CDIP Domain 4: CDI Metrics & Statistics

MAC -answer Medicare Administrative Contractor RAC -answer Recovery Audit Contractor Denial rate is calculated by -answer Dividing the number of claims or line items denied, by the number of claims or line items submitted Query response rate -answer the number of responses from the providers to the queries that have been written. QRR -answer Query Response Rate Calculation of the QRR is performed by -answer dividing the number of queries responses by the number of queries written Calculation of the QRR is based on -answer responses only, and may also be based on completion within the established time frame PPC -answer Potentially Preventable Complications PPA -answer Potentially Preventable Admissions CMI -answer Case Mix Index Physician Compare -answer CMS website that assists in finding and choosing physicians and other health care professionals enrolled in Medicare so that you can make informed choices about the health care you get, as required by the Affordable Care Act (ACA) of 2010 SPS -answer Safe Practice Score CPOE -answer Computerized Physician Order Entry EBHR -answer Evidence-Based Hospital Referral IPS -answer ICU Physician Staffing HCAHPS -answer Hospital Consumer Assessment of Healthcare Providers and Systems Hospital Compare -answer A consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. Can be used to assist consumers with making informed decisions about health care. Agree/disagree rate -answer a way to measure the manner in which the physician and the CDI program staff are clear in their understanding of the query and the CDI process