CCM Exam |Questions with Correct Answers| Verified| Latest
Update
Tools to identify patients who might benefit from disease management include all except
a. ICD 9
b. CPT codes
c. utilization data
d. radiology data - Answer✔✔d. radiology data
Which is not included as one of the three major elements that are globally accepted to
achieve health and wellness
a. knowledge
b. to be in a position to chose better health
c. the empowerment to make decisions and sick to those decisions
d. money - Answer✔✔d. money
If a case manager is working with a home health agency within a managed care network and
there is a complaint regarding the quality of the staff they are sending, the case manager
should first address the complaint with
a. accrediting agency that oversees the managed care agency
b. quality department within the managed care organization
c. home health agency director of nurses
d. risk department - Answer✔✔b. quality department
Social service agencies may differ from volunteer organizations because
a. they usually require the patient to meet certain eligibility requirements not required by
most voluntary organizations
b. they charge a fee, while volunteer agencies are free
c. they are financed with state funds, while volunteer agencies are financed with federal
funds
d. volunteer organizations are more loosly structured. - Answer✔✔a. they usually require
the patient to meet certain eligibiity criteria not required by volunteer organizations
,Which heath assessment screening tool would be a common choice when assessing the
chronic alcoholic patient
a. ROSE
b. SF 36
c. BASIS 32
d. OASIS - Answer✔✔C. BASIS
ROSE-cardiac disease, SF 36 - health assessment screening tool, OASIS-not used as a health
too-used in home health
The 80-20 rule demonstrates
a. that there is a direct ratio between health care spending and the risk population that uses
health care resources
b. that supervisors have a way to determine case management case load
c. the ratio between insured and uninsured
d. the ratio of those covered by private insurance and those covered by managed care
organizations - Answer✔✔a. the ratio between health care spending and the at risk
population using health resources
The mother of a diabetic child tells the case manager that her son is not sticking tot he diet
and has had high sugar levels over the past week and has missed school. The case manager
uses what skills to address the problem
a. negotiation
b. conflict resolution
c. consultation
d. accountability - Answer✔✔b. conflict management
The case manager working in the provider setting whose role is to ensure that resources are
used in an appropriate manner for the payer and the provider may be found in which
setting
a. hospital
,b. managed care organization
c. professional organization
d. credentialing organization - Answer✔✔a. hospital
In a stated contract used by the provider delivering services, it is implied that
a. cost will be competitive
b. quality will be assured
c. confidentiality will be maintained
d. the provider will be paid for services rendered - Answer✔✔d. the provider will be paid for
services rendered
The first phase of the case management process is
a. patient identification and referral
b. examination of the benefits and limitations
c. assessment of the patient
d. development of the treatment plan - Answer✔✔c. assessment of the patient
Dietary planning is an essential part of the diabetic patient's regimen. The ADA recommends
which of the following caloric guidelines for daily meal planning
a. 50%complex carbs, 20-25% protein, 20-25% fat
b. 45% compex carbs, 25-30% protein, 30-35% fat
c. 70% complex carbs, 20-30% protein, 10-20% fat
d. 60% complex carbs, 12-15% protein, 20-25% fat - Answer✔✔d. 60% complex carbs, 12-
15% protein, 20-25% fat
The ultimate goal of a comprehensive rehab program is
a.decrease the services needed for appropriate patient management
b. reduce the physical, emotional and economic effects of a disability on the injured or ill
person
c. limit the long term cost of services for the client
, maxamize the available services to enhance the treatment plan
c. - Answer✔✔b. reduce the physical, emotional and economic effects of a disability on the
injured or ill person
The primary reason to conduct a job analysis is to
a. prevent further work injuries in the workplace
b. identify essential job functions necessary to perform the job
c. determine the educational requirements to perform the job
d. determine the job market in a given demographic area. - Answer✔✔b. identify essential
job functions necessary to perform the job
To prevent carpal tunnel syndrome, a typist wrist should be in what position
a. flexed
b. extended
c. neutral
c. comfortably at a 45 degree angle - Answer✔✔c. neutral
Efficient data management systems allow for data to be analyzed and evaluated as part of
the
a. continuous quality improvement process
b. risk management process in malpractice
c. bill process in provider organizations
d. coding process in medical records - Answer✔✔a. continuous quality improvement
process
By incorporating best practices the case managers achieve all of the following EXCEPT
a. improved clinical outcomes
b. improved administrative efficiences
c. reduced cost in health care
d. eliminate chronic illness - Answer✔✔d. eliminate chronic illness
