CRC Coding Exam Test (best for
studies)2023
MEAT substantiation - CORRECT ANSWER-Monitor, Evaluate, Assess/Adress, Treat
MEAT (monitor) - CORRECT
... [Show More] ANSWER-signs, symptoms, disease progression, disease
regression
MEAT (evaluate) - CORRECT ANSWER-test results, medication effectiveness,
response to treatment
MEAT (assess/address) - CORRECT ANSWER-ordering tests, discussion, review
records, counseling
MEAT (treat) - CORRECT ANSWER-medications, therapies, other modalities
TAMPER substantation - CORRECT ANSWER-Treat, Assess, Monitor/Medicate, Plan,
Evaluate, Refer
TAMPER (treat) - CORRECT ANSWER-physical/occupational therapy; patient refusal
of treatment
TAMPER (assess) - CORRECT ANSWER-condition assessed in the physical exam
TAMPER (monitor/medicate) - CORRECT ANSWER-both OTC and prescription (Rx)
TAMPER (plan) - CORRECT ANSWER-orders for studies i.e. lipid panel, urinalysis, x
ray or biopsy
TAMPER (evaluate) - CORRECT ANSWER-review lab, pathology, radiology results;
discussion of progress towards health goal
TAMPER (refer) - CORRECT ANSWER-referral to a specialist
purpose of risk adjustment - CORRECT ANSWER-level payment and expectations
HCC-C - CORRECT ANSWER-hierarchichal condition categories-Medicare part C
HCCRx - CORRECT ANSWER-hierarchichal condition categories-prescription drugs
ACG - CORRECT ANSWER-ambulatory care group-Medicaid managed care plan
CDPS - CORRECT ANSWER-chronic illness and disability payment system-Medicaid
managed care plan
CDPS-MH - CORRECT ANSWER-chronic illness and disability payment systemMedicaid managed care plan-mental health
CRG - CORRECT ANSWER-clinical risk group-Medicaid managed care plan
DCG - CORRECT ANSWER-diagnostic cost group-Medicaid managed care plan
DPS - CORRECT ANSWER-disability payment system-Medicaid managed care plan
ERG - CORRECT ANSWER-episode risk groups-Medicaid managed care plan
PRG - CORRECT ANSWER-pharmacy risk groups-Medicaid managed care plan
HHS-HCC - CORRECT ANSWER-Health and human services - HCC - ACA managed
care plan
risk adjustment plans are: - CORRECT ANSWER-federally funded plans
paid per enrollee/beneficiary
diagnoses drive payment
--acuity
--demographics (age, gender, location
additional requirements
consistently request documentation
--quarterly
traditional FFS plans - CORRECT ANSWER-dx, procedures & services, supplies, dme,
etc=payments
risk adjustment model - CORRECT ANSWER-an actuarial tool used to predict health
care costs based on relative actuarial risk of enrollees in risk adjustment covered plans
risk adjustment elements - CORRECT ANSWER-age
sex
disabled status
original reason for entitlement
medicaid eligibility
disease heirarchy
ACA (HHS) - CORRECT ANSWER-enrollee risk score is based on the individual's
demographic and health status information
ACA (HHS) risk score calculation - CORRECT ANSWER-risk score is calculated as the
sum of these demographic and health factors weighted by their estimated marginal
contributions to total risk [Show Less]