Week 6 Exam

Question 1

the process of identifying and defining the problem; determining what happened to cause it; and identifying what steps or possible solutions will be necessary to resolve it

Answer 1

problem solving

Question 2

the process of choosing among several alternatives

Answer 2

decision making

Question 3

what are the 5 steps in the decision making process?

Answer 3

1. problem identification
2. problem analysis
3. criteria establishment
4. alternative development and decision making
5. problem solution and feedback

Question 4

what are the 5 principles of LEAN?

Answer 4

1. identify value
2. map the value stream
3. create flow
4. establish pull
5. seek perfection or continuous improvement

Question 5

a LEAN manufacturing tool that helps to clean and organize the workplace, as well as improve how things are done through standardization

Answer 5

5S System

Question 6

what are the components of a 5S System

Answer 6

1. sort
2. simplify
3. shine
4. standardize
5. sustain

Question 7

comparing measures of process against those of recognized leaders in the field and how it measures up to the standard set by those leaders. Typically has 4 categories

Answer 7

benchmarking

Question 8

what are the 4 categories of benchmarking?

Answer 8

cost effectiveness, staff productivity, process efficiency, time cycle

Question 9

developing ideas for creative problem solving. Objective is quantity not quality of ideas

Answer 9

brainstorming

Question 10

pairs of numerical data with one variable on each axis, to look for a relationship between them. if the variables are correlated, the points will fall along a line or curve. the better the correlation, the tighter the points will hug the line

Answer 10

scatter diagrams

Question 11

brainstorming activity that encourages participants in a discussion to look at an idea from more than one viewpoint. a valuable development of the pros and cons technique.

Answer 11

PMI - plus/minus/interesting

Question 12

this is a visual way to look at cause and effect relationships which helps identify root causes of a problem

Answer 12

a fishbone diagram

Question 13

these are maintained by local, county, state, or federal entities. these profits are held by the entity to further its cause. Exist to provide a service such as “healthcare.” these operate as a non-profit

Answer 13

public sector labs

Question 14

privately held and its profits are distributed to the owners and its primary purpose is to generate revenue. “ for- profit”

Answer 14

private sector labs

Question 15

process of planning, controlling, and evaluating available fiscal, material and personnel resources of an organization

Answer 15

financial management

Question 16

a manager should be familiar with the basic accounting, economic, and financial principles, and their relationship to laboratory operations. this is how to….

Answer 16

maintain success

Question 17

the analysis of cost and revenue data that provides information on operations and budgeting for managers.

Answer 17

managerial cost accounting

Question 18

the process of determining the actual cost of performing a billable procedure

Answer 18

micro costing

Question 19

fixed, variable, or semi-variable or mixed cost that may coincide with test volume

Answer 19

cost behaviors

Question 20

includes all costs directly related performing the test. cost considers the test volume

Answer 20

direct cost

Question 21

includes expenses that are part of doing business, but not directly related to the cost of the test being evaluated (all non-labor expenses, not test volume)

Answer 21

indirect cost

Question 22

defined as the cost of providing a billable procedure

Answer 22

expense

Question 23

a test that is billed to a payer

Answer 23

billable

Question 24

contributes to the generation of a billable test result, but which is not directly reimbursable

Answer 24

non-billable

Question 25

defined as the price of services rendered. it is the amount charged for a test or service

Answer 25

revenue

Question 26

refers to the hospital, the outpatient department, the physician or healthcare professional who furnishes care to the patient

Answer 26

provider

Question 27

refers to the government agencies and other public sources of funds: Trumpcare or Obamacare

Answer 27

payer

Question 28

refers to agencies such as blue cross and other commercial insurers

Answer 28

private payers

Question 29

people who do not have any other type of insurance

Answer 29

self payers

Question 30

amount charged by the insurer to insure against specific risks

Answer 30

premiums

Question 31

represents the amount the insured must first pay before benefits are payable

Answer 31

deductibles

Question 32

the proportion of the total medical costs, or a pre-determined dollar amount that the insured must pay out of pocked each time health services are received after the deductible has been paid

Answer 32

co-payments

Question 33

means providing healthcare services within a network of healthcare provide4rs

Answer 33

managed care

Question 34

a patient classification system initially developed to evaluate quality and resource consumption in a hospital setting

Answer 34

diagnostic related groups

Question 35

DRGs are used to reimburse hospital costs for medicare patients for..........

