CCRM PRACTICE SOLUTION TEST 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
●● Quality, Promoting Interoperability, Improvement Activity, Cost
Answer: MIPS Collection Types Categories
●● When are Star Ratings publicly published?
Answer: October of each year
●● HEDIS types of collection
Answer: Surveys, Medical Chart Reviews, Insurance Claims, Medical
Office Visits, Procedures
●● What does Abbreviation MAC stand for?
Answer: Medicare Administrative Contractor
●● Each year, Medicare normalizes risk scores to maintain an average of
what?
Answer: 1.0
,●● Which type of documentation can be used to support diagnoses
reported under risk adjustment models?
Answer: Inpatient admission note
●● Risk adjustment models are used to:
Answer: Determine projected costs of health care based on the
condition(s) of patients
●● When submitting records for RADV audit, will additional current
diagnoses that were not originally reported be considered when
documentation is submitted for the audit?
Answer: Yes, additional current diagnoses not included on claims data
may be approved during the audit.
●● For commercial plans, funding is allocated based on
Answer: Current year's known diagnoses
●● What is the impact on reimbursement under the risk adjustment
model if chronic conditions are not coded properly?
Answer: Failure to code for a chronic condition the patient has may
result in an inaccurate RAF.
●● What is the purpose of a RADV
Answer: To evaluate the appropriateness of risk scores to patients.
, ●● How many records are submitted by health plans per patient in a
RADV audit?
Answer: 5
●● Each record submitted for a RADV should include:
Answer: I. Complete list and legible records
2. Credential for the rendering provider
3.Provider signature or attestation
●● How is predictive modeling used in risk adjustment?
Answer: Determine suspected diagnoses based on data elements.
●● What might happen as a result of predictive modeling?
Answer: Disease Management Programs
●● In the CMS Star Ratings program, which measure is given the
highest weight?
Answer: Outcomes
●● The results of a RADV audit are extrapolated across all members of
the plan that was audited. What does this mean?
Answer: Financial penalties will be averaged over the plan membership
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
●● Quality, Promoting Interoperability, Improvement Activity, Cost
Answer: MIPS Collection Types Categories
●● When are Star Ratings publicly published?
Answer: October of each year
●● HEDIS types of collection
Answer: Surveys, Medical Chart Reviews, Insurance Claims, Medical
Office Visits, Procedures
●● What does Abbreviation MAC stand for?
Answer: Medicare Administrative Contractor
●● Each year, Medicare normalizes risk scores to maintain an average of
what?
Answer: 1.0
,●● Which type of documentation can be used to support diagnoses
reported under risk adjustment models?
Answer: Inpatient admission note
●● Risk adjustment models are used to:
Answer: Determine projected costs of health care based on the
condition(s) of patients
●● When submitting records for RADV audit, will additional current
diagnoses that were not originally reported be considered when
documentation is submitted for the audit?
Answer: Yes, additional current diagnoses not included on claims data
may be approved during the audit.
●● For commercial plans, funding is allocated based on
Answer: Current year's known diagnoses
●● What is the impact on reimbursement under the risk adjustment
model if chronic conditions are not coded properly?
Answer: Failure to code for a chronic condition the patient has may
result in an inaccurate RAF.
●● What is the purpose of a RADV
Answer: To evaluate the appropriateness of risk scores to patients.
, ●● How many records are submitted by health plans per patient in a
RADV audit?
Answer: 5
●● Each record submitted for a RADV should include:
Answer: I. Complete list and legible records
2. Credential for the rendering provider
3.Provider signature or attestation
●● How is predictive modeling used in risk adjustment?
Answer: Determine suspected diagnoses based on data elements.
●● What might happen as a result of predictive modeling?
Answer: Disease Management Programs
●● In the CMS Star Ratings program, which measure is given the
highest weight?
Answer: Outcomes
●● The results of a RADV audit are extrapolated across all members of
the plan that was audited. What does this mean?
Answer: Financial penalties will be averaged over the plan membership
