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Risk Adjustment Coding (RAC) Microcredential

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The Risk Adjustment Coding (RAC) Microcredential is for individuals who conduct risk adjustment coding as part of their role. This microcredential is intended for individuals working in settings such as surgical hospitals, physician offices, medical administrative services, patient accounting, outpatient care centers, insurance carriers, technology consulting services, and management consulting.

Assessments are administered through our partner vendor, Questionmark through and internet-based testing portal and are available 24 hours a day, 7 days per week. (Browsers that support the Questionmark platform include Google Chrome, Microsoft Edge, Firefox, and Safari.)

Candidates have three hours to complete the assessment. The assessment contains a total of 65 questions (50 scored and 15 unscored questions randomly distributed throughout the assessment). The purpose of unscored questions is to gather data on the performance of these questions. Unscored questions do not count towards a candidate's score. Question types used for the assessment may include matching, multiple-choice or multiple-select, true/false, select-a-blank, pull-down lists, ranking, and may include scenarios presented as images to assess practical application of skills.

  • Risk Adjustment Methodology
    • This domain has five related tasks.
    • Example of task: Differentiate among the risk adjustment models
  • Risk Adjustment Documentation and Compliance
    • This domain has five related tasks.
    • Example of task: distinguish between acceptable versus unacceptable facilities, specialty types, and care-support credentials when reviewing documentation in the health record
  • Medical Terminology Anatomy
    • This domain has three related tasks.
    • Example of task: recognize chronic illnesses and identify common symptoms and treatments for chronic conditions
  • Quality or Regulatory Reform
    • This domain has four related tasks.
    • Example of task: recognize areas of possible non-compliance as established by the Department of Health and Human Services Office of Inspector General (OIG) and its work plan
  • Foundational Coding
    • This domain has two related tasks.
    • Example of task: Review a health record and apply applicable coding guidelines and conventions
  • Frequently Coded Hierarchical Condition Category (HCC) Conditions
    • The tasks related to this domain will be assessed in conjunction with the domains and tasks statements shown above.
    • Individuals wanting to take this assessment should be familiar with many of the frequently coded HCC conditions. Some examples are: social determinants of health, rheumatologic diseases, cardiac arrhythmias, common vascular diseases, aneurysms, bone marrow transplant, ostomy statuses, and more.

 

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