CDEO Chapter 8 Exam With Answers

CDEO Chapter 8 Exam With Answers PREDICTIVE MODELING -Correct Answer-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 -Correct Answer-Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews -Correct Answer-Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors -Correct Answer-* Known/Expected clinical progression of an illness or disease * DME needs * PDE * Laboratory test findings * CPT codes reported during the year in review * HCPCS codes reported during the year in review * Socioeconomic status * Disability: Hospice: ESRD and other such statuses of the patient being reviewed Quality of Care -Correct Answer-Quality Measures Star Ratings HEDIS -Correct Answer-Healthcare Effectiveness Data and Information Set CMS Stars Ratings -Correct Answer- QBPs -Correct Answer-Quality Bonus Payments Quality Bonus Payments -Correct Answer-TO make quality of care a priority the Affordable Care Act set a requirement that CMS make quality bonus payments to Medicare Advantage plans that earn four or more stars in a five-star quality rating system would receive a bonus payment. Ear