CCM Glossary Question and answer rated A+ 2023

CCM Glossary Question and answer rated A+ 2023AAPM&R American Academy of Physical Medicine and Rehabilitation Access to care the ability and ease of clients to obtain healthcare when they need it Accessible 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) 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. Accreditation A standardized program for evaluating healthcare organizations to ensure a specified level of quality, as defined by a set of national industry standards. Actionable tort A legal duty, imposed by statute or otherwise, owing by defendant to the one injured Active listening A structured way of communication and interacting in which one is 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 Routine activities an individual tends to de every day for self-care and normal living. These include eating, bathing, grooming, dressing, toileting, transferring and continence. Activity limitations Difficulties an individual may have in executing activities. These 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. Actual value is also referred to as Real value is also referred to as Actual value Measures the worth one derives from using or consuming a good, product, service or an item, and represents the utility of the good, product, service, or item. Actuarial study Statistical analysis of a population based on its utilization of healthcare services and demographic trends of teh population. Results used to estimate healthcare plan premiums or costs. Actuary A trained insurance professional who specializes in determining policy rates, calculating premiums, and conducting statistical studies. Acuity Complexity and severity of the client's health/medical condition Acute care Focuses on treating sudden and ___________ episodes of illness such as medical and surgical management or emergency treatment which otherwise cannot be taken care of in a less intense care setting. ADA Americans with Disabilities Act of 1990 ADAAA Americans with Disabilities Ammendments Act of 2008 Adaptive behavior The effectiveness and degree to which an individual meets standards of self-sufficiency and social responsibility for his/her age-related cultural group Adherence The extent to which a person's behavior--taking medication, following a dieth, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider. Adhesive contract An agreement between two parties where one party with stronger bargaining power sets the terms and conditions and the other party, which is the weaker of the two with little to no ability to negotiate, must adhere to the contract and is placed in a "take it or leave it" position. Adjusted Clinical Group (ACG) System The system clusters clients into homogenous groups based on a unique approcach to measuring morbidity to ultimately improve accuracy and fairness in evaluating healthcare provider performance, identifying clients at high risk, forecasting healthcare utilization, and setting equitable payment structure and rates for the providers of care. Adjuster A person who handles claims Administrative law That branch of public laws that deals with the various organizations of federal, state, and local governments which prescribes in detail the manner of their activities. Administrative Services Only (ASO) An insurance company or third-party administrator that delivers administrative services to an employer group. This usually requires the employer to be at risk for the cost of healthcare services provided. Admission certification A form of utilization review in which an assessment is made of the medical necessity of a client's admission to a hospital or other inpatient facility. It ensures taht clients requiring a hospital-based level of care and length of stay appropriate for the admission diagnosis are usually assigned and certified and payment for teh services are approved. Admission review A review that occurs within 24 hours of a client's admission to a healthcare facility or according to the time frame required in the contractual agreement between healthcare provider and the health insurance plan. Advance directive Legally executed document that explains the client's healthcare related wishes and decisions. It is drawn up while the client is still competent and is used if the client becomes incapacitated or incompetent. Adverse events Any untoward occurrences, which under most conditions are not natural consequences of the client's disease process or treatment outcomes. Advocacy The act of recommending, pleading the cause of another; to speak or write in favor of. Advocate A person or agnecy who speaks on behalf of others and promotes their causes.