Cdeo study guide Study guides, Class notes & Summaries

PREDICTIVE MODELING - 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 - Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors - * Known/Expected clinical...

CDEO Chapter 7 Exam Study Guide with Complete Solutions RBRVS - Answer️️ -Resource-Based Relative Value Scale RBRVS System - Answer️️ -Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - Answer️️ -Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - Answer️️ -...

CDEO Chapter 8 Study Guide with Complete Solutions PREDICTIVE MODELING - Answer️️ -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 - Answer️️ -Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - Answer️️ -Analysis of the information identified is used to target retrospective r...

CDEO - Chapter 2 Exam Study Guide with Complete Solutions (HIPAA) - Answer️️ -Health Insurance Portability and Accountability Act of 1996 HIPAA was enacted on _________. - Answer️️ -August 21, 1996 HIPAA aka as ______ bill, was originally enacted to provide rights and protections for participants and beneficiaries of group health plans. Under this law, exclusions for preexisting conditions were limited, and discrimination against employees and dependents based on their health stat...

Congestive Heart Failure - ANSWER A chronic condition in which the heart doesn't pump blood as well as it should. Hypertension - ANSWER A condition in which the force of the blood against the artery walls is too high. HEDIS - ANSWER Healthcare Effectiveness Data and Information Set HIPAA - ANSWER Health Insurance Portability and Accountability Act MPFS - ANSWER Medicare National Physician Fee Schedule Multiple procedure rule - ANSWER The highest value code is paid at 100%. The se...

CDEO EXAM Study Guide. HIPPA - answerHealth Insurance Portability and Accountability Act of 1996 and the Healthcare Fraud and abuse control program. Far-reaching program to combat fraud and abuse in healthcare including both public and private health plans. Individuals protected health information - answerDemographic data, name, address, birth date, and SS number. central focus of clinical documentation - answershould be to demonstrate the quality of care provided to the patient with deta...

CDEO Chapter 7 Exam Study Guide RBRVS - answerResource-Based Relative Value Scale RBRVS System - answerEstablished by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - answerEach CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - answer1) Physician work- time, skill, training, and intensity o...