Certified Case Management 2024
Study Guide
function - CORRECT ANSWER -Set of tasks that are completed as part of a role
activity - CORRECT ANSWER -Specific task to meet the needs of the role
To get more questions with correct answers email banks
and other E books - CORRECT ANSWER -
process - CORRECT ANSWER -A series of actions or steps taken to achieve an end/goal
Likert Scale - CORRECT ANSWER -a numerical scale used to assess attitudes; includes a set
of possible answers with labeled anchors on each extreme.
1- able to do
2- moderate
3- severe
4- needs total asst
Caseload Matrix - CORRECT ANSWER -Identifies variables in various settings affecting
caseload.
1- initial elements
2- comprehensive needs assessment
3- case management interventions
4- outcomes
Standards of Practice - CORRECT ANSWER -A list of standards to assist the professional in
making good decisions while conducting day to day responsibilities within his or her scope of
practice.
,standards of care - CORRECT ANSWER -legal requirements for nursing practice that
describe minimum acceptable nursing care
evidence-based practice - CORRECT ANSWER -nursing care provided that is supported by
sound scientific rationale
Rancho Los Amigos Scale - CORRECT ANSWER -evaluates traumatic brain injuries
I-nonresponsive; II, III- decreased response; IV, V, VI- confused; VII-VIII-appropriate levels
social security disability insurance - CORRECT ANSWER -Pays benefits to the individual (and
certain family members) if the individual worked long enough and paid Social Security taxes.
COBRA - CORRECT ANSWER -Consolidated Omnibus Budget Reconciliation Act; law to
provide terminated employees or those who lose insurance coverage because of reduced
work to be able to buy group insurance for themselves and their families for a limited
amount of time.
if disabled within 60 days of obtaining Cobra and remain disabled throughout 18 months of
coverage then you will be able to apply for an additional 11 month extension for a total
coverage of 29 months
patient activation measure (PAM) - CORRECT ANSWER -13 item predictive screening tool to
evaluate a client's ability for self care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
WHODAS (World Health Organization Disability Assessment Schedule) - CORRECT ANSWER
-Assesses general health and disability including mental, neuro, substance abuse.
Utilization Management (UM) - CORRECT ANSWER -Collection of systems and processes
used to determine if health care services are appropriate and medically necessary.
, Utilization review - CORRECT ANSWER -process of evaluating the appropriateness of
services provided
Medicare - CORRECT ANSWER -A federal program of health insurance for persons 65 years
of age and older
Medicare Part B - CORRECT ANSWER -The part of the Medicare program that pays for
physician services, outpatient hospital services, durable medical equipment, and other
services and supplies.
Medicare Part A (Hospital Insurance) - CORRECT ANSWER -covers Medicare inpatient care,
including care received while in a hospital, a skilled nursing facility, and, in limited
circumstances, at home.
Medicare—Part D Prescription Drug Coverage - CORRECT ANSWER -is a voluntary program
for paying for your prescription drugs. If you earn more, you pay more.
Medicaid - CORRECT ANSWER -A federal and state assistance program that pays for health
care services for people who cannot afford them.
Can be 3 months retroactive.
SCHIP (State Children's Health Insurance Program) - CORRECT ANSWER -is a program
administered by the United States Department of Health and Human Services that provides
matching funds to states for health insurance to families with children.
WHCRA ( Women's health and cancer right act) - CORRECT ANSWER -Requires insurance
coverage of breast construction or complications of mastectomy if plan provides
medical/surgical benefits for mastectomy
TEFRA - CORRECT ANSWER -Tax Equity and Fiscal Responsibility Act
provides incentives for cost contamination
Study Guide
function - CORRECT ANSWER -Set of tasks that are completed as part of a role
activity - CORRECT ANSWER -Specific task to meet the needs of the role
To get more questions with correct answers email banks
and other E books - CORRECT ANSWER -
process - CORRECT ANSWER -A series of actions or steps taken to achieve an end/goal
Likert Scale - CORRECT ANSWER -a numerical scale used to assess attitudes; includes a set
of possible answers with labeled anchors on each extreme.
1- able to do
2- moderate
3- severe
4- needs total asst
Caseload Matrix - CORRECT ANSWER -Identifies variables in various settings affecting
caseload.
1- initial elements
2- comprehensive needs assessment
3- case management interventions
4- outcomes
Standards of Practice - CORRECT ANSWER -A list of standards to assist the professional in
making good decisions while conducting day to day responsibilities within his or her scope of
practice.
,standards of care - CORRECT ANSWER -legal requirements for nursing practice that
describe minimum acceptable nursing care
evidence-based practice - CORRECT ANSWER -nursing care provided that is supported by
sound scientific rationale
Rancho Los Amigos Scale - CORRECT ANSWER -evaluates traumatic brain injuries
I-nonresponsive; II, III- decreased response; IV, V, VI- confused; VII-VIII-appropriate levels
social security disability insurance - CORRECT ANSWER -Pays benefits to the individual (and
certain family members) if the individual worked long enough and paid Social Security taxes.
COBRA - CORRECT ANSWER -Consolidated Omnibus Budget Reconciliation Act; law to
provide terminated employees or those who lose insurance coverage because of reduced
work to be able to buy group insurance for themselves and their families for a limited
amount of time.
if disabled within 60 days of obtaining Cobra and remain disabled throughout 18 months of
coverage then you will be able to apply for an additional 11 month extension for a total
coverage of 29 months
patient activation measure (PAM) - CORRECT ANSWER -13 item predictive screening tool to
evaluate a client's ability for self care.
- higher the score the better (scored 0-52)
-predicts health care outcomes, medication adherence and ER visits.
WHODAS (World Health Organization Disability Assessment Schedule) - CORRECT ANSWER
-Assesses general health and disability including mental, neuro, substance abuse.
Utilization Management (UM) - CORRECT ANSWER -Collection of systems and processes
used to determine if health care services are appropriate and medically necessary.
, Utilization review - CORRECT ANSWER -process of evaluating the appropriateness of
services provided
Medicare - CORRECT ANSWER -A federal program of health insurance for persons 65 years
of age and older
Medicare Part B - CORRECT ANSWER -The part of the Medicare program that pays for
physician services, outpatient hospital services, durable medical equipment, and other
services and supplies.
Medicare Part A (Hospital Insurance) - CORRECT ANSWER -covers Medicare inpatient care,
including care received while in a hospital, a skilled nursing facility, and, in limited
circumstances, at home.
Medicare—Part D Prescription Drug Coverage - CORRECT ANSWER -is a voluntary program
for paying for your prescription drugs. If you earn more, you pay more.
Medicaid - CORRECT ANSWER -A federal and state assistance program that pays for health
care services for people who cannot afford them.
Can be 3 months retroactive.
SCHIP (State Children's Health Insurance Program) - CORRECT ANSWER -is a program
administered by the United States Department of Health and Human Services that provides
matching funds to states for health insurance to families with children.
WHCRA ( Women's health and cancer right act) - CORRECT ANSWER -Requires insurance
coverage of breast construction or complications of mastectomy if plan provides
medical/surgical benefits for mastectomy
TEFRA - CORRECT ANSWER -Tax Equity and Fiscal Responsibility Act
provides incentives for cost contamination
