18 Reporting & Data Quality Practice Questions & Answers

1. 1. A physician asks for a one-time list of every patient aged 65 or older who carries a diabetes diagnosis and has no A1c result recorded in the past 12 months. No report on the system's menu produces this list. What should the EHR specialist do?

   • A.Run the standardized patient roster and mark the qualifying patients by hand
   • B.Build an ad hoc report with the fields, filters, and date range requested✓ Answer
   • C.Submit the request to the public health registry that tracks chronic disease
   • D.Export the full patient list and let the physician filter it in a spreadsheet

   A request that the existing report menu cannot answer, and that is not a recurring need, calls for an ad hoc (custom) report: the user selects the specific record fields, the criteria that define the population, and the date range. Standardized reports have pre-defined content and layout, so they cannot be reshaped to answer a new question.

   Source: NHA CEHRS Test Plan, Reporting (generating ad hoc clinical reports using EHR fields)Report a problem with this question

2. 2. A practice manager needs the same summary of outstanding balances at the close of every month, in the same format, so results can be compared period to period. Which approach fits this need?

   • A.Run the system's standardized month-end report on the same schedule each period✓ Answer
   • B.Design a new custom report each month using whichever fields seem relevant then
   • C.Export the raw transaction table and reformat it manually every month
   • D.Have each biller tally the outstanding balances by hand and combine the lists

   Standardized (canned) reports have pre-defined fields and layout and can be run on demand or on a fixed schedule, which is what makes the numbers repeatable and comparable from one period to the next. Rebuilding a custom report every month risks changing the underlying definitions, so the months would no longer measure the same thing.

   Source: NHA CEHRS Test Plan, Reporting (running standardized financial reports)Report a problem with this question

3. 3. What most clearly distinguishes an ad hoc report from a standardized report?

   • A.An ad hoc report always contains identifiable patient data; a standardized one never does
   • B.An ad hoc report is stored outside the record system; a standardized report inside it
   • C.An ad hoc report may be run only by a supervisor; a standardized report by any user
   • D.An ad hoc report is built for a specific request, with the user choosing fields and criteria✓ Answer

   An ad hoc report is a custom, query-based report built on request for a non-recurring question, in which the user selects the fields, filters, date range and sort order; a standardized report is a pre-built template with fixed content. Ad hoc reporting is a legitimate routine function, and it is not defined by who may run it or by whether the output happens to contain identifiable data.

   Source: NHA CEHRS Test Plan, Reporting (methods to generate reports: queries, standardized reports, custom reports)Report a problem with this question

4. 4. A manager asks for "our no-show rate for last quarter." Before building the ad hoc report, which decision most determines whether the resulting number is meaningful?

   • A.Running the report on two different days to confirm the system is stable
   • B.Sorting the finished report by provider so the busiest schedules appear first
   • C.Defining the population precisely before building the report✓ Answer
   • D.Adding every available appointment field so that no information is left out

   A rate is a numerator divided by a denominator, so the answer changes entirely depending on whether cancelled, rescheduled or same-day appointments sit in the denominator and on what the practice counts as a no-show. Those definitions must be settled before the report is built; layout, sorting and re-running the report do not make an ill-defined number valid.

   Source: NHA CEHRS Test Plan, Reporting (generating ad hoc reports using EHR fields); CMS Measure Management System, measure population definitionsReport a problem with this question

5. 5. A practice manager wants to identify claims that have gone unpaid long enough to risk a timely-filing denial. Which standardized financial report is designed for that?

   • A.A guarantor report, which groups outstanding balances by the party financially responsible
   • B.A carrier report, which groups outstanding balances by the insurance plan responsible
   • C.An aging report, which groups outstanding balances by how long they have gone unpaid✓ Answer
   • D.A cost of procedures report, which groups charges by the service that was performed

   An accounts receivable aging report sorts outstanding balances into standard buckets by age — current, 31 to 60 days, 61 to 90, 91 to 120, and beyond — so staff can see which claims are drifting toward a filing or collection limit. The carrier, guarantor and cost reports slice the same receivables by a different attribute and say nothing about how old a balance is.

   Source: NHA CEHRS Test Plan, Reporting (types and requirements of financial reports: aging)Report a problem with this question

6. 6. A report lists account balances by financial guarantor. For a minor treated at the clinic, whose name appears as the guarantor on that report?

   • A.The party who accepted financial responsibility for the account✓ Answer
   • B.The rendering provider, because that provider generated the charges
   • C.The minor patient, because the services were rendered to that patient
   • D.The insurance carrier, because it pays the largest share of the balance

   The guarantor is the person who accepted financial responsibility for the account, which is not necessarily the patient — for a minor it is typically a parent or legal guardian. A guarantor report therefore groups balances by the responsible party so statements and collection follow-up reach whoever actually owes the money.

   Source: NHA CEHRS Test Plan, Reporting (financial guarantor reports)Report a problem with this question

7. 7. A practice administrator requests a relative value unit (RVU) report. What does that report measure?

