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Case Management Certification Exam Glossary & Study Guide

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This document is a comprehensive glossary of terms and concepts essential for case management certification. It provides detailed definitions for a wide array of terms used in the healthcare and insurance industries. The glossary covers topics such as healthcare delivery models (HMO, PPO), managed care concepts (Capitation, DRGs), legal and ethical terms (Informed Consent, HIPAA), insurance terminology (Coinsurance, Claim), and clinical terms (Activities of Daily Living, Comorbidity). It is designed as a reference for candidates preparing for the Certified Case Manager (CCM) exam or other case management certifications.

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Glossary of Terms for Case Management
Certification Final Exam Questions And Answers
2026
Graded A+
D
O
N
O
T

AAPM&R - ANSWER-American Academy of Physical Medicine
C

and Rehabilitation
O
PY

ACCESS TO CARE - ANSWER-The ability and ease of clients to
obtain healthcare when they need it.


ACCESSIBLE - ANSWER-A term used to denote building facilities
that are barrier-free thus enabling all members of society safe
access, including persons with physical disabilities.

,ACCOUNTABLE CARE ORGANIZATION (ACO) - ANSWER-A set of
healthcare providers including primary care physicians,
specialists, and hospitals that work together collaboratively and
accept collective accountability for the cost and quality of care
delivered to a population of patients. ACOs became popular in
the Medicare fee-for-service benefit system as a result of the
Affordable Care Act.
D

ACCREDITATION - ANSWER-A standardized program for
O

evaluating healthcare organizations to ensure a specified level
of quality, as defined by a set of national industry standards.
N
O

ACTIONABLE TORT - ANSWER-A legal duty, imposed by statute
T

or otherwise, owing by defendant to the one injured.
C
O

ACTIVE LISTENING - ANSWER-A structured way of
PY

communication and interacting in which one is actively engaged
with the speaker primarily through focused attention and
suspension of one's own frame of reference, biases,
distractions and judgment.


ACTIVITIES OF DAILY LIVING (ADLS) - ANSWER-Routine activities
an individual tends to do every day for self-care and normal
living. These include eating, bathing, grooming, dressing,

,toileting, transferring (such as walking, bed to chair) and
continence.


ACTIVITY LIMITATIONS - ANSWER-Difficulties an individual may
have in executing activities. An activity limitation may range
from a slight to a severe deviation in terms of quality or
quantity in executing the activity in a manner or to the extent
that is expected of people without the health condition.
D
O

ACTUAL VALUE - ANSWER-Also referred to as real value.
N

Measures the worth one derives from using or consuming a
O

good, product, service or an item, and represents the utility of
the good, product, service, or item.
T
C

ACTUARIAL STUDY - ANSWER-Statistical analysis of a population
O

based on its utilization of healthcare services and demographic
PY

trends of the population.


ACTUARIAL STUDY - ANSWER-Statistical analysis of a population
based on its utilization of healthcare services and demographic
trends of the population. Results used to estimate healthcare
plan premiums or costs.

, ACTUARY - ANSWER-A trained insurance professional who
specializes in determining policy rates, calculating premiums,
and conducting statistical studies.


ACUITY - ANSWER-Complexity and severity of the client's
health/medical condition.
D

ACUTE CARE - ANSWER-The acute care delivery systems focus
O

on treating sudden and acute episodes of illness such as
medical and surgical management or emergency treatment,
N

which otherwise cannot be taken care of in a less intense care
O

setting. Acute care settings may include hospitals, acute
rehabilitation centers, emergency care, transitional hospitals,
T

and follow-up long-term disease management settings.
C
O

ADA - ANSWER-Americans with Disabilities Act of 1990 and
PY

Americans with Disabilities Act Amendments Act of 2008.


ADA AMENDMENTS ACT (ADAAA) - ANSWER-Refers to the
amendments made to the Americans with Disabilities Act.


ADL - ANSWER-Activities of Daily Living. Routine activities
carried out for personal hygiene and health and for operating a

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