CRC EXAM Questions and Answers (Latest Update 2025) Verified Answers Risk Adjustment Data Element - Correct Answers ✅Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient- specific conditions hospice, ESRD RAF - Correct Answers ✅Risk Adjustment Factor Scores Three main types of reviews - Correct Answers ✅Retrospective, Concurrent and prospective Retrospective - Correct Answers ✅reviews are performed after the information has been reported and in risk adjustment these are prior years dos Concurrent reviews - Correct Answers ✅performed ongoing as patients are seen prior to reporting and in risk adjustment the current year Prospective reviews - Correct Answers ✅will effect the next year and not the current year where payment is concerned.They are used to forcast Types of Risk Adjustment Models(HHS) - Correct Answers ✅HHS hEALTH AND HUMAN SERVICES hIERARCHICAL CONDITION(Commercial, individual and small grooup 1 / 2
CRC EXAM Questions and Answers (Latest Update 2025) Verified Answers Types of Risk Adjustment Modles(CDPS) - Correct Answers ✅Chronic Illness and Disability payment systems(Medicaid) Types of Risk Adjustment Models(HCC-C) - Correct Answers ✅Hierarchical Condition Category, Part C Types of Risk Adjustment model (DRG) - Correct Answers ✅Diagnosis Related Group (Inpatient) Types of Risk Adjustment model (ACG) - Correct Answers ✅Adjusted Clinical Groups(Outpatient)
Prescription based program risk adjustment examples:UCSD -
Correct Answers ✅Medicaid Rx(UCSD) Prescription based program risk adjustment examples(Dxcg) - Correct Answers ✅RxGroups(DxCG) Prescription based program risk adjustment examples(HCC-D)
- Correct Answers ✅Hierarchical Condition Category, Part
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