CCM EXAM UPDATED Exam Questions
and CORRECT Answers
Who is eligible for WIC? - CORRECT ANSWER - Women, infants, children
What does WIC provide? - CORRECT ANSWER - Vouchers for food, infant cereal, baby
food,veggies, etc
Utilization Review - CORRECT ANSWER - Evaluates appropriateness of an admission to
a health care facility or extension of stay; also measures efficiency
What is the CAGE acronym stand for and when is it used? - CORRECT ANSWER -
Screens for alcoholism
1. Have you felt the need to CUT down on drinking?
2. Have ppl ANNOYED you by criticizing your drinking?
3. Have you felt GUILTY about drinking?
4. Have you felt the need for a drink in the AM (EYE Opener)
Who does hospice serve? - CORRECT ANSWER - Both patient and family
What is the Medicare criteria for hospice and which Part covers it? What will Medicare NOT
cover? - CORRECT ANSWER - <6 month life expectancy
-Part A
-Not cover treatment to cure illness, room and board
$0 OOP cost for hospice
What is the O2 sat level for Medicare to approve home O2? - CORRECT ANSWER - 88%
or less to approve home O2 at rest/awake
88% or less x5 min while asleep
,custodial care - CORRECT ANSWER - Bathing, eating, dressing
Family typically covers it
SSDI (Social Security Disability Income) - CORRECT ANSWER - Means of income for
an individual who are restricted in their ability to work due to a disability (usually physical); total
disability (not short term);available to workers who have accumulated a sufficient number of
work credits
-must be younger than 65
-5 month waiting period
-SSDI is funded by the Social Security taxes paid by workers, employers and self-employed
people
POS (Point of Service) - CORRECT ANSWER - Allows individual to choose provider
Higher cost in premiums, deductibles and coinsurance
Primary HIV infection prevention - CORRECT ANSWER - reduction of transmission and
acquisition of HIV
secondary HIV infection prevention - CORRECT ANSWER - prevent a person with HIV
from becoming ill or dying
What does the Rancho Los Amigos scale measure? - CORRECT ANSWER - Assess
individuals after a closed head injury, such as traumatic brain injury (TBI), based on cognitive
and behavioural presentations as they emerge from COMA
I = no response to all stimuli
III = localized response (specific not inconsistent)
V = confused/inappropriate
VIII = purposeful, appropriate, A&O x4
,Delerium - CORRECT ANSWER - - Disturbance of conciousness; reduced ability to
focus, sustain or shift attention; change in cognition
- Develops over hours or days and fluctuates during the course of the day
Dementia - CORRECT ANSWER - Overall decline in intellectual function, including
language difficulty, simple calculations, planning, judgement, motor skills
privileged communication - CORRECT ANSWER - legal term for a right that belongs to a
client
Medicare requirement prior to SNF admission - CORRECT ANSWER - 3 day hospital
stay is required
Wellness coach per-requisites - CORRECT ANSWER - - Can open own business
w/minimal training
- For health care employers: generally a Bachelor's degree is required
Examples of community based programs - CORRECT ANSWER - Church grief support,
ESL tutoring, social organizations
mental capacity - CORRECT ANSWER - A person's "ability" or "capacity"
Describes a cluster of mental skills people use in their everyday lives
Case management vs Disease Management - CORRECT ANSWER - CM = oversees an
individual patient
DM = groups of pts with high cost diagnosis
Demand Management - CORRECT ANSWER - Self care CM through patient education to
determine problems and seek treatment when appropriate
, Ergonomics - CORRECT ANSWER - Study of interaction of people and things; designing
and organizing them for efficient, safe use
Clinical Pathways - CORRECT ANSWER - aka Critical paths, care paths, critical
pathways
They are plans used to manage patient care through GOALS that define WHAT is needed and in
a timely manner (eg. STEMI care path)
due diligence - CORRECT ANSWER - Effort made by someone to avoid harming himself
or someone else
**What is the main difference between clinical vs ethical committees? - CORRECT
ANSWER - Types of experts
Clinical = experts in clinical issues
Organizational= utilization management, code of professional conduct, corporate compliance
How often should CM send a cost benefit analysis of their case load to their employer? -
CORRECT ANSWER - Quarterly
What is Worker's Comp and how is it paid?
