CRC EXAM Questions and Answers (Latest Update 2025) Verified Answers

CRC EXAM Questions and Answers
(Latest Update 2025) Verified Answers
Risk Adjustment Data Element - Correct Answers ✅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 - Correct Answers ✅Risk Adjustment Factor Scores


Three main types of reviews - Correct Answers
✅Retrospective, Concurrent and prospective


Retrospective - Correct Answers ✅reviews are performed
after the information has been reported and in risk
adjustment these are prior years dos


Concurrent reviews - Correct Answers ✅performed ongoing
as patients are seen prior to reporting and in risk adjustment
the current year


Prospective reviews - Correct Answers ✅will effect the next
year and not the current year where payment is concerned.
They are used to forcast


Types of Risk Adjustment Models(HHS) - Correct Answers
✅HHS hEALTH AND HUMAN SERVICES hIERARCHICAL
CONDITION(Commercial, individual and small grooup

, CRC EXAM Questions and Answers
(Latest Update 2025) Verified Answers

Types of Risk Adjustment Modles(CDPS) - Correct Answers
✅Chronic Illness and Disability payment systems(Medicaid)


Types of Risk Adjustment Models(HCC-C) - Correct Answers
✅Hierarchical Condition Category, Part C


Types of Risk Adjustment model (DRG) - Correct Answers
✅Diagnosis Related Group (Inpatient)


Types of Risk Adjustment model (ACG) - Correct Answers
✅Adjusted Clinical Groups(Outpatient)


Prescription based program risk adjustment examples:UCSD -
Correct Answers ✅Medicaid Rx(UCSD)


Prescription based program risk adjustment examples(Dxcg) -
Correct Answers ✅RxGroups(DxCG)


Prescription based program risk adjustment examples(HCC-D)
- Correct Answers ✅Hierarchical Condition Category, Part
D(HCC-D