CPHRM Exam Prep - Claims and Litigation Questions and Answers

CPHRM Exam Prep - Claims and
Litigation Questions and Answers
AdverseAEventA-
AAnswerAAnyAinjuryA(undesirableAclinicalAoutcome)AcausedAbyAmedicalAcareAandAnotAanAunderlyingA
diseaseAprocess.


AdverseAOutcomeA-
AAnswerAClinicalAoutcomeAthat,AwhileAneitherAdesirableAnorAnecessarilyAanticipated,AmayAstillAhaveA
beenAaAknownApossibilityAassociatedAwithAtheAtreatmentAorAprocedure.


AlternativeADisputeAResolutionA-
AAnswerAAAprocessAorAsystemAtoAresolveAdisputesAoutsideAtheAformalAjudicialAprocess.


NegotiationA-
AAnswerAAAvoluntary,AusuallyAinformal,AunstructuredAprocess.AThereAisAnoAthirdApartyAfacilitatorAbu
tApartiesAmayAbeArepresentedAbyAlegalAcounsel.A(BETWEENATWOAPARTIESAONLY).


MediationA-
AAnswerAAAprocessAinAwhichAaAneutralAthirdApartyAhelpsAtheApartiesAreachAaAmutuallyAacceptableA
agreement.A(TwoApartiesAselectAanAagreedAuponApersonAtoAmediate).


ArbitrationA-
AAnswerATheAhearingAandAdeterminationAofAaAcaseAinAquestionAsomeoneAeitherAchosenAbyAtheAoppo
singApartiesAorAbyAaApersonAappointedAunderAstatutoryAauthority.


BindingAArbitrationA-AAnswerAAnAagreementAthatAisAfinalAandAnotAappealable.


Non-BindingAArbitrationA-
AAnswerAAnAagreementAisAnotAfinalAuntilAitAisAenteredAbyAtheAcourtAintoAtheArecordAallowingAtheA
partyAtoAcontinueAtheAcivilAlitigationAprocess.


AnswerA-
AAnswerAAAdocumentAfiledAwithAtheAcourtAinAresponseAtoAaAcomplaintAorApetition.AGenerallyAtheAA
nswerAmustAadmitAthatAplaintiff'sAallegationsAareAtrue;AdenyAthatAtheAplaintiff'sAallegationsAareAtru
e;AorAstateAthatAtheAdefendantAdoesAnotAhaveAinformationAregardingAtheAtruthAorAfalsityAofAtheAall
egations.


AppealA-
AAnswerAAnAactionAthatAisAtakenAafterAtheAtrialAofAaAmatterAorAafterAaAdispositiveAmotionAhasAbe
enAenteredAinAtheAmatter.AAnAappealAmayAbeAtakenAforAtheApurposeAofAcorrectingAanAerrorAmadeA

, byAtheAtrialAcourtAorAtoAobtainAaAnewAtrial.AAlso,AitAisAaAresortAtoAaAhigherAcourtAtoAobtainAaAre
viewAofAaAlowerAcourt'sAdecisionAandAaAreversalAofAtheAlowerAcourt'sAjudgmentAorAgrantingAofAane
wAtrial.


AssaultA-
AAnswerAAnAintentionalAactAthatAisAdesignedAtoAmakeAtheAvictimAfearfulAandAthatAproducesAreason
ableAapprehensionAofAharm.


Attorney-ClientAPrivilegeA-
AAnswerAAAlegalAdoctrineArecognizedAbyAbothAcommonAandAstatutoryAlawAprotectingAcertainAconfide
ntialAcommunicationsAbetweenAanAattorneyAandAhisAorAherAclientAfromAdiscoveryAinAaAlegalAproceed
ingAunlessAtheAprivilegeAisAwaivedAbyAtheAclient.


AttorneyAWorkAProductAPrivilegeA-
AAnswerAAAlegalAdoctrineArecognizedAbyAbothAcommonAandAstatutoryAlawAprotectingAtheAdocuments
Agenerated,AtheoriesAdevised,AlegalAstrategiesAformulated,Aetc.AbyAanAattorneyAonAbehalfAofAaAclien
tAfromAdiscoveryAinAaAlegalAproceedingAunlessAtheAprivilegeAisAwaivedAbyAtheAclient.


BatteryA-
AAnswerAInAtortAlaw,AtheAintentionalAcausationAofAharmfulAorAoffensiveAcontactAwithAaApersonAwith
outAthatAperson'sAconsent.


ClaimA-
AAnswerAFormalAnotification,AeitherAinAwritingAorAorallyAthatAmonetaryAdamagesAorAdemandAforAse
rvicesAareAbeingAsoughtAfromAtheAhealthcareAorganizationAbyAaAthirdApartyAforAanAallegedAinjury.A
CanAbeAmadeAbyApatient,AorApatient'sAfamily,Aguardian,AorAattorney.


Claims-MadeACoverageA-
AAnswerAProvidesAcoverageAforAaAclaimAthatAoccurredAAFTERAtheAinceptionAorAretroactiveAcoverageA
dateAofAtheApolicyAandAisAreportedAtoAtheAinsuranceAcompanyAwhileAtheApolicyAorAanyAreplacement
ApolicyAisAstillAinAeffect.


Complaint/GrievanceA-
AAnswerAAAformalAorAinformalAwrittenAorAverbalAcomplaintAmadeAtoAtheAhospitalAbyAtheApatientAo
rAtheApatient'sArepresentativeAregardingAtheApatient'sAcare.AMedicare/MedicaidAHospitalAConditionsA
ofAParticipationArequireAaAformalAprocessAforApatientAnotificationAofAtheirArightsAandAforAresponseA
andAfollowAupAwithAtheApatient.


ComplaintA(Legal)A-
AAnswerAOneAofAtheAinitialAfilingsAwithAtheAcourtAtoAbeginAaAlawsuit;AnormallyArecitesAallAofAtheA
allegationsAagainstAtheAdefendantAandAtheoriesAuponAwhichAtheAplaintiffAseeksAtoArecoverAdamages
A(mayAbeAcalledAaApetitionAinAsomeAjurisdictions).