Hedis Study guides, Class notes & Summaries

Near misses - Which of the following is defined as a patient safety event that did not reach the patient? a. Incidents b. Near misses c. Unsafe conditions d. None of the above All of the above are categories - Which of the following is NOT one of the four major categories of quality measures? a. Structure b. Process c. Outcome d. All of the above are categories Benchmarking - ________ is the process of comparing one or more performance measures against a standard. a. Assessing b. ...

What is the first step in quality control? A) To take corrective action when standards have not been met B) To collect data to determine whether standards have been met C) To determine criteria and standards D) To determine who will measure the standard C An RN is a supervisor in an organization that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. How does the RN practice TQM on the unit? A) Encouraging employees to thi...

How is predictive modeling used in risk adjustment? - 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 - Answer-d. I, II, III, and IV What might happen as a result of predictive modeling? a. Disease management programs b. Concurrent aud...

What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set What is HEDIS? - is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combination of surveys, provider med...

CPMSM Practice Tests QUESTIONS AND ANSWERS RATED A+ 2023|2024 UPDATE What does HEDIS stand for? - Correct Answer-Healthcare Effectiveness Data and Information Set What is HEDIS? - Correct Answer-is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer...

CPCS Exam Questions and Answers (Graded A) CPCS Exam Questions and Answers (Graded A) CPCS Exam Questions and Answers (Graded A) CPCS Exam Questions and Answers (Graded A) MCO acronym for - ANSWER-Managed Care Organization - main accreditors: NCQA, URAC NAMSS acronym for - ANSWER-National Association of Medical Staff Services CPCS acronym for - ANSWER-Certified Provider Credentialing Specialist CVO acronym for - ANSWER-Credential Verifications Organization HEDIS acronym for - A...

A critical early step in designing an EHR is to develop a(n) ________in which the characteristics of each data element are defined. A) Accreditation manual B) Core content C) Continuity of care record D) Data dictionary - ANSWER-D) Data dictionary (2) Once hospital discharge abstract systems were developed and their ability to provide comparative data to hospitals was established, it became necessary to develop: A) Data sets B) Data elements C) Electronic data interchange D) Bills of ...

CPCS Exam 2023 Already Graded A MCO acronym for Managed Care Organization - main accreditors: NCQA, URAC NAMSS acronym for National Association of Medical Staff Services CPCS acronym for Certified Provider Credentialing Specialist CVO acronym for Credential Verifications Organization HEDIS acronym for Healthcare Effectiveness Data Information Set CAHPS acronym for Consumer Assessment of Healthcare Providers & Systems Structure of a CVO Director - Contract Sales - Credentialing Staff - Huma...

CPMSM Study Guide Questions and Answers Fully solved 2024 Non-profit under religious/community control. Voluntary/Charitable Hospital Non-profit under city, state, county. Govt (non-federal) hospital Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:07 / 0:15 Full screen Owned/operated by fed gov't, supported by fed funds, e.g., VA. Under direct supervision of Surgeon General. Govt (federal) hospital Owned by corpor...

What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set What is HEDIS? - is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combination of surveys, provider med...