CCM GUIDE TEST
QUESTIONS AND
CORRECT ANSWERS
GRADED A+ 2025-2026
HMO - ANS-health maintenance organization
ACO - ANS-Accountable Care Organization
Viatical Settlements - ANS-ability to sell own insurance policy
CHAMPVA - ANS-Civilian Health and Medical Program of the Veterans Administrationtr
CHAMPVA for Life - ANS-provides healthcare benefits to families of permanently
disabled veterans, or killed in line of duty, not eligible for tricare. Covers 65 or older, is
a Medicare supplement.
TRICARE - ANS-is a U.S. government health insurance plan for active military
personnel, national guard, reserves, retirees, their families and some former spouse's.
TRICARE for Life - ANS-primarily a supplemental insurance with those with Medicare A
& B coverage, &eligible for TRICARE in US. Is the primary insurance overseas.
advance directives - ANS-A signed document indicating that the person's wishes
regarding care during dying.
,ASO - ANS-administrative services only, and insurance company or TPA that provides
administrative services for an employer group.
Adverse Events - ANS-any untoward occurrences not of natural consequences.
Advocacy - ANS-support; active pleading on behalf of someone or something
Alternate level of care - ANS-level of care used safely in place of current level,
determined by acuity.
Assessments - ANS-The process of collecting in-depth information about a persons
situation and function to identity needs.
assistive device - ANS-tool, software, or hardware to assist in performing daily
activities
Assistive technology - ANS-equipment or products used by individuals with disabilities
to improve functioning in activities
Autonomy - ANS-person's right to self determination and independence
Beneficence - ANS-Doing good or causing good to be done; kindly action
Beneficiary - ANS-a person who derives advantage from something, especially a trust,
will, or life insurance policy.
Benefit package - ANS-the sum of services a health plan, government agency, or
employer contracts to provide.
Benefits - ANS-the amount payable by the insurance company to a claimant or
beneficiary under claimant s coverage.
, Brain injury - ANS-Any brain damage that impairs normal functioning of the brain,
either temporarily or permanently
Burden of proof - ANS-the obligation facing a persuasive speaker to prove that a
change from current policy is necessary
Capitation - ANS-fixed amount of money per member-per-month paid to care provider
for covered services.
CARF - ANS-commission on accreditation of rehabilitation facilities, private, non profit
organization that establishs standards of quality services for people with disabilities.
Carve outs - ANS-services that are excluded from a provider contract, provider not
responsible for services carved out of contract
Caseload - ANS-total number of patients followed by a case manager at any point in
time.
case management - ANS-collaborative process that assesses, plans, implements,
coordinates, monitors &evaluates options and services to meet needs of individuals.
Case Management System - ANS-a computer program that helps a counselor organize
information used to serve a specific client
Case mix index (CMI) - ANS-sum of DRG-relative weights of all patients seen in years
time divided by patients hospitalized
Case rate - ANS-rate of reimbursement that packages pricing for a certain category of
services.
Catastrophic case - ANS-case with complexities, multiple providers, and services that
will be costly to patient and providers
QUESTIONS AND
CORRECT ANSWERS
GRADED A+ 2025-2026
HMO - ANS-health maintenance organization
ACO - ANS-Accountable Care Organization
Viatical Settlements - ANS-ability to sell own insurance policy
CHAMPVA - ANS-Civilian Health and Medical Program of the Veterans Administrationtr
CHAMPVA for Life - ANS-provides healthcare benefits to families of permanently
disabled veterans, or killed in line of duty, not eligible for tricare. Covers 65 or older, is
a Medicare supplement.
TRICARE - ANS-is a U.S. government health insurance plan for active military
personnel, national guard, reserves, retirees, their families and some former spouse's.
TRICARE for Life - ANS-primarily a supplemental insurance with those with Medicare A
& B coverage, &eligible for TRICARE in US. Is the primary insurance overseas.
advance directives - ANS-A signed document indicating that the person's wishes
regarding care during dying.
,ASO - ANS-administrative services only, and insurance company or TPA that provides
administrative services for an employer group.
Adverse Events - ANS-any untoward occurrences not of natural consequences.
Advocacy - ANS-support; active pleading on behalf of someone or something
Alternate level of care - ANS-level of care used safely in place of current level,
determined by acuity.
Assessments - ANS-The process of collecting in-depth information about a persons
situation and function to identity needs.
assistive device - ANS-tool, software, or hardware to assist in performing daily
activities
Assistive technology - ANS-equipment or products used by individuals with disabilities
to improve functioning in activities
Autonomy - ANS-person's right to self determination and independence
Beneficence - ANS-Doing good or causing good to be done; kindly action
Beneficiary - ANS-a person who derives advantage from something, especially a trust,
will, or life insurance policy.
Benefit package - ANS-the sum of services a health plan, government agency, or
employer contracts to provide.
Benefits - ANS-the amount payable by the insurance company to a claimant or
beneficiary under claimant s coverage.
, Brain injury - ANS-Any brain damage that impairs normal functioning of the brain,
either temporarily or permanently
Burden of proof - ANS-the obligation facing a persuasive speaker to prove that a
change from current policy is necessary
Capitation - ANS-fixed amount of money per member-per-month paid to care provider
for covered services.
CARF - ANS-commission on accreditation of rehabilitation facilities, private, non profit
organization that establishs standards of quality services for people with disabilities.
Carve outs - ANS-services that are excluded from a provider contract, provider not
responsible for services carved out of contract
Caseload - ANS-total number of patients followed by a case manager at any point in
time.
case management - ANS-collaborative process that assesses, plans, implements,
coordinates, monitors &evaluates options and services to meet needs of individuals.
Case Management System - ANS-a computer program that helps a counselor organize
information used to serve a specific client
Case mix index (CMI) - ANS-sum of DRG-relative weights of all patients seen in years
time divided by patients hospitalized
Case rate - ANS-rate of reimbursement that packages pricing for a certain category of
services.
Catastrophic case - ANS-case with complexities, multiple providers, and services that
will be costly to patient and providers
