Concurrent reviews - Study guides, Class notes & Summaries

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element - Correct Answer ️️ -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 Answer ️️ -Risk Adjustment Factor Scores Three main types of reviews - Correct Answer ️️ -Retrospective, Concurrent and prospective Retrospective - Correct Ans...

What are the roles of physician advisor? - Regulatory oversight, cost containment, Medicare audits and denials, commercial insurance denials, length of stay management, clinical documentation improvement, and ICD-10 implementation. Done with concurrent reviews, daily MDR rounds, patient quality and safety initiatives, compliance, coding, CDI and physician education. PSROs- Professional standards review organizations - Created to review the quality, quantity, and cost of hospital care provided...

CDFM MODULE 1 Test | Questions and Answers 100% Correct 2023 Latest. What prevents Congress and the President from unilaterally making laws and treaties? - correct answersSeparation of Power What give Congress the authority to make laws? - correct answersArticle 1, Section 8 of the Constitution Who reviews the constitution for interpretation of the constitution? - correct answersSupreme Court Who has the power to raise taxes given in Article 1 of the Constitution? - correct answersCongres...

Psychiatric Mental Health Nursing 8th edition by Shelia Videbeck||ISBN NO-10 2,ISBN NO-13 978-8|| All Chapter Covered 1-24 | Complete Guide A+. Psychiatric Mental Health Nursing 8th edition by Shelia Videbeck Test Bank , All Chapter Covered 1-24 | Complete Guide A+: UNIT 1 Current Theories and Practice • 1. Foundations of Psychiatric–Mental Health Nursing • 2. Neurobiologic Theories and Psychopharmacology • 3. Psychosocial Theories and Therapy • 4. Treatment Settings and Therapeutic Pr...

CDIP Toolkit (Clinical Documentation Improvement Toolkit AHIMA) with Complete Solutions CDIP Toolkit (Clinical Documentation Improvement Toolkit AHIMA) with Complete Solutions CDIP Toolkit (Clinical Documentation Improvement Toolkit AHIMA) with Complete Solutions recent drivers of CDI (p2) - ANSWER-- MS-DRGs 2007 to reflect SOI/ROM - POA indicators 2008 - Medicare Advantage/Part C (capitated, HCC) - some payers moving to APR DRGs - compliance reviews: RAC, Zone Program Integri...

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element - Correct Answer ️️ -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 Answer ️️ -Risk Adjustment Factor Scores Three main types of reviews - Correct Answer ️️ -Retrospective, Concurrent and prospective Retrospective - Correct Ans...

Evidence-based medicine (EBM) is - Answer-the integration of the best research evidence with clinical expertise and patient values There are two main categories of research: - Answer-basic research and applied research 4 Sources of Evidence-Based Medicine - Answer-- clinical expertise - research evidence - information from the practice context - client's values and circumstances How to determine the strength of the evidence: - Answer-First, classify the type of information as primary or...

Chapter 04: Community-Based Nursing Practice Potter: Essentials for Nursing Practice, 8th Edition MULTIPLE CHOICE 1. A student nurse is beginning the community-based primary care rotation. The student nurse anticipates that the assignment in community-based health care will most likely be at which organization? a. An acute care hospital b. A rehabilitation hospital c. A nursing home d. A high school ANS: D High schools focus on primary rather than acute care and provide kno...

HCA 416 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++ OLAP, OLTP Where Does Data Come From? ( 2 terms Acronyms) Health related event Where is Healthcare Data Created From? Patients health record Where Does Healthcare Data Come From? (primary source) Healthcare information database Where Does Healthcare Data Come From? (secondary) Provides additional care for patients with complex needs or posthospital services What is Case Management do? Medicare COP and TJC st...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...