CRC FINAL EXAM NEWEST 2024 ACTUAL EXAM
COMPLETE 250 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED CORRECT ANSWER)
ALREADY GRADED A+.
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 predictivemodeling?
I. DME claims
II. Prescription drug eventsIII.
Physician claims data IV. Facility
claims data
a. III and IV b. I,
II, and IVc. I, II,
and III
d. I, II, III, and IV - CORRECT ANSWER:->>> >>>>d. I, II, III, and IV
What might happen as a result of predictive modeling?a. Disease
management programs
b. Concurrent audits
c. Transporation benefits
,d. Reduction in case management - CORRECT ANSWER:->>>
>>>>a.Disease management programs
In the CMS Star Ratings program, which measure is given thehighest weight?
a. Outcomes
b. Client experience
c. Customer service
d. Accurate RAF scores - CORRECT ANSWER:->>> >>>>a. Outcomes
How often are HEDIS measures revised?a. As needed
b. Monthly
c. Bi-annually
d. Annually - CORRECT ANSWER:->>> >>>>d. Annually
Which statement is TRUE regarding the CMS Stars qualityrating system?
a. Quality bonus payments are made to physician who scoreat least four stars.
b. Quality bonus payments are made to Medicare Advantageplans who
score at least four stars.
c. Quality bonus payments are made to physician who scoreat least five stars.
d. Quality bonus payments are made to Medicare Advantage plans who score at
,least five stars. - CORRECT ANSWER:->>> >>>>b. Qualitybonus payments are
made to Medicare Advantage plans whoscore at least four stars.
Merit-based Incentive Payment System (MIPS) includeswhich
performance categories?
I. Promoting InteroperabilityII. Cost
III. Improvement ActivitiesIV.
Quantity
V. Quality
a. I and II
b. I, III, and V
c. I, II, III, and V
d. I, II, III, IV, and V - CORRECT ANSWER:->>> >>>>c. I, II, III, and V
Which of the following are domains in CMS Part C & D StarsRating?
I. Staying Healthy
II. Managing Chronic Conditions
III. Member Experience with Health Plans
IV. Member Complaints, Problems Getting Services, andImprovement in
the Health Plan's Performance
, V. Health Plan Customer Service
a. I, II and III b. I,
III, and V
c. I, II, III, IV and V
d. I, II, III and V - CORRECT ANSWER:->>> >>>>c. I, II, III, IV and V
What are the participation tracks available through MedicareAccess and CHIP
Reauthorization Act (MACRA)?
I. Merit-based Incentive Payment SystemsII. Sustainable
Growth System
III. Advanced Alternative Payment Modelsa. I
b. II and III
c. I and III
d. I, II and III - CORRECT ANSWER:->>> >>>>c. I and III
What is predictive modeling?
a. An analytical review of known data elements to establish ahypothesis
related to the future health of clients.
b. An analytical review of payments to health plans todetermine the
cost of future healthcare.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller PurityKauri. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.49. You're not tied to anything after your purchase.
