The process of evaluating the benefits and barriers of a program, including assessing any political, operational, and resource-related issues, is described by which of the following terms?

The CDI program manager is responsible for creating and maintaining the department policies and procedures that include the industry guidance from DOJ, OIG, and the Cooperating Parties. What is one question to ask when designing compliance policies and procedures?

A focused case review should be conducted as part of the outpatient CDI assessment. Which of the following is commonly identified as an outpatient clinical documentation area of opportunity that could be the subject of a focused case review?

As part of the CDI implementation plan, data analysis and audit are conducted to identify areas of focus around claims submission, such as coding errors due clinical documentation gaps or inaccurate code assignment. Which of the following types of analysis can assist in correcting compliance issues identified?

Often charge capture errors occur because the description is misinterpreted and an incorrect service item is selected. What is the root cause of this issue?

The act that provides healthcare coverage for eligible children through the Medicaid and Children’s Health Insurance Programs administered by the states based on federal requirements is:

The benefits of an outpatient CDI program are far reaching and include more accurate reimbursement and procedure code and APC assignment as well as decreased denials, decreased AR days, and __________.

The OIG has developed a series of guidance documents for voluntary compliance programs in hospitals, small group physician practices, and third-party medical billing companies. This guidance recommends that organizations self-audit claims to ensure which of the following standards is met?

A patient taking phenytoin for seizure management reports gingival hyperplasia and unsteady gait. What should the nurse do next?

The skill sets and qualifications of the outpatient clinical documentation specialist include knowledge of the vast array of disease and procedure classifications, technology solutions, quality measurement programs in the ambulatory healthcare industry today, and what other subject area?