Quality bonus payments - Study guides, Class notes & Summaries

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 IV b. I, II, and IV c. I, II, and III d. I, II, III, and IV -:- d. I, II, III, and IV What might happen as a result of predictive modeling? 2 0 2 4 / 2 0 2 5 | © copyright | This work may not be...

FPC Test Questions & Answers A 16-year-old employee works part-time during the summer. Under the FLSA, what are the maximum hours, if any, the employee can work during a workweek? a. 8 hours per day b. 18 hours per week c. 40 hours per week d. There is no limitation on the number of hours that can be worked during the week. Submit - d. There is no limitation on the number of hours that can be worked during the week. All of the following situations satisfy federal minimum wage requ...

Calculate the payment amount for the loan in cell C15. Reference the cells containing the appropriate loan information as the arguments for the function you use. Cells C20- C67 in the "Payment" column are populated with the payment amount from cell C15. [34 Points] - Correct answer-=PMT(C13/12,C12,C11) Calculate, in cell D20, the interest amount for period 1 by multiplying the balance in period 0 (cell F19) by the loan interest rate (cell C13) divided by 12. Dividing the interest rate by...

PREDICTIVE MODELING - ANSWER-is an analytical review of known data elements to establish a hypothesis related to the future health needs of patients or a population of patients Suspect Logic - ANSWER-Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - ANSWER-Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors - ANSW...

ETS MFT BUSINESS EXAM The principal difference between variable costing and absorption costing centers on: a) whether variable manufacturing costs should be included as product costs b) whether fixed manufacturing costs should be included as product costs c) whether fixed manufacturing costs and fixed selling and administrative costs should be included as product costs d) none of these. General Bikes is debating which marketing research options to employ. The traditional p...

Solution manual for Canadian Income Taxation 20222023 25th Edition by William Buckwold, Joan Kitunen, Matthew Roman CHAPTER 1 TAXATION― ITS ROLE IN BUSINESS DECISION MAKING Review Questions 1. If income tax is imposed after profits have been determined, why is taxation relevant to business decision making? 2. Most business decisions involve the evaluation of alternative courses of action. For example, a marketing manager may be responsible for choosing a strategy for establishing ...

What is an organisation? correct answers A collection of people working together, where the labour or tasks are divided, to achieve a common goal. Why do organisations exist? correct answers Organisations should provide a product or service to fulfill a social need (i.e. solve a problem or add value). Total Quality Management (TQM) correct answers Organization-wide efforts to install and make a permanent climate in which an organization continuously improves its ability to deliver high-qua...

PREDICTIVE MODELING - is an analytical review of known data elements to establish a hypothesis related to the future health needs of patients or a population of patients Suspect Logic - Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors - * Known/Expected clinical...

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 ...

Once a claim is captured, the enrollment status is checked and the member is covered, what is the next step for processing the claim?determining what to pay Plans can receive bonus payments for high star quality ratings. The bonus payments can be used to:(All) Reduce cost sharing Provide additional benefits Reduce enrollee premiums Dual Eligible Special Needs Plans enroll individuals who are "dual eligible." Who are the "dual eligible"?Individuals who are eligible for Medicare and...