   • A.The volume of work each provider performed, expressed in a payer-neutral unit✓ Answer
   • B.The share of practice revenue collected from each insurance carrier in the period
   • C.The average time patients spend waiting before they are seen by a provider
   • D.The balance each patient still owes after the insurance payment has been posted

   Relative value units express the resources a service consumes — physician work, practice expense and malpractice components — in a unit that does not depend on what any particular payer reimburses. An RVU report is therefore a productivity tool for comparing provider workload, not a statement of what a patient or a carrier owes.

   Source: CMS Medicare Physician Fee Schedule, relative value units (work, practice expense, malpractice); NHA CEHRS Test Plan, ReportingReport a problem with this question

8. 8. Under a prospective payment system, how is the payment amount for an episode of care determined?

   • A.A predetermined amount is paid for the episode regardless of the actual cost incurred✓ Answer
   • B.Each service is paid separately at the charge amount the provider submitted for it
   • C.The patient is billed the difference between the total charges and the allowed amount
   • D.The amount is calculated after discharge from the itemized supplies and services used

   A prospective payment system pays a rate set in advance for a classified episode or encounter, so the payment is fixed whether the actual cost of care runs above or below it, and the financial risk sits with the facility. That is the opposite of fee-for-service, where each item billed generates its own payment.

   Source: CMS Prospective Payment Systems (Medicare Learning Network); NHA CEHRS Test Plan, ReportingReport a problem with this question

9. 9. A clinic wants to reach out to every patient carrying a hypertension diagnosis who has not been seen in more than a year. Which standardized clinical report supports that outreach?

   • A.An immunization status report showing the vaccines recorded for each patient
   • B.A diagnosis-based patient registry showing patients with the condition and last visit date✓ Answer
   • C.A provider productivity report showing the encounter volume for each clinician
   • D.A procedure log showing the services that were performed during the reporting period

   Clinical reports sliced by diagnosis build a condition registry, which is the standard tool for recall lists, closing care gaps and maintaining continuity of care for chronic disease. Generating and using such a list for treatment and health care operations is a permitted use of protected health information and needs no separate patient authorization.

   Source: NHA CEHRS Test Plan, Reporting (standardized clinical reports by diagnosis supporting continuity of care)Report a problem with this question

10. 10. While verifying a clinical report before distribution, an EHR specialist notices several laboratory values flagged outside the reference range. What is the appropriate action?

    • A.Remove the abnormal rows so that the provider reviews only the expected results
    • B.Confirm the report is complete and accurate, then route it to the provider✓ Answer
    • C.Call the affected patients to discuss the findings and schedule follow-up visits
    • D.Add a note to each affected chart explaining what the abnormal values indicate

    The EHR specialist's role in reporting is to extract, verify, format and distribute data, while interpreting clinical results and deciding what they mean for a patient belongs to the licensed provider. Editing the report to drop rows would also destroy the accuracy the verification step exists to protect.

    Source: NHA CEHRS Test Plan, Reporting (verifying accuracy of generated reports; EHR specialist scope of practice)Report a problem with this question

11. 11. An ad hoc report on patient smoking status returns a blank value for most patients, even though the information appears in the visit notes. What is the most likely explanation?

    • A.The date range excluded any encounter that occurred in a prior calendar year
    • B.The patients declined consent, so the system suppressed that field on the report
    • C.The report ran before the nightly backup finished, so recent entries were left out
    • D.The information was documented as free text instead of in a discrete, coded field✓ Answer

    Only discrete, structured entries — drop-down selections, checkboxes and coded fields — can be reliably queried and extracted; narrative text and scanned images cannot be mined, so the data exists in the chart but is invisible to the report. The fix is a documentation and template change at the point of entry, not a change to the report.

    Source: NHA CEHRS Test Plan, Reporting (data mining and extraction methods); ONC Certified Health IT structured data criteriaReport a problem with this question

12. 12. A report of visits by provider lists the same patient twice, each row carrying a different visit count. Which underlying problem most likely produced this?

    • A.The patient's insurance changed mid-year, which generated a second claim
    • B.The report was sorted by provider name rather than by the patient's name
    • C.The patient has duplicate medical record numbers✓ Answer
    • D.The date range covered a full quarter instead of a single calendar month

    Duplicate entries in the master patient index give one person two record numbers, so encounters land in two places and every report built on them double-counts and understates each row. The correction is to resolve the duplicate records at the source, not to delete a line from the finished report.

    Source: NHA CEHRS Test Plan, Reporting (common reporting errors); master patient index duplicate record resolutionReport a problem with this question

13. 13. An inpatient unit recorded 240 total inpatient days and 60 discharges for the month. What is the average length of stay?

