planning Review

Vocabulary-style flashcards covering project planning tools, data visualization techniques, hospital billing status indicators, and healthcare statistics based on the HIM practice questions lecture.

Gantt Chart

A planning technique providing a visual timeline of tasks against a calendar where bars show when each task starts and ends, but it does not map out task dependencies as a network.

Flowchart

A tool used to map the steps and decision points of a repeatable process laid out from start to finish, used to help team members understand how a process runs.

Pie Chart

An illustrational technique used to show how parts make up a whole, such as the percentage of denials by reason, but does not involve sequencing or scheduling.

PERT Chart

A network diagram planning technique, also known as Program Evaluation and Review Technique, that identifies the sequence of activities, their projected durations, and the critical path.

Benchmark

A single reference point or target used to compare performance against a peer hospital or industry standard; it is not a live view.

Dashboards

A tool that pulls several key metrics onto one screen (gauges, small charts, and indicators) to provide real-time data that can be monitored at a glance.

Pareto Chart

A tool used to rank problems by frequency of occurrence to identify the few causes accounting for most of the trouble, following the "$80/20$" rule.

Line Graph

A graphic technique used to track one continuous measure across consecutive time periods, such as years or months, to make trend direction visible at a glance.

Histogram

A graphic used to see how values are distributed across ranges, such as patient age groups, rather than showing change over time.

Scatter Diagram

An analysis tool used to see whether two variables are related, testing for correlation (e.g., hours worked vs. error rate).

Force-Field Analysis

A technique used to weigh forces pushing a change forward versus forces resisting it before deciding how to implement something new.

Status Indicator

A single letter tag next to each $CPT$ or $HCPCS$ code on an outpatient hospital bill that tells Medicare's payment system the specific rule for how to pay that line.

Status Indicator "V"

Indicates a clinic or $ER$ visit that is always paid at $100\%$.

Status Indicator "S"

Indicates a significant procedure that stands on its own and is always paid at $100\%$.

Status Indicator "X"

Indicates an ancillary service, such as an $X-ray$ or lab test, that is always paid at $100\%$.

Status Indicator "T"

Indicates a significant procedure subject to discounting; the highest-paid code is reimbursed at $100\%$, while additional "T" codes on the same visit are usually discounted to $50\%$.

Fixed Percentage Random Sample

An audit method where work output is multiplied by a set percentage (e.g., $5\% \text{ or } 0.05$) to determine the number of records needed for quality review.

Fishbone Diagram

Also called an Ishikawa or cause-and-effect diagram, it organizes contributing factors into major branches (People, Process, Policy, Technology, Environment) to identify the root cause of a problem.

Average Daily Census

The total number of inpatient service days divided by the number of days in the period ($\frac{\text{Total Inpatient Service Days}}{\text{Number of Days in Period}}$).

Case-Mix Index (CMI)

The average relative weight per discharge, calculated as the $\frac{\text{sum of relative DRG weights}}{\text{number of discharges}}$.

APC (Ambulatory Payment Classifications)

A system that groups $CPT/HCPCS$ codes that are clinically and resource-similar; one encounter may have multiple codes but fewer distinct $APCs$ if codes share categorization.

Time Ladder

A distractor answer choice that is not a standard, recognized $HIM$ monitoring tool in real practice.