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AHIP AHM-530 Exam - Topic 3 Question 33 Discussion

Health plans typically conduct two types of reviews of a provider's medical records: an evaluation of the provider's medical record keeping (MRK) practices and a medical record review (MRR). One true statement about these types of reviews is that:
A) An MRK covers the content of specific patient records of a provider.
B) The NCQA requires an examination of MRK with all of a health plan's office evaluations.
C) An MRR includes a review of the policies, procedures, and documentation standards the provider follows to create and maintain medical records.
D) The NCQA requires MRR for both credentialing and recredentialing of providers in a health plan's network.

AHIP AHM-530 Exam - Topic 3 Question 33 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 33
Topic #: 3
[All AHM-530 Questions]

Health plans typically conduct two types of reviews of a provider's medical records: an evaluation of the provider's medical record keeping (MRK) practices and a medical record review (MRR). One true statement about these types of reviews is that:

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Suggested Answer: A

by Cheryl at May 05, 2022, 03:36 AM

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Brunilda
11 months ago
B seems off, I don't recall NCQA needing that for all evaluations.
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Ashanti
11 months ago
I thought MRK was just about record keeping, not specific patient records.
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Dorathy
11 months ago
Wait, does NCQA really require that for recredentialing?
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Carmen
11 months ago
Totally agree, C is the right answer!
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Noemi
11 months ago
I think an MRR looks at policies and procedures.
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Catalina
12 months ago
I'm feeling pretty good about this one. The training data set is used to build the predictive models, which is option D. The validation set is for comparing models and selecting the final one.
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Holley
12 months ago
I'm a little confused by the wording of the question. Are they asking about the best method or just a method that helps estimate project value? I'll need to re-read it carefully.
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