CHAA Exam Reading Guide
Future Development - Part II
Pages 113-122
1. Key Performance Indicators help an organization define and measure progress toward organizational ______. KPI’s must be quantifiable (______) measurements, agreed to ______, that reflect the critical ______factors of an organization.
2. There are a number of KPIs involved in the healthcare ______. In the past, hospitals tended to focus their efforts at the end of the cycle (on billing and collection). But most revenue cycle problems originate early on when the hospital is ______and ______patient information needed to ensure a clean claim. Therefore, hospitals have shifted their focus on ______processes to help ensure problems do not arise in the first place.
3. Lack of alignment between ______and ______functions is a leading cause of revenue-cycle problems for many hospitals. Proper alignment and focus on ______, ______, and ______functions will positively affect revenue-cycle results as monitored by KPIs.
4. The following Key Performance Indicators generally monitored in patient access are:
a. Pre-registration ______
b. Scheduling and arrival ______
c. ______rate
d. ______/POS ______
e. ______dollars
f. ______/______satisfaction
5. The following KPIs are generally monitored for various departments in the revenue cycle:
a. Days in ______Receivable/ A/R Days
b. Total ______collections
c. ______(DNFB)
d. ______claims/______claim percentage
e. ______percentage
f. ______balances
g. ______to collect ratio
h. ______expense
i. ______expense
6. Performance Improvement Methods are used in the act of incrementally (small steps) exceeding the expectations or requirements of a process through continual ______and ______.
7. FOCUS – PDCA
a. F – ______a process improvement opportunity
b. O – ______ a team who understands the process
c. C - ______ the current knowledge of the process
d. U – ______the root cause of the poor outcome
e. S – ______the ‘P- D- C-A’ cycle
i. P- ______
ii. D- ______
iii. C- ______
iv. A- ______
8. Six Sigma is a process blending ______wisdom with proven ______tools. The ultimate goal is to create ______for the customer and provider. It measures ‘defects’ and attempts to eliminate them to get as close to “______” as possible. A defect is defined as failing to deliver what the ______/______wants.
9. Lean focuses on eliminating ______-______added steps and activities in a process.
10. Process Reengineering is an improvement technique that involves the fundamental rethinking and radical ______of business processes to achieve ______improvements. Its goal is to be ______(extreme); ______(not incremental); and ______(non-traditional).
11. Performance Improvement Tools include ______and ______maps.
12. ______is a graphical representation of activities that make up a process. By identifying each step in a process, you can analyze and possibly improve it.
13. ______is a graphical picture of the actual workflow of a company. This helps clarify who is responsible for a step or task in the process.
14. Patient Access Training Models for patient access staff are: ______computer training; ______classroom training; ______to ______training; CBT ______; Self ______; ______Playing; ______.
15. Patient Access Training Modules help staff learn various systems and processes. Helpful topics are: Computer ______training; ______Service Standards; ______verification; Pre- ______; ______patient liability; overview of healthcare ______; ______/Medicaid; ______Care; ______Cycle Operations; ______Terminology; ______; Regulations such as ______, ______, etc.
16. Due to the complexities of the content, most training should be conducted in a ______with ______systems and role playing. After training, competence should be demonstrated though ______and ______exams. ______will assist in identifying additional training needs or areas of focus.
17. A standardized requirement for an employee to properly perform a specific job is known as ______. It encompasses knowledge, ______, and ______utilized to improve performance. It is the state or quality of being adequately ______to perform a specific role.
18. The two types of Competencies are B______and T______. ______competencies include registering, verifying, calculating deposits, etc and are typically learned in an ______environment or on the job. ______competencies are adaptability, decisiveness, integrity, dealing with pressure, etc and are learned though ______experiences and our ______patterns.
19. ______competencies encompass knowledge, skills, attitudes, and actions that distinguish ______performers; identify behaviors that enable employees to achieve ______performance; and provide a ______to understanding how to achieve success as a patient access associate.
Label the following as either a Behavioral Competency (BC) or a Technical Competency (TC):
20. ______Knowledge of regulatory standards such as EMTALA, HIPPA, etc
21. ______Knowledge of basic CPT/ICD coding
22. ______Uses time wisely and knows how to prioritize tasks accordingly and accomplish several tasks at once.
23. ______Proficient at using Microsoft Word, Excel, and PowerPoint
24. ______Pays attention and understands when others are talking. Gives the patient nonverbal and verbal signs they are listening.
25. ______Able to stay calm and professional and maintain a positive manner during difficult or stressful situations.
26. ______Knows and understands medical/insurance terminology and requirements
27. ______Able to work without close supervision by ensuring that tasks are finished on time without error and up to quality standards.
28. ______The ability to develop, maintain, and strengthen partnerships with others inside or outside the organization
29. ______Identifies what needs to be done and does it before being asked or the situation needs it.
30. ______Possesses good writing and verbal communication skills