CRC Exam Prer with All Correct & 100% Verified
Answers |Already Graded A+
the Definition for the best medical record for a RADV audit is ✔Correct Answer-Documentation
validates the CMS requested HCCs contains all the necessary documentation elements and has an
additional HCC not requested by CMS
What is reported by a provider for beneficiaries in a Medicare Advantage Plan? ✔Correct Answer-
Nature of the presenting problem and all chronic conditions
What is a good source for a retrospective chart audit? ✔Correct Answer-Cardiologist record
Retrospective Chart audits should include ✔Correct Answer-Provider signatures , supporting
documents of DXs and DOS
Which type of audit evaluates appropriate risk scores in patients ✔Correct Answer-RADV
What information is required when submitting documentation to support a DX for a RADV/IVA ?
✔Correct Answer-a single DOS for outpatient records and the full inpatient set for hospital records
How often should a provider see and assess a patient in a year to validate amputation status?
✔Correct Answer-once a year
What is an effective way to review documentation deficiencies with a provider? ✔Correct Answer-
Provide the provider examples of their documentation and suggested impovements
what is usually documented by the provider during the pts history ? ✔Correct Answer-pts response
to current treatment, the reason for encounter and pts use of tobacco
how are resolved conditions coded ✔Correct Answer-reported as HISTORY OF when appropriate
data mining is performed to ✔Correct Answer-identify data that might be related to patient risk
scores
what does CMS Star Ratings program monitor? ✔Correct Answer-Performance of Medicare
Advantage plans
Which risk adjustment model is used for Medicaid programs? ✔Correct Answer-CDPS
What can be submitted for HCC Validation? ✔Correct Answer-Physician office notes, Outpatient
Hospital, Critical Access Hospital
how many charts can be submitted to CMS to validate an HCC? ✔Correct Answer-5
RADV/IVA audit submissions typically require ✔Correct Answer-Two pts identifiers and Providers
signature
Answers |Already Graded A+
the Definition for the best medical record for a RADV audit is ✔Correct Answer-Documentation
validates the CMS requested HCCs contains all the necessary documentation elements and has an
additional HCC not requested by CMS
What is reported by a provider for beneficiaries in a Medicare Advantage Plan? ✔Correct Answer-
Nature of the presenting problem and all chronic conditions
What is a good source for a retrospective chart audit? ✔Correct Answer-Cardiologist record
Retrospective Chart audits should include ✔Correct Answer-Provider signatures , supporting
documents of DXs and DOS
Which type of audit evaluates appropriate risk scores in patients ✔Correct Answer-RADV
What information is required when submitting documentation to support a DX for a RADV/IVA ?
✔Correct Answer-a single DOS for outpatient records and the full inpatient set for hospital records
How often should a provider see and assess a patient in a year to validate amputation status?
✔Correct Answer-once a year
What is an effective way to review documentation deficiencies with a provider? ✔Correct Answer-
Provide the provider examples of their documentation and suggested impovements
what is usually documented by the provider during the pts history ? ✔Correct Answer-pts response
to current treatment, the reason for encounter and pts use of tobacco
how are resolved conditions coded ✔Correct Answer-reported as HISTORY OF when appropriate
data mining is performed to ✔Correct Answer-identify data that might be related to patient risk
scores
what does CMS Star Ratings program monitor? ✔Correct Answer-Performance of Medicare
Advantage plans
Which risk adjustment model is used for Medicaid programs? ✔Correct Answer-CDPS
What can be submitted for HCC Validation? ✔Correct Answer-Physician office notes, Outpatient
Hospital, Critical Access Hospital
how many charts can be submitted to CMS to validate an HCC? ✔Correct Answer-5
RADV/IVA audit submissions typically require ✔Correct Answer-Two pts identifiers and Providers
signature
