CCM Exam Prep - All Topics Review Questions and Answers

Case management a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the client's health and human services needs. Case Management Characteristics characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Glagow Coma Scale Client assessment tool that measures level of coma in the acute phase of injury it is an objective way of recording the conscious state of a person. Eye opening, Best verbal, best motor. 8 coma, 13-15 mild injury. Strengths Based Model assesses clients capacities and potential resources as well as problems and current unmet needs. Eliciting capacities and potential resources as well as problems and current unmet needs. Independent Living Model sees a disability as a construct of society Medicare Prospective Payment System hospitals paid a pre-determined rate for each Medicare admission. Each patient is classified into a DRG. PHQ-9 Client assessment tool for depression Braden Scale Client assessment tool for pressure sore risk Clinical Pathway Structured multidisciplinary CM plan designed to support the implementation of specific clinical guidelines and protocols. They are maps that guide the healthcare team on usual treatment patterns related to common diagnoses, conditions and procedures e.g., CHF SF-36 Client assessment tool to measure physical and mental health. Medicare Established in 1965 under Title XVIII or Social Security Act. Four Parts A-hospital insurance, B-medical insurance (doctors visits), C-Medicare Advantage program in a private plan such as HMO, D-prescription drug benefit Medicare Benefits and Cost Sharing Not covered are: Acupuncture, chiropractor, cosmetic, custodial home care, dental care, DME convenience, hearing aids, eyeglasses, foot care, meals on wheels, personal convenience, prescription drugs, private nurses, routine physical, vision