CRC Exam questions with correct answers

to determine suspected diagnosis based on data elements. - correct answer How is predictive modeling used in risk adjustment? d. I, II, III, and IV - correct answer Which of the following data elements are used in predictive modeling? I. DME claims II. Prescription drug events III. Physician claims data IV. Facility claims data a. III and IV b. I, II, and IV c. I, II, and III d. I, II, III, and IV a. Disease management programs - correct answer What might happen as a result of predictive modeling? a. Disease management programs b. Concurrent audits c. Transporation benefits d. Reduction in case management a. Outcomes - correct answer In the CMS Star Ratings program, which measure is given the highest weight? a. Outcomes b. Patient experience c. Customer service d. Accurate RAF scores