CCM2019 PRACTICE QUESTIONS FOR TEST. WITH
COMPLETE SOLUTIONS 100% 2023/2024
Diagnostic related groups were developed to:
Pay hospital rate.
To coordinate cost effective quality homecare products and services the case manager should:
Critically assess providers
A type of health care insurance that covers out of pocket cost for Medicare covered services is:
Medigap
Which of the following statements best defines return on investment ROÍ?
The ratio of care cost to savings.
Extra contractual benefits are:
Sometimes an option when alternative sources are unavailable.
In reference to mental health,the term co occurring disorder is used interchangeably with :
Dual diagnosis
A healthcare cost trend factor that can be most directly impacted by case manager s is:
Intensity of service
Disease management programs typically focus on patients with:
Chronic illnesses
cost benefit analysis reports include:
Alternative treatment plans.
Case managers must intervene if which of the following are identified?
Safety concerns
Legally, a client has which of the following rights in regard to personal health information?
Read information in the file
Discharge planning a spinal cord injury should begin:
At time of admission
The use of telemedicine by home agencies
Can provide improved patient access.
An example of a reasonable accommodation is:
,Providing a medical examination for the individual with a disability so that the employer will know
what environmental changes are needed.
Utilization review and accreditation committee URAC accreditation is:
National recognized and reputable
Motivational interviewing theory,a individual in the contemplation stage of change:
acknowledges there is a problem
The contractual right to recover payment made to claimant for healthcare costs after that claimant
has received payment for damages in a legal action is:
Subrogation
case management organizations are frequently challenged to manage caseloads for effective,quality
practice. Which of the following is a major consideration?
The case management model
The most common barrier to obtaining access to resources and services for the chronically ill elderly
persons is:
Financial limitations
A diabetic action plan is an effective tool in helping a client make behavior changes by:
Defining self management goals.
Higher order norms or fundamental assumptions that are consistent with a society's moral principles
and constitute higher standards of moral behavior are:
Ethical principles
The state children's Health Insurance Program SCHIP provides health insurance coverage for
uninsured and underinsured children who:
Have household income above the Medicaid qualifying income.
The need for nursing home care for the elderly has declined due to :
Development of alternative community caregiving arrangements
The goal of work hardening include,
Increase confidence,control of manifestation of condition ,and increased work tolerance and rate.
When a case manager coordinates the transfer of a catastrophically or chronically ill patient from one
facility to another,
The case manager can usually claim a savings if the patient transfers from higher to a lower intensity
of care
The attainment of a level of competence that allows a client to return to work is a goal of:
Work hardening
, Historically, senior programs in the US have not served older people well due to:
Lack of care coordination
Intensity of services and severity of illness are factors considered in which of the following utilization
management guideline sets?
Interqual.
Which of the following organizations provide a systematic review of managed care organizations for
accreditation
NCQA
For patients with dual diagnosis, gap and fragmentation of care can be avoided if the healthcare team
exercises close collaborator and:
Communication
When a case manager's secondary activities have the potential to compromise primary
responsibilities, this is referred as:
Conflict of interest
Two essential components of a risk management program are:
Loss control and loss prevention
Viatical settlement is the sale of a life insurance policy by the :
Policy owner before the policy matures.
In a workers compensation case, field-based case manager intervention may be required if the
treating physician:
Labels the period of disability as indefinite.
In determining the quality of rehabilitation facility and its programs the case manager should:
Assess accreditation, scope of practice, proximity, flexibility, and outcomes measurement systems.
The main purpose of clients involvement in developing a rehabilitation plan is to:
Improve Percision and achievement of goals.
The most common method of assessing the effectiveness of case management is:
Savings reports.
According to the American nurses Association eight and a guide, staffing decisions should be based
on:
The needs of patients and qualifications of staff.
In a group counseling setting, the counselor must:
COMPLETE SOLUTIONS 100% 2023/2024
Diagnostic related groups were developed to:
Pay hospital rate.
To coordinate cost effective quality homecare products and services the case manager should:
Critically assess providers
A type of health care insurance that covers out of pocket cost for Medicare covered services is:
Medigap
Which of the following statements best defines return on investment ROÍ?
The ratio of care cost to savings.
Extra contractual benefits are:
Sometimes an option when alternative sources are unavailable.
In reference to mental health,the term co occurring disorder is used interchangeably with :
Dual diagnosis
A healthcare cost trend factor that can be most directly impacted by case manager s is:
Intensity of service
Disease management programs typically focus on patients with:
Chronic illnesses
cost benefit analysis reports include:
Alternative treatment plans.
Case managers must intervene if which of the following are identified?
Safety concerns
Legally, a client has which of the following rights in regard to personal health information?
Read information in the file
Discharge planning a spinal cord injury should begin:
At time of admission
The use of telemedicine by home agencies
Can provide improved patient access.
An example of a reasonable accommodation is:
,Providing a medical examination for the individual with a disability so that the employer will know
what environmental changes are needed.
Utilization review and accreditation committee URAC accreditation is:
National recognized and reputable
Motivational interviewing theory,a individual in the contemplation stage of change:
acknowledges there is a problem
The contractual right to recover payment made to claimant for healthcare costs after that claimant
has received payment for damages in a legal action is:
Subrogation
case management organizations are frequently challenged to manage caseloads for effective,quality
practice. Which of the following is a major consideration?
The case management model
The most common barrier to obtaining access to resources and services for the chronically ill elderly
persons is:
Financial limitations
A diabetic action plan is an effective tool in helping a client make behavior changes by:
Defining self management goals.
Higher order norms or fundamental assumptions that are consistent with a society's moral principles
and constitute higher standards of moral behavior are:
Ethical principles
The state children's Health Insurance Program SCHIP provides health insurance coverage for
uninsured and underinsured children who:
Have household income above the Medicaid qualifying income.
The need for nursing home care for the elderly has declined due to :
Development of alternative community caregiving arrangements
The goal of work hardening include,
Increase confidence,control of manifestation of condition ,and increased work tolerance and rate.
When a case manager coordinates the transfer of a catastrophically or chronically ill patient from one
facility to another,
The case manager can usually claim a savings if the patient transfers from higher to a lower intensity
of care
The attainment of a level of competence that allows a client to return to work is a goal of:
Work hardening
, Historically, senior programs in the US have not served older people well due to:
Lack of care coordination
Intensity of services and severity of illness are factors considered in which of the following utilization
management guideline sets?
Interqual.
Which of the following organizations provide a systematic review of managed care organizations for
accreditation
NCQA
For patients with dual diagnosis, gap and fragmentation of care can be avoided if the healthcare team
exercises close collaborator and:
Communication
When a case manager's secondary activities have the potential to compromise primary
responsibilities, this is referred as:
Conflict of interest
Two essential components of a risk management program are:
Loss control and loss prevention
Viatical settlement is the sale of a life insurance policy by the :
Policy owner before the policy matures.
In a workers compensation case, field-based case manager intervention may be required if the
treating physician:
Labels the period of disability as indefinite.
In determining the quality of rehabilitation facility and its programs the case manager should:
Assess accreditation, scope of practice, proximity, flexibility, and outcomes measurement systems.
The main purpose of clients involvement in developing a rehabilitation plan is to:
Improve Percision and achievement of goals.
The most common method of assessing the effectiveness of case management is:
Savings reports.
According to the American nurses Association eight and a guide, staffing decisions should be based
on:
The needs of patients and qualifications of staff.
In a group counseling setting, the counselor must:
