AAMCN EXAM Questions AND Correct Answers
A collaborative process of assessment, planning, facilitation and
advocacy for options and services to meet an individual's health
needs through communication and available resources to promote
quality, cost effective outcomes. - ✔✔case management
A nurses' role in managed care can vary greatly in responsibilities.
Roles can include aspects of case management, disease management,
utilization management and quality management. - ✔✔True
A system of coordinated healthcare interventions and
communications for populations with conditions in which patient self-
care efforts are significant. - ✔✔Disease Management
AAAHC establishes standards in the areas of ambulatory health,
behavioral health, and health education and wellness. - ✔✔True
Advantages of the Electronic Health Record (EHR) include? -
✔✔Smooth transfer and coordination of care
As an employee of an MCO, you have a role in compliance - ✔✔True
Balance billing means charging or collecting from a Medicare
beneficiary an amount in excess of the Medicare reimbursement rate
for Medicare-covered services or supplies provided to a Medicare
, beneficiary, except when - ✔✔Medicare is the beneficiary's secondary
insurer
Certification is not required in every state to become a certified
health care navigator - ✔✔True
Credentialing - ✔✔the process of checking a practitioner's references
and documenting his/her training, experience, demonstrated ability,
licensure verification, and adequate malpractice insurance and must
be verified every 3 years.
Documentation is an important as the actual negotiation - ✔✔true
Focuses on wellness and prevention and identifies high risk though
screening and assessment. - ✔✔Demand/Population management
Founded in 1990 as a private, not-for-profit orgnaization dedicated to
improving the quality of managed care plans - ✔✔NCQA
hat are the four principle clusters? - ✔✔Autonomy, non-maleficence,
beneficence, and. justice
How many domains does the Quality Improvement Systems for
Managed Care (QISMC) encompass - ✔✔4
A collaborative process of assessment, planning, facilitation and
advocacy for options and services to meet an individual's health
needs through communication and available resources to promote
quality, cost effective outcomes. - ✔✔case management
A nurses' role in managed care can vary greatly in responsibilities.
Roles can include aspects of case management, disease management,
utilization management and quality management. - ✔✔True
A system of coordinated healthcare interventions and
communications for populations with conditions in which patient self-
care efforts are significant. - ✔✔Disease Management
AAAHC establishes standards in the areas of ambulatory health,
behavioral health, and health education and wellness. - ✔✔True
Advantages of the Electronic Health Record (EHR) include? -
✔✔Smooth transfer and coordination of care
As an employee of an MCO, you have a role in compliance - ✔✔True
Balance billing means charging or collecting from a Medicare
beneficiary an amount in excess of the Medicare reimbursement rate
for Medicare-covered services or supplies provided to a Medicare
, beneficiary, except when - ✔✔Medicare is the beneficiary's secondary
insurer
Certification is not required in every state to become a certified
health care navigator - ✔✔True
Credentialing - ✔✔the process of checking a practitioner's references
and documenting his/her training, experience, demonstrated ability,
licensure verification, and adequate malpractice insurance and must
be verified every 3 years.
Documentation is an important as the actual negotiation - ✔✔true
Focuses on wellness and prevention and identifies high risk though
screening and assessment. - ✔✔Demand/Population management
Founded in 1990 as a private, not-for-profit orgnaization dedicated to
improving the quality of managed care plans - ✔✔NCQA
hat are the four principle clusters? - ✔✔Autonomy, non-maleficence,
beneficence, and. justice
How many domains does the Quality Improvement Systems for
Managed Care (QISMC) encompass - ✔✔4