Update
Tools to identify patients who might benefit from disease management include all except
a. ICD 9
b. CPT codes
c. utilization data
d. radiology data - Answer✔✔d. radiology data
Which is not included as one of the three major elements that are globally accepted to
achieve health and wellness
a. knowledge
b. to be in a position to chose better health
c. the empowerment to make decisions and sick to those decisions
d. money - Answer✔✔d. money
If a case manager is working with a home health agency within a managed care network and
there is a complaint regarding the quality of the staff they are sending, the case manager
should first address the complaint with
a. accrediting agency that oversees the managed care agency
b. quality department within the managed care organization
c. home health agency director of nurses
d. risk department - Answer✔✔b. quality department
Social service agencies may differ from volunteer organizations because
a. they usually require the patient to meet certain eligibility requirements not required by
most voluntary organizations
b. they charge a fee, while volunteer agencies are free
c. they are financed with state funds, while volunteer agencies are financed with federal
funds
d. volunteer organizations are more loosly structured. - Answer✔✔a. they usually require
the patient to meet certain eligibiity criteria not required by volunteer organizations
,Which heath assessment screening tool would be a common choice when assessing the
chronic alcoholic patient
a. ROSE
b. SF 36
c. BASIS 32
d. OASIS - Answer✔✔C. BASIS
ROSE-cardiac disease, SF 36 - health assessment screening tool, OASIS-not used as a health
too-used in home health
The 80-20 rule demonstrates
a. that there is a direct ratio between health care spending and the risk population that uses
health care resources
b. that supervisors have a way to determine case management case load
c. the ratio between insured and uninsured
d. the ratio of those covered by private insurance and those covered by managed care
organizations - Answer✔✔a. the ratio between health care spending and the at risk
population using health resources
The mother of a diabetic child tells the case manager that her son is not sticking tot he diet
and has had high sugar levels over the past week and has missed school. The case manager
uses what skills to address the problem
a. negotiation
b. conflict resolution
c. consultation
d. accountability - Answer✔✔b. conflict management
The case manager working in the provider setting whose role is to ensure that resources are
used in an appropriate manner for the payer and the provider may be found in which
setting
a. hospital
,b. managed care organization
c. professional organization
d. credentialing organization - Answer✔✔a. hospital
In a stated contract used by the provider delivering services, it is implied that
a. cost will be competitive
b. quality will be assured
c. confidentiality will be maintained
d. the provider will be paid for services rendered - Answer✔✔d. the provider will be paid for
services rendered
The first phase of the case management process is
a. patient identification and referral
b. examination of the benefits and limitations
c. assessment of the patient
d. development of the treatment plan - Answer✔✔c. assessment of the patient
Dietary planning is an essential part of the diabetic patient's regimen. The ADA recommends
which of the following caloric guidelines for daily meal planning
a. 50%complex carbs, 20-25% protein, 20-25% fat
b. 45% compex carbs, 25-30% protein, 30-35% fat
c. 70% complex carbs, 20-30% protein, 10-20% fat
d. 60% complex carbs, 12-15% protein, 20-25% fat - Answer✔✔d. 60% complex carbs, 12-
15% protein, 20-25% fat
The ultimate goal of a comprehensive rehab program is
a.decrease the services needed for appropriate patient management
b. reduce the physical, emotional and economic effects of a disability on the injured or ill
person
c. limit the long term cost of services for the client
, maxamize the available services to enhance the treatment plan
c. - Answer✔✔b. reduce the physical, emotional and economic effects of a disability on the
injured or ill person
The primary reason to conduct a job analysis is to
a. prevent further work injuries in the workplace
b. identify essential job functions necessary to perform the job
c. determine the educational requirements to perform the job
d. determine the job market in a given demographic area. - Answer✔✔b. identify essential
job functions necessary to perform the job
To prevent carpal tunnel syndrome, a typist wrist should be in what position
a. flexed
b. extended
c. neutral
c. comfortably at a 45 degree angle - Answer✔✔c. neutral
Efficient data management systems allow for data to be analyzed and evaluated as part of
the
a. continuous quality improvement process
b. risk management process in malpractice
c. bill process in provider organizations
d. coding process in medical records - Answer✔✔a. continuous quality improvement
process
By incorporating best practices the case managers achieve all of the following EXCEPT
a. improved clinical outcomes
b. improved administrative efficiences
c. reduced cost in health care
d. eliminate chronic illness - Answer✔✔d. eliminate chronic illness
