CDEO Chapter 8 Questions and Answers (Graded A)

CDEO Chapter 8 Questions and Answers (Graded A) CDEO Chapter 8 Questions and Answers (Graded A) CDEO Chapter 8 Questions and Answers (Graded A) PREDICTIVE MODELING - ANSWER-is an analytical review of known data elements to establish a hypothesis related to the future health needs of patients or a population of patients Suspect Logic - ANSWER-Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - ANSWER-Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors - ANSWER-* Known/Expected clinical progression of an illness or disease * DME needs * PDE * Laboratory test findings * CPT codes reported during the year in review * HCPCS codes reported during the year in review * Socioeconomic status * Disability: Hospice: ESRD and other such statuses of the patient being reviewed Quality of Care - ANSWER-Quality Measures Star Ratings HEDIS - ANSWER-Healthcare Effectiveness Data and Information Set