CCM CORE EXAM TEST QUESTIONS AND ANSWERS RATED
A+
✔✔ADA Title I - ✔✔employers with 15 or more employees are prohibited from
discriminating against people with disabilities
✔✔Advocate - ✔✔main focus of Case management
✔✔Primary nursing model of care - ✔✔the same nurse provides comprehensive care
for the member the entire period of care
✔✔Case management model of care - ✔✔IDT group monitors and discusses patients
health care progress, more cost-effective
✔✔Family-Centered Model of Care - ✔✔collaborates with the family & healthcare team
to support patient healthcare decisions
✔✔Public Health nursing model of care - ✔✔focuses on an entire population that has
similar health issues
✔✔Integrative model of care - ✔✔IDT model of care that encompasses medical,
psychosocial and social needs of the patient
✔✔Medical Home model - ✔✔care focus on primary provider care and relationship
between patient, family, and physician
✔✔chronic care model - ✔✔focused on proactive evidenced based, population based,
& patient-centered care for patients with chronic medical conditions
✔✔Workers Compensation - ✔✔provides coverage of injury or illness that occurred
while at work or work-related task
✔✔case management process - ✔✔identify patients, assess problems, develop,
Implement, evaluate, & terminate POC
✔✔Magnuson Model - ✔✔model to determine the patient intensity or Acuity levels.
✔✔Broker model - ✔✔standard model, design to identify needs of the client & access to
identified resources
✔✔signs of abuse - ✔✔unexplained bruising, malnutrition, unkempt, multiple ER visits
✔✔BATNA - ✔✔Best Alternative To a Negotiated Agreement, allows CM to explore
alternative solutions
, ✔✔Active listening - ✔✔essential to negotiating , includes listening to direct and indirect
communications
✔✔Uilization Review Accreditation Commission (URAC) - ✔✔non-profit organization
that provides accreditation to Health Care organizations
✔✔Goal of the URAC - ✔✔to encourage continued Improvement in quality and efficient
Healthcare Management to education and accreditation
✔✔National Quality Forum (NQF) - ✔✔organization that's set standards used to
measure public report Healthcare quality
✔✔Assistive Technology - ✔✔array of devices that permit people with disabilities to
improve their functioning
✔✔Non-maleficence - ✔✔deals with the practitioner (do no harm)
✔✔OSHA - ✔✔in the Department of Labor to maintain a safe and healthy work
environment
✔✔Family and Medical Leave Act of 1993 (FMLA) - ✔✔Requires employers to provide
up to 12 weeks of unpaid leave for family and medical emergencies
✔✔Mental Health Parity Act of 1996 - ✔✔prohibits lifetime or annual dollar limits on
Mental Health Care unless same limits apply to medical/surgical tx
✔✔Newborns and Mothers Health Protection Act of 1996 (NMHPA) - ✔✔an amendment
to title VII of Civil Rights Act of 1964, that cover private/public hospitals length of stay
following childbirth, pregnancy must be treated same as other employee related
iilnesses
✔✔Women's Health and Cancer Rights Act of 1998 (WHCRA) - ✔✔requires insurance
coverage of breast reconstruction following mastectomy
✔✔HIPAA stands for - ✔✔Health Insurance Portability and Accountability Act of 1996
✔✔HIPAA - ✔✔Title I guarantees health insurance access portability and renewal,
prohibits discrimination based on health status
✔✔Email communication - ✔✔non-verbal communication
✔✔Wickline vs. State of California - ✔✔found the CM's are liable for damage if their
referral is careless and leads to patient harm
A+
✔✔ADA Title I - ✔✔employers with 15 or more employees are prohibited from
discriminating against people with disabilities
✔✔Advocate - ✔✔main focus of Case management
✔✔Primary nursing model of care - ✔✔the same nurse provides comprehensive care
for the member the entire period of care
✔✔Case management model of care - ✔✔IDT group monitors and discusses patients
health care progress, more cost-effective
✔✔Family-Centered Model of Care - ✔✔collaborates with the family & healthcare team
to support patient healthcare decisions
✔✔Public Health nursing model of care - ✔✔focuses on an entire population that has
similar health issues
✔✔Integrative model of care - ✔✔IDT model of care that encompasses medical,
psychosocial and social needs of the patient
✔✔Medical Home model - ✔✔care focus on primary provider care and relationship
between patient, family, and physician
✔✔chronic care model - ✔✔focused on proactive evidenced based, population based,
& patient-centered care for patients with chronic medical conditions
✔✔Workers Compensation - ✔✔provides coverage of injury or illness that occurred
while at work or work-related task
✔✔case management process - ✔✔identify patients, assess problems, develop,
Implement, evaluate, & terminate POC
✔✔Magnuson Model - ✔✔model to determine the patient intensity or Acuity levels.
✔✔Broker model - ✔✔standard model, design to identify needs of the client & access to
identified resources
✔✔signs of abuse - ✔✔unexplained bruising, malnutrition, unkempt, multiple ER visits
✔✔BATNA - ✔✔Best Alternative To a Negotiated Agreement, allows CM to explore
alternative solutions
, ✔✔Active listening - ✔✔essential to negotiating , includes listening to direct and indirect
communications
✔✔Uilization Review Accreditation Commission (URAC) - ✔✔non-profit organization
that provides accreditation to Health Care organizations
✔✔Goal of the URAC - ✔✔to encourage continued Improvement in quality and efficient
Healthcare Management to education and accreditation
✔✔National Quality Forum (NQF) - ✔✔organization that's set standards used to
measure public report Healthcare quality
✔✔Assistive Technology - ✔✔array of devices that permit people with disabilities to
improve their functioning
✔✔Non-maleficence - ✔✔deals with the practitioner (do no harm)
✔✔OSHA - ✔✔in the Department of Labor to maintain a safe and healthy work
environment
✔✔Family and Medical Leave Act of 1993 (FMLA) - ✔✔Requires employers to provide
up to 12 weeks of unpaid leave for family and medical emergencies
✔✔Mental Health Parity Act of 1996 - ✔✔prohibits lifetime or annual dollar limits on
Mental Health Care unless same limits apply to medical/surgical tx
✔✔Newborns and Mothers Health Protection Act of 1996 (NMHPA) - ✔✔an amendment
to title VII of Civil Rights Act of 1964, that cover private/public hospitals length of stay
following childbirth, pregnancy must be treated same as other employee related
iilnesses
✔✔Women's Health and Cancer Rights Act of 1998 (WHCRA) - ✔✔requires insurance
coverage of breast reconstruction following mastectomy
✔✔HIPAA stands for - ✔✔Health Insurance Portability and Accountability Act of 1996
✔✔HIPAA - ✔✔Title I guarantees health insurance access portability and renewal,
prohibits discrimination based on health status
✔✔Email communication - ✔✔non-verbal communication
✔✔Wickline vs. State of California - ✔✔found the CM's are liable for damage if their
referral is careless and leads to patient harm
