CRC EXAM QUESTIONS AND
ANSWERS 100% PASS
Risk Adjustment Data Element - CORRECT 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 - CORRECT ANSWER-Risk Adjustment Factor Scores
Three main types of reviews - CORRECT ANSWER-Retrospective, Concurrent
and prospective
Retrospective - CORRECT ANSWER-reviews are performed after the
information has been reported and in risk adjustment these are prior years dos
Concurrent reviews - CORRECT ANSWER-performed ongoing as patients are
seen prior to reporting and in risk adjustment the current year
Prospective reviews - CORRECT 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) - CORRECT ANSWER-HHS hEALTH
AND HUMAN SERVICES hIERARCHICAL CONDITION(Commercial,
individual and small grooup
Types of Risk Adjustment Modles(CDPS) - CORRECT ANSWER-Chronic Illness
and Disability payment systems(Medicaid)
Types of Risk Adjustment Models(HCC-C) - CORRECT ANSWER-Hierarchical
Condition Category, Part C
Types of Risk Adjustment model (DRG) - CORRECT ANSWER-Diagnosis
Related Group (Inpatient)
Types of Risk Adjustment model (ACG) - CORRECT ANSWER-Adjusted
Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD - CORRECT
ANSWER-Medicaid Rx(UCSD)
Prescription based program risk adjustment examples(Dxcg) - CORRECT
ANSWER-RxGroups(DxCG)
Prescription based program risk adjustment examples(HCC-D) - CORRECT
ANSWER-Hierarchical Condition Category, Part D(HCC-D
COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED
ANSWERS 100% PASS
Risk Adjustment Data Element - CORRECT 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 - CORRECT ANSWER-Risk Adjustment Factor Scores
Three main types of reviews - CORRECT ANSWER-Retrospective, Concurrent
and prospective
Retrospective - CORRECT ANSWER-reviews are performed after the
information has been reported and in risk adjustment these are prior years dos
Concurrent reviews - CORRECT ANSWER-performed ongoing as patients are
seen prior to reporting and in risk adjustment the current year
Prospective reviews - CORRECT 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) - CORRECT ANSWER-HHS hEALTH
AND HUMAN SERVICES hIERARCHICAL CONDITION(Commercial,
individual and small grooup
Types of Risk Adjustment Modles(CDPS) - CORRECT ANSWER-Chronic Illness
and Disability payment systems(Medicaid)
Types of Risk Adjustment Models(HCC-C) - CORRECT ANSWER-Hierarchical
Condition Category, Part C
Types of Risk Adjustment model (DRG) - CORRECT ANSWER-Diagnosis
Related Group (Inpatient)
Types of Risk Adjustment model (ACG) - CORRECT ANSWER-Adjusted
Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD - CORRECT
ANSWER-Medicaid Rx(UCSD)
Prescription based program risk adjustment examples(Dxcg) - CORRECT
ANSWER-RxGroups(DxCG)
Prescription based program risk adjustment examples(HCC-D) - CORRECT
ANSWER-Hierarchical Condition Category, Part D(HCC-D
COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED
