CRC Exam B with all Correct & 100% Verified Answers |
Already Graded A+
How many charts can be submitted to CMS to validate an HCC? ✔Correct Answer-5. RADV permits
5 medical records to be submitted for each HCC to be validated.
The results of a RADV audit are extrapolated across all members of the plan that was audited. What
does this mean? ✔Correct Answer-Financial penalties will be imposed across the plan
membership.
Retrospective audits generally include finding additional diagnoses, CMS has stated that the deletion
of conditions needs to be part of these audits; why is it so hard for companies to follow CMS
directives? ✔Correct Answer-There is a potential of loss of revenue.
Billing compliance issues might come too light.
What would prevent a chart from being coded for Medicare risk adjustment? ✔Correct Answer-
Medical record does not include the credentials of the treating provider.
Which diagnoses can be coded from a medical record that states a member has the condition, but
does not contain supporting documentation? ✔Correct Answer-COPD, A-Fib, Parkinson's, and MS
RADV/IVA audit submissions typically require: ✔Correct Answer-the provider signature,
credentials, and two patient ID's such as patient name and DOB. The printed provider name is only
necessary when the signature is illegible and there is a need to identify the provider.
Which statements are TRUE regarding retrospective audits? ✔Correct Answer-Both internal and
external, onshore and offshore resources can perform retrospective chart audits as long as a
Business Agreement is signed by the external vendor. Retrospective
audits are performed following data submission to validate correct information was submitted and
correct any errors in data submitted.
If a medical record has conflicting information documented, how is it resolved? ✔Correct Answer-
The provider is queried and an addendum/late entry is created to address the conflicting
information.
A patient has the diagnosis of diabetes and gangrene and osteomyelitis; which one of the following is
most TRUE? ✔Correct Answer-Diabetes can have a causal relationship to these conditions.
Which sentence best describes the attributes of an Absence seizure (petit mal)? ✔Correct Answer-
Characterized by blank staring and subtle body movements that begin and end abruptly. It may cause
a brief loss of consciousness.
Which of the following statements are TRUE regarding problem lists? ✔Correct Answer-In some
EHRs the problem list can be carried over from a previous visit without updating the information.
Problem lists include chronic conditions. Problem lists can include previously treated conditions. In
some EHRs the problem list can include conditions from previous years
Already Graded A+
How many charts can be submitted to CMS to validate an HCC? ✔Correct Answer-5. RADV permits
5 medical records to be submitted for each HCC to be validated.
The results of a RADV audit are extrapolated across all members of the plan that was audited. What
does this mean? ✔Correct Answer-Financial penalties will be imposed across the plan
membership.
Retrospective audits generally include finding additional diagnoses, CMS has stated that the deletion
of conditions needs to be part of these audits; why is it so hard for companies to follow CMS
directives? ✔Correct Answer-There is a potential of loss of revenue.
Billing compliance issues might come too light.
What would prevent a chart from being coded for Medicare risk adjustment? ✔Correct Answer-
Medical record does not include the credentials of the treating provider.
Which diagnoses can be coded from a medical record that states a member has the condition, but
does not contain supporting documentation? ✔Correct Answer-COPD, A-Fib, Parkinson's, and MS
RADV/IVA audit submissions typically require: ✔Correct Answer-the provider signature,
credentials, and two patient ID's such as patient name and DOB. The printed provider name is only
necessary when the signature is illegible and there is a need to identify the provider.
Which statements are TRUE regarding retrospective audits? ✔Correct Answer-Both internal and
external, onshore and offshore resources can perform retrospective chart audits as long as a
Business Agreement is signed by the external vendor. Retrospective
audits are performed following data submission to validate correct information was submitted and
correct any errors in data submitted.
If a medical record has conflicting information documented, how is it resolved? ✔Correct Answer-
The provider is queried and an addendum/late entry is created to address the conflicting
information.
A patient has the diagnosis of diabetes and gangrene and osteomyelitis; which one of the following is
most TRUE? ✔Correct Answer-Diabetes can have a causal relationship to these conditions.
Which sentence best describes the attributes of an Absence seizure (petit mal)? ✔Correct Answer-
Characterized by blank staring and subtle body movements that begin and end abruptly. It may cause
a brief loss of consciousness.
Which of the following statements are TRUE regarding problem lists? ✔Correct Answer-In some
EHRs the problem list can be carried over from a previous visit without updating the information.
Problem lists include chronic conditions. Problem lists can include previously treated conditions. In
some EHRs the problem list can include conditions from previous years