    • A.5.0 days
    • B.3.0 days
    • C.0.25 days
    • D.4.0 days✓ Answer

    Average length of stay is total inpatient days divided by the number of discharges, so 240 divided by 60 equals 4.0 days. Reversing the two figures gives 0.25, which is the classic error on this calculation because it answers discharges per day rather than days per patient.

    Source: NHA CEHRS Test Plan, Reporting (quality improvement measures: average length of stay)Report a problem with this question

14. 14. Which of the following is a process measure rather than an outcome measure?

    • A.The percentage of patients with diabetes whose blood pressure was under control
    • B.The rate of surgical site infections after procedures performed at the facility
    • C.The percentage of patients with diabetes who received an A1c test during the year✓ Answer
    • D.The rate of readmission within 30 days of discharge from the facility

    A process measure counts what was done for the patient — a test performed, a screening completed, an immunization given — while an outcome measure counts the resulting health status, such as an infection, a readmission or a value brought under control. Candidates over-choose "outcome" for anything clinical, but ordering and performing the test is the process, not the result.

    Source: CMS Measure Management System / eCQI Resource Center (structure, process and outcome measures)Report a problem with this question

15. 15. In an electronic clinical quality measure, a patient is removed from the denominator before the numerator is calculated because the measured event does not apply to that patient at all. Which term describes that removal?

    • A.Denominator exclusion✓ Answer
    • B.Numerator exclusion
    • C.Denominator exception
    • D.Initial population

    A denominator exclusion removes a patient before the numerator is calculated because the measured event is simply not applicable to that person, so counting them would distort the measure. A denominator exception is removed after the numerator is calculated, for a documented medical, patient or system reason why an applicable action was not clinically appropriate — that timing is the whole distinction.

    Source: CMS eCQM specifications (denominator exclusion versus denominator exception)Report a problem with this question

16. 16. A practice compiles data from its certified record system and submits it to a federal quality reporting program. What is the durable purpose of that obligation?

    • A.To transfer responsibility for retaining the underlying records to the receiving agency
    • B.To replace the practice's internal audits, which end once the submission is accepted
    • C.To obtain the diagnosis and procedure code sets the practice will use the next year
    • D.To demonstrate with data drawn from the record that care was delivered and measured✓ Answer

    External quality reporting exists so a practice can show, using data captured in certified electronic record technology, that specified care actually happened and was measured against a defined population. The program names, measure lists and attestation details have been renamed and rewritten repeatedly, but the underlying obligation to evidence care from the record itself has not changed, and the practice still owns and retains those records.

    Source: NHA CEHRS Test Plan, Reporting (compiling EHR data for external reporting); ONC Certified Health ITReport a problem with this question

17. 17. Before distributing a month-end financial report, the specialist finds that the report total does not match the posted day-sheet totals for the same period. What is the correct next step?

    • A.Rerun the report with a wider date range so that the missing amount is captured
    • B.Distribute the report with a note asking recipients to disregard the totals column
    • C.Investigate the discrepancy and confirm the parameters before releasing it✓ Answer
    • D.Correct the figure in a spreadsheet so it matches the day sheet, then send the report out

    Verifying a report before distribution means reconciling its totals against a known source, and when the figures do not tie out the cause must be found first — a date range off by a period, a filter that silently excluded records, or transactions never posted. Editing the output or widening the range to force a match hides the defect instead of correcting the data or the query that produced it.

    Source: NHA CEHRS Test Plan, Reporting (verifying accuracy of generated reports prior to distribution)Report a problem with this question

18. 18. A regional quality collaborative asks the practice for its diabetes screening rate. The draft report lists every diabetic patient by name, record number, address and full visit history. What is wrong with sending it?

    • A.It carries more identifiable data than the stated purpose of the request requires✓ Answer
    • B.It was produced as a custom report when a standardized report was required
    • C.It cannot be released to any outside party without a court order compelling disclosure
    • D.It was not sorted by rendering provider before the specialist reviewed the output

    The minimum necessary standard limits a use or disclosure of protected health information to what is needed for the stated purpose, and a request for a rate needs aggregate counts, not an identified roster with addresses and visit histories. This is also the classic "too much data on the report" error: the fix is to narrow the fields and criteria before the report leaves the facility.

    Source: HIPAA Privacy Rule, 45 CFR 164.502(b) minimum necessary standard; NHA CEHRS Test Plan, Reporting (common reporting errors)Report a problem with this question

Practice questions based on the NHA CEHRS Test Plan, the HIPAA Privacy and Security Rules (45 CFR Part 164), and the HITECH Act. This site is not affiliated with or endorsed by the National Healthcareer Association. Every electronic health record system arranges its own screens and menus, so workflows here are described in general terms — follow your own system's documentation and your facility's policies. Record-retention periods, permissible abbreviations, and many release-of-information details are set by state law and facility policy rather than federally, and penalty amounts are adjusted over time; verify all of these against current sources rather than against a practice test. Confirm current eligibility and exam requirements with NHA before you test. About the CEHRS certification →