If a person accepts Worker's Comp, what can they NOT expect? - CORRECT ANSWER -
-Provides coverage or injury or illness at work or that's work related
-premiums are paid by employer
-if worker is covered by and accepts coverage under worker's comp, they may NOT claim
benefits under a group insurance policy or bring suit against employer for work related injuries
What does OASIS stand for and who receives reimbursement through OASIS? - CORRECT
ANSWER - Outcome and Assessment Information Set
Any home health agency MUST use this form to get reimbursement through Medicare
and CORRECT Answers
Who is eligible for WIC? - CORRECT ANSWER - Women, infants, children
What does WIC provide? - CORRECT ANSWER - Vouchers for food, infant cereal, baby
food,veggies, etc
Utilization Review - CORRECT ANSWER - Evaluates appropriateness of an admission to
a health care facility or extension of stay; also measures efficiency
What is the CAGE acronym stand for and when is it used? - CORRECT ANSWER -
Screens for alcoholism
1. Have you felt the need to CUT down on drinking?
2. Have ppl ANNOYED you by criticizing your drinking?
3. Have you felt GUILTY about drinking?
4. Have you felt the need for a drink in the AM (EYE Opener)
Who does hospice serve? - CORRECT ANSWER - Both patient and family
What is the Medicare criteria for hospice and which Part covers it? What will Medicare NOT
cover? - CORRECT ANSWER - <6 month life expectancy
-Part A
-Not cover treatment to cure illness, room and board
$0 OOP cost for hospice
What is the O2 sat level for Medicare to approve home O2? - CORRECT ANSWER - 88%
or less to approve home O2 at rest/awake
88% or less x5 min while asleep
,custodial care - CORRECT ANSWER - Bathing, eating, dressing
Family typically covers it
SSDI (Social Security Disability Income) - CORRECT ANSWER - Means of income for
an individual who are restricted in their ability to work due to a disability (usually physical); total
disability (not short term);available to workers who have accumulated a sufficient number of
work credits
-must be younger than 65
-5 month waiting period
-SSDI is funded by the Social Security taxes paid by workers, employers and self-employed
people
POS (Point of Service) - CORRECT ANSWER - Allows individual to choose provider
Higher cost in premiums, deductibles and coinsurance
Primary HIV infection prevention - CORRECT ANSWER - reduction of transmission and
acquisition of HIV
secondary HIV infection prevention - CORRECT ANSWER - prevent a person with HIV
from becoming ill or dying
What does the Rancho Los Amigos scale measure? - CORRECT ANSWER - Assess
individuals after a closed head injury, such as traumatic brain injury (TBI), based on cognitive
and behavioural presentations as they emerge from COMA
I = no response to all stimuli
III = localized response (specific not inconsistent)
V = confused/inappropriate
VIII = purposeful, appropriate, A&O x4
,Delerium - CORRECT ANSWER - - Disturbance of conciousness; reduced ability to
focus, sustain or shift attention; change in cognition
- Develops over hours or days and fluctuates during the course of the day
Dementia - CORRECT ANSWER - Overall decline in intellectual function, including
language difficulty, simple calculations, planning, judgement, motor skills
privileged communication - CORRECT ANSWER - legal term for a right that belongs to a
client
Medicare requirement prior to SNF admission - CORRECT ANSWER - 3 day hospital
stay is required
Wellness coach per-requisites - CORRECT ANSWER - - Can open own business
w/minimal training
- For health care employers: generally a Bachelor's degree is required
Examples of community based programs - CORRECT ANSWER - Church grief support,
ESL tutoring, social organizations
mental capacity - CORRECT ANSWER - A person's "ability" or "capacity"
Describes a cluster of mental skills people use in their everyday lives
Case management vs Disease Management - CORRECT ANSWER - CM = oversees an
individual patient
DM = groups of pts with high cost diagnosis
Demand Management - CORRECT ANSWER - Self care CM through patient education to
determine problems and seek treatment when appropriate
, Ergonomics - CORRECT ANSWER - Study of interaction of people and things; designing
and organizing them for efficient, safe use
Clinical Pathways - CORRECT ANSWER - aka Critical paths, care paths, critical
pathways
They are plans used to manage patient care through GOALS that define WHAT is needed and in
a timely manner (eg. STEMI care path)
due diligence - CORRECT ANSWER - Effort made by someone to avoid harming himself
or someone else
**What is the main difference between clinical vs ethical committees? - CORRECT
ANSWER - Types of experts
Clinical = experts in clinical issues
Organizational= utilization management, code of professional conduct, corporate compliance
How often should CM send a cost benefit analysis of their case load to their employer? -
CORRECT ANSWER - Quarterly
What is Worker's Comp and how is it paid?
If a person accepts Worker's Comp, what can they NOT expect? - CORRECT ANSWER -
-Provides coverage or injury or illness at work or that's work related
-premiums are paid by employer
-if worker is covered by and accepts coverage under worker's comp, they may NOT claim
benefits under a group insurance policy or bring suit against employer for work related injuries
What does OASIS stand for and who receives reimbursement through OASIS? - CORRECT
ANSWER - Outcome and Assessment Information Set
Any home health agency MUST use this form to get reimbursement through Medicare
