DVA CRC Exam 9 Questions With 100% Correct Answers

DVA CRC Exam 9 Questions With 100% Correct Answers Risk adjustment coding is done using which code system? - answerICD-10-CM. Section __ of ICD-10-CM guidelines contains the General Guidelines. These guidelines apply in any setting, whether it's Inpatient, Outpatient, Professional Service, or Risk Adjustment. - answerSection I What insurance term is defined as "a situation where the probability of a variable is known but when a mode of occurrence or the actual value of the occurrence is not"? - answerRisk The Balanced Budget Act of created two more plans that were Risk Adjustment, namely, ____________ and __________. - answerAmbulatory Care Group, (ACG), and Disability Payment System (DPS). Originally, in 2000, HCC was applied exclusively to the ______________ environment. In 2004, HCC was applied to the _______________ environment. - answerinpatient / outpatient Which governing entity determines the particular payment system that will be used for their Medicaid Managed Care Plans? - answerState Medicaid Managed Care Plans may be paid according to a number of payment methodologies, including: _____, _____, and _____, among others. - answerAmbulatory Care Groups, (ACG), Clinical Risk Groups (CRG), and Pharmacy Risk Groups (PRG) The ________ the severity of the illness, the higher the risk score, the ________ the payment from the insurance carrier. - answerhigher / higher An actuarial tool used to predict health care costs based on the relative actuarial risk of enrollees in risk adjustment covered plans is the definition for a risk adjustment _______. - answermodel Factors that influence risk adjustment do not currently include ___________. - answerrace Which of the following does not directly factor into the risk adjustment score? - answerGeographic location does not factor into the risk adjustment score. However, it is included in the final payment calculation. Medicaid eligibility, age, and disabled status do factor into the risk adjustment score.