Risk adjustment crc Study guides, Class notes & Summaries

AAPC CRC study guide Questions solutions 100% correct which medicare part is reimbursed based on the risk adjustment models part c who typically employs risk adjustment coders health plans is a health plan required to follow the minimum necessary rule yes, health plans are covered entities and are therefore required to follow the minimum necessary rule what is an example of fraud reporting a diagnosis or co-morbidity that does not exist to obtain higher reimbursement

CRC practice Questions with solutions 100% correct What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services? a. OIG Compliance Plan Guidance b. OIG Security Summary c. OIG Work Plan d. OIG Investigation Plan C. OIG Work Plan Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are lis...

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient-specific conditions hospice, ESRD RAF Risk Adjustment Factor Scores Three main types of reviews Retrospective, Concurrent and prospective Retrospective reviews are performed after the information has been reported and in risk adjustment these ar...

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element - Correct Answer ️️ -Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient-specific conditions hospice, ESRD RAF - Correct Answer ️️ -Risk Adjustment Factor Scores Three main types of reviews - Correct Answer ️️ -Retrospective, Concurrent and prospective Retrospective - Correct Ans...

CRC Exam Questions and Answers 100% Pass How is predictive modeling used in risk adjustment? - Correct Answer ️️ -to determine suspected diagnosis based on data elements. Which of the following data elements are used in predictive modeling? I. DME claims II. Prescription drug events III. Physician claims data IV. Facility claims data a. III and IV b. I, II, and IV c. I, II, and III d. I, II, III, and IV - Correct Answer ️️ -d. I, II, III, and IV What might happen as a result ...

CRC Exam Questions with 100% Correct Answers | Verified | Updated 2024

CRC Exam Chapter 1 Questions and Answers 100% Pass Who are covered entities according to HIPAA? - Correct Answer ️️ -Health Care Providers Health Plans Health Care Clearinghouses Risk Adjustment Coders should have knowledge in? - Correct Answer ️️ -The use of medications, treatments of the patient, and diagnostic testing. What document assists provider offices with the development of Compliance Manuals? - Correct Answer ️️ -OIG Compliance Plan Guidance Under HIPAA, what wou...

Risk Adjustment CRC exam questions 2024 latestRisk Adjustment CRC exam questions 2024 latest

Mock CRC Exam questions With Verified Answers 1. _____ regulations determine the coding requirements for Medicare Advantage plans. A. FEHB B. HIAA C. CMS D. ERISA - answerD. ERISA 2. Medicare Advantage combines the benefits of which of the following plans? A. Medicare Part A and Part B B. Medicare Part A and Part D C. Medicare Part B and Part D D. Medicare Part A and Part B, and sometimes Part D - answerD. Medicare Part A and Part B, and sometimes Part D 3. The medical coding classi...