How is predictive modeling used in risk adjustment?
-:- 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 I...
Which of the following are domains in CMS Part C & D Stars Rating?
I. Staying Healthy
II. Managing Chronic Conditions
III. Member Experience with Health Plans
IV. Member Complaints, Problems Getting Services, and Improvement 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
4|Page | Grade A+| 2024/2025
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