©THESTAR 2025 ALL RIGHTS RESERVED 10:34 PM A+
CRC Exam Questions And Answers |Latest
2025 | Guaranteed Pass
Risk Adjustment Data Element - Answer✔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 - Answer✔Risk Adjustment Factor Scores
Three main types of reviews - Answer✔Retrospective, Concurrent and prospective
Retrospective - Answer✔reviews are performed after the information has been reported and in
risk adjustment these are prior years dos
Concurrent reviews - Answer✔performed ongoing as patients are seen prior to reporting and in
risk adjustment the current year
Prospective reviews - Answer✔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) - Answer✔HHS hEALTH AND HUMAN SERVICES
hIERARCHICAL CONDITION(Commercial, individual and small grooup
1
, ©THESTAR 2025 ALL RIGHTS RESERVED 10:34 PM A+
Types of Risk Adjustment Modles(CDPS) - Answer✔Chronic Illness and Disability payment
systems(Medicaid)
Types of Risk Adjustment Models(HCC-C) - Answer✔Hierarchical Condition Category, Part C
Types of Risk Adjustment model (DRG) - Answer✔Diagnosis Related Group (Inpatient)
Types of Risk Adjustment model (ACG) - Answer✔Adjusted Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD - Answer✔Medicaid Rx(UCSD)
Prescription based program risk adjustment examples(Dxcg) - Answer✔RxGroups(DxCG)
Prescription based program risk adjustment examples(HCC-D) - Answer✔Hierarchical Condition
Category, Part D(HCC-D
Trump List - Answer✔Families or hierarchies set a value base on severity of illness with more
severe diagnoses carrying the overall risk score for that family.
Stage 1 Pressure Ulcer - Answer✔Persistent focal erythema
stage 2 pressure ulcer - Answer✔Partial thickness skin loss involving epidermis, dermis, or both
Stage 3 pressure ulcer - Answer✔Full Thickness skin loss extending through subcutaneous
tissue
Stage 4 Pressure ulcer - Answer✔Necrosis of soft tissue extending to muscle and bone
2
CRC Exam Questions And Answers |Latest
2025 | Guaranteed Pass
Risk Adjustment Data Element - Answer✔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 - Answer✔Risk Adjustment Factor Scores
Three main types of reviews - Answer✔Retrospective, Concurrent and prospective
Retrospective - Answer✔reviews are performed after the information has been reported and in
risk adjustment these are prior years dos
Concurrent reviews - Answer✔performed ongoing as patients are seen prior to reporting and in
risk adjustment the current year
Prospective reviews - Answer✔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) - Answer✔HHS hEALTH AND HUMAN SERVICES
hIERARCHICAL CONDITION(Commercial, individual and small grooup
1
, ©THESTAR 2025 ALL RIGHTS RESERVED 10:34 PM A+
Types of Risk Adjustment Modles(CDPS) - Answer✔Chronic Illness and Disability payment
systems(Medicaid)
Types of Risk Adjustment Models(HCC-C) - Answer✔Hierarchical Condition Category, Part C
Types of Risk Adjustment model (DRG) - Answer✔Diagnosis Related Group (Inpatient)
Types of Risk Adjustment model (ACG) - Answer✔Adjusted Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD - Answer✔Medicaid Rx(UCSD)
Prescription based program risk adjustment examples(Dxcg) - Answer✔RxGroups(DxCG)
Prescription based program risk adjustment examples(HCC-D) - Answer✔Hierarchical Condition
Category, Part D(HCC-D
Trump List - Answer✔Families or hierarchies set a value base on severity of illness with more
severe diagnoses carrying the overall risk score for that family.
Stage 1 Pressure Ulcer - Answer✔Persistent focal erythema
stage 2 pressure ulcer - Answer✔Partial thickness skin loss involving epidermis, dermis, or both
Stage 3 pressure ulcer - Answer✔Full Thickness skin loss extending through subcutaneous
tissue
Stage 4 Pressure ulcer - Answer✔Necrosis of soft tissue extending to muscle and bone
2
