Qbps - Study guides, Class notes & Summaries

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...

Quality Bonus Payments - TO make quality of care a priority the Affordable Care Act set a requirement that CMS make quality bonus payments to Medicare Advantage plans that earn four or more stars in a five-star quality rating system would receive a bonus payment. Earning fewer than four stars would receive no bonus. 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 inf...

PREDICTIVE MODELING correct answersis 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 correct answersMany organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews correct answersAnalysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Lo...

HEDIS - ANSWER-Healthcare Effectiveness Data and Information Set QBPs - ANSWER-Quality bonus payments 5 Stars - ANSWER-Excellent Performance 4 Stars - ANSWER-Above Average Performance 3 Stars - ANSWER-Average Performance 2 Stars - ANSWER-Below Average Performance 1 Star - ANSWER-Poor Performance Month of Star Ratings Publication

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...

CDEO - Quality, Ch 4 Questions and Answers 100% CorrectCDEO - Quality, Ch 4 Questions and Answers 100% CorrectCDEO - Quality, Ch 4 Questions and Answers 100% CorrectCDEO - Quality, Ch 4 Questions and Answers 100% CorrectCDEO - Quality, Ch 4 Questions and Answers 100% Correct HEDIS - ANSWER-Healthcare Effectiveness Data and Information Set QBPs - ANSWER-Quality bonus payments 5 Stars - ANSWER-Excellent Performance

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 - ANSWER-* Known/Expected clinical progression of an illness or disease * DME needs * PDE * Laboratory test findings * CPT codes reported during the year in review * HCPCS codes rep...

HEDIS - Healthcare Effectiveness Data and Information Set QBPs - Quality bonus payments 5 Stars - Excellent Performance 4 Stars - Above Average Performance 3 Stars - Average Performance 2 Stars - Below Average Performance 1 Star - Poor Performance Month of Star Ratings Publication - October Number of Domains for Part C MA - 9 Domains Number of Domains for Part D MA - 4 Domains NCQA - National Committee for Quality Assurance ABA - Adult BMI Assessment

CDEO Chapter 8 Study Guide with Complete Solutions PREDICTIVE MODELING - Answer️️ -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 - Answer️️ -Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - Answer️️ -Analysis of the information identified is used to target retrospective r...

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 ...