Question 1 of 20
Explain prospective versus retrospective controls as you would to a new CRC. What is the governing rule, what documentation boundary matters, and what common shortcut would you reject?
Strong Interview Answer
Prospective controls operate before submission to prevent unsupported or incorrect data; retrospective controls operate after coding/submission to detect and correct errors. Examples of prospective controls include pre-submission chart validation and edit checks; retrospective controls include post-submission audits, reconciliation, and RADV preparation. Prospective prevents; retrospective detects/corrects.
What to Listen For
- PRE = prevent
- POST = correct
- prospective
Caution
Do not accept an answer that relies on this shortcut: Calling every chart review retrospective.