- Study guides, Class notes & Summaries

function Ans--Set of tasks that are completed as part of a role activity Ans--Specific task to meet the needs of the role process Ans--A series of actions or steps taken to achieve an end/goal Likert Scale Ans--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 Ans--Identifies variables in various settings affecting caseload. 1- initial elem...

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31 pages

Written in 2023/2024

Grade A+

Axpert

Accreditation Ans--A standardized program for evaluating healthcare organizations to ensure a specified level of quality, as defined by a set of national industry standards. Organizations that meet accreditation standards receive an official authorization or approval of their services. Entails a voluntary survey process that assesses the extent of a healthcare organization's compliance with the standards for the purpose of improving the systems and processes of care (performance) a...

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57 pages

Written in 2023/2024

Grade A+

Axpert

Certified Case Management 2026 Study Guide – Case Management & Healthcare Systems is a comprehensive exam-preparation resource designed for learners preparing for case management certification and professional healthcare assessments. It covers essential concepts in case management, healthcare systems, care coordination, utilization management, discharge planning, patient advocacy, quality improvement, reimbursement, healthcare delivery, interdisciplinary collaboration, ethics, documentation, t...

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44 pages

Written in 2026/2027

Grade A+

VERIFIEDPASS

certified case management proctored exam 180 Question

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10 pages

Written in 2025/2026

Grade A+

stuviaexams

Case Manager Certification Exam Questions and Correct Answers

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8 items

Axpert

Ancillary Providers Ans--A subset of care providers including non-physician providers such as rehabilitation, transportation, dialysis, etc. Attending Physician Ans--The physician primarily responsible for the inpatient health care of an individual. AWP Ans--Two definitions: "Average wholesale price" is a calculation used to determine reimbursements for pharmacies. "Any willing provider" are contractors under HMO (Health Maintenance Organization) contracts who meet their provi...

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14 pages

Written in 2023/2024

Grade A+

Axpert

Target Populations Ans--diagnosis, high utilizers, age & health status, procedure, LOS, psychological factors, vocational, functional impairments, disability Case finding and intake Ans--ID member, obtain consent, communicating member needs to others, ID members who need alternate levels of care Provision of services Ans--facilitate and coordinate, communicate with other healthcare providers, monitor progress, review and modify healthcare services, collaborate with stakeholders on C...

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39 pages

Written in 2023/2024

Grade A+

Axpert

Acuity Ans--a way to measure complexity and severity of the patient's health/medical condition. ADA Ans--The federal Americans with Disabilities Act of 1990. Administrative Services Only (ASO) Ans--An insurance company or third party administrator (TPA) that delivers administrative services to an employer group. This usually requires the employer to be selfinsured or atrisk for the cost of health care services provided, which the ASO processes and manages the claims. Advance Direc...

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62 pages

Written in 2023/2024

Grade A+

Axpert

high risk present danger is immediate, significant, and observable; impending danger is im- minent Adoption and Safe Families Act (ASFA) Which of the following is not part of the danger threat threshold criteria? A)vulnerable child B) imminence C) severity D) observable E) high risk Which of the following statements best describes the definition of

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7 items

Clayjohnson

Health Status Survey predictive modeling Role function activity process Likert Scale Caseload Matrix Standards of Practice A tool that provides a clients self assess- ment and functional health and quality of life issues A process in which historical data based on behaviors and events are blended with multiple variables and used to con- struct models of