Answer 35

part A services (not physician services)

Question 36

what does ICD stand for?

Answer 36

international classification of diseases

Question 37

A doctor used the DRG system for services but used CPT coding to be reimbursed for all the labs they ordered for the patients hospital stay

Answer 37

physician reimbursement (Part B care)

Question 38

what does CPT stand for?

Answer 38

current procedural terminology

Question 39

what are the 3 relative value units that each code has?

Answer 39

work practice expense or overhead malpractice expense

Question 40

what do the ICD-10 and CPT codes justify?

Answer 40

the medical necessity of treatment and lab tests ordered

Question 41

used to pay hospitals for inpatient services

Answer 41

DRGs

Question 42

used to calculate pay to physicians for inpatient and outpatient visits and services

Answer 42

RBRVs

Question 43

to pay hospitals for outpatient services and emergency room care

Answer 43

APCs

Question 44

what are the 3 payment methodologies

Answer 44

DRGs, RBRVs, APCs

Question 45

prospective payment agreement between an insurance plan and provider (HMO policy)

Answer 45

capitation

Question 46

in patient care may be reimbursed on a per diem or per day basis

Answer 46

per diem

Question 47

reimbursement on a per case basis similar to the federal prospective payment system

Answer 47

per case

Question 48

certain types of care will be carved out of the set reimbursement amount

Answer 48

carve out

Question 49

what are computer systems composed of?

Answer 49

hardware, software, and tools for data entry and retrieval

Question 50

connected to mainframe computer forming the hospital information systems

Answer 50

servers

Question 51

allows communication between servers for different data management systems and between lab instruments and LIS software

Answer 51

interface software

Question 52

an internationally recognized program and the only one of its kind that utilizes teams of practicing laboratory professionals as inspectors

Answer 52

CAP

Question 53

improve patient safety by advancing the quality of pathology and laboratory services through education, standard setting, and ensuring laboratories meet or exceed regulatory requirements

Answer 53

the goal of CAP

Question 54

American Society of Clinical Pathologists (ASCP) established

Answer 54

1922

Question 55

first chemistry survey conducted CAP cooperates in American Medical Association blood bank survey

Answer 55

1949

Question 56

-first bacteriology survey conducted -national registry of forensic pathology founded with CAP support -college sends brochure on cytology to all US physicians first model laboratory operated at regular American Medical Association meeting

Answer 56

1958

Question 57

online surveys educational enhancements launched

Answer 57

2004

Question 58

what is the group decision-/making model approach? plan, do check, act. internal and external customers are taken into consideration

Answer 58

shewart cycle of management

Question 59

which process improvement technique cuts waste, makes work easier and simplifies system. also eliminates non value added steps to improve efficiencies?

Answer 59

LEAN

Question 60

which process improvement technique uses define, measure analyze, improve, control?

Answer 60

Six sigma DMAIC methodology

Question 61

tracking the path or a person on paper who are performing tasks. this step by step documentation is a visual creation of the flow and describes than actual activities, distance from the last step, estimated task time, observations, and return rate.

Answer 61

standard work chart (spaghetti diagram)

Question 62

amount of money and schedule when it is paid

Answer 62

cash flow

Question 63

what is the formula for cost per test?

Answer 63

fixed cost + variable cost / # of test run

Question 64

what does DRG stand for?

Answer 64

Diagnostic related groups

Question 65

wjat does RBRVs stand for?

Answer 65

resource based relative value scale

Question 66

what does APCs stand for?

Answer 66

ambulatory payment categories

Question 67

with a new LIS do all SOPs need to be updated?

Answer 67

YES

Question 68

electronic devices must be equipped with security measures to prevent

Answer 68

hacks patient privacy HIPPA prevent access by unauthorized users

Question 69

how often does cap give inspection?

Answer 69

2 years

Question 70

CVP

Answer 70

cost, volume,profit

Question 71

formula for CVP

Answer 71

total fixed cost / contribution margin test