HCC -CHC Midterm Exam Questions Fully Solved 2024.

At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal - Answer b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a review of Medicare Review Council; and fifth level is a judicial review in federal court. If an at-risk patient is left unattended and has an adverse response to medication, this is known as: a. sentinel event b. initiator c. latent outcome d. slip - Answer a. sentinel event Sentinel event is an adverse occurrence that is not in the normal progression of a patient's illness. In this scenario, an adverse drug event is considered a sentinel event. AND whenever a sentinel events is confirmed, the facility should perform a Root Cause Analysis (RCA). A Latent Outcome - less apparent failures of organization or design that contributed to the error/patient harm. A Slip - can be a fall or an everyday risk at hospitals.