A PACKAGE DEAL FOR CRC Exam 2023 with 100% correct answers

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...

Risk Adjustment (a prospective payment system) The process of increasing or reducing payments to health plans to reflect higher or lower than expected spending. Risk adjusting is designed to compensate health plans that enroll an older and sicker population as a way to discourage plans from selecti...

1908 Federal Employees Worker's Comp Act Provided an alternative to suing companies for work related injuries. 1914 War-Risk Act Gave the US government the ability to provide insurance to private company ships who were supplying the allies. 1917 Smith-Hughes Act Made federal money ...

A patient is admitted to the hospital for repair of an open fracture, type 1, of the head of the left femur. The patient has been previously diagnosed with symptomatic HIV. What ICD-10-CM code(s) is/are reported for the admission? S72.052B, B20 A 22-year-old female is admitted to ICU for acu...

Who are covered entities according to HIPAA? Health Care Providers Health Plans Health Care Clearinghouses Risk Adjustment Coders should have knowledge in? The use of medications, treatments of the patient, and diagnostic testing. What document assists provider offices with the dev...

Before placing the client in an on-the-job evaluation a rehab counselor needs to perform Job analysis A client who has difficulty with thinking and reasoning, processing speed attention, concentration and memory would be best referred to which professional to assess functional capacities and...

Federal Employees Worker's Comp Act 1908 - Alternative to suing for work-related injuries Smith-Hughes Act 1917- Provided Federal funding to states on a matching basis for vocational educational programs; established Federal Board for Vocational Education; Board later administered veteran/...

Interactions What are extra RA values or factors added when a patient has more than one major significant dx identified in model ? Quality, Promoting Interoperability, Improvement Activity, Cost MIPS Collection Types Categories When are Star Ratings publicly published? October of ea...

Employability Possessing the skills, abilities, and worker traits necessary to performing A/any job Placeability Ability to actually find employment A "power" test is a test... that most people finish within the time limit According to Hershenson's Theory of Work Adjustmen...

Bowen considered this to be the smallest unit of human relationships that is stable Triangle: Murray Bowen has stated that the smallest stable unit for human relationships is a triangle. A two person is unstable because it tolerates little tension before involving a third person. Two people in a co...

Which of the following medications are prescribed to cancer patients to eradicate the cancer or for prophylaxis? I. Tamoxifen II. Anastrozole III. Januvia IV. Crestor A. I and II B. I and III C. II and III D. I, II, III and IV A Anastrozole is used to treat breast cancer in women who have ...

How many charts can be submitted to CMS to validate an HCC? A. One B. Three C. Two D. Five D RADV to permits 5 medical records to be submitted for each HCC to be validated. The results of a RADV audit are extrapolated across all members of the plan that was audited. What does this mean?...

The Medical Model Focused on specific medical conditions viewed as "problems;" intrinsic to individuals experiencing them. Emphasized diagnosis and corresponding limitation or functional incapacity relative to societal norm. The Social Model Reaction to medical model. Emphasized societa...

What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer...