Risk Adjustment CRC exam
questions WITH Correct Answers
100% PASS
Interactions - CORRECT ANSWER-What are extra RA values or factors added
when a patient has more than one major significant dx identified in model ?
Quality, Promoting Interoperability, Improvement Activity, Cost - CORRECT
ANSWER-MIPS Collection Types Categories
When are Star Ratings publicly published? - CORRECT ANSWER-October of
each year
HEDIS types of collection - CORRECT ANSWER-Surveys, Medical Chart
Reviews, Insurance Claims, Medical Office Visits, Procedures
What does Abbreviation MAC stand for? - CORRECT ANSWER-Medicare
Administrative Contractor
Each year, Medicare normalizes risk scores to maintain an average of what? -
CORRECT ANSWER-1.0
, Which type of documentation can be used to support diagnoses reported under
risk adjustment models? - CORRECT ANSWER-Inpatient admission note
Risk adjustment models are used to: - CORRECT 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? - CORRECT ANSWER-Yes, additional current diagnoses not included
on claims data may be approved during the audit.
For commercial plans, funding is allocated based on - CORRECT ANSWER-
Current year's known diagnoses
What is the impact on reimbursement under the risk adjustment model if chronic
conditions are not coded properly? - CORRECT ANSWER-Failure to code for a
chronic condition the patient has may result in an inaccurate RAF.
What is the purpose of a RADV - CORRECT ANSWER-To evaluate the
appropriateness of risk scores to patients.
How many records are submitted by health plans per patient in a RADV audit? -
CORRECT ANSWER-5
Each record submitted for a RADV should include: - CORRECT ANSWER-I.
Complete list and legible records
COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED
questions WITH Correct Answers
100% PASS
Interactions - CORRECT ANSWER-What are extra RA values or factors added
when a patient has more than one major significant dx identified in model ?
Quality, Promoting Interoperability, Improvement Activity, Cost - CORRECT
ANSWER-MIPS Collection Types Categories
When are Star Ratings publicly published? - CORRECT ANSWER-October of
each year
HEDIS types of collection - CORRECT ANSWER-Surveys, Medical Chart
Reviews, Insurance Claims, Medical Office Visits, Procedures
What does Abbreviation MAC stand for? - CORRECT ANSWER-Medicare
Administrative Contractor
Each year, Medicare normalizes risk scores to maintain an average of what? -
CORRECT ANSWER-1.0
, Which type of documentation can be used to support diagnoses reported under
risk adjustment models? - CORRECT ANSWER-Inpatient admission note
Risk adjustment models are used to: - CORRECT 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? - CORRECT ANSWER-Yes, additional current diagnoses not included
on claims data may be approved during the audit.
For commercial plans, funding is allocated based on - CORRECT ANSWER-
Current year's known diagnoses
What is the impact on reimbursement under the risk adjustment model if chronic
conditions are not coded properly? - CORRECT ANSWER-Failure to code for a
chronic condition the patient has may result in an inaccurate RAF.
What is the purpose of a RADV - CORRECT ANSWER-To evaluate the
appropriateness of risk scores to patients.
How many records are submitted by health plans per patient in a RADV audit? -
CORRECT ANSWER-5
Each record submitted for a RADV should include: - CORRECT ANSWER-I.
Complete list and legible records
COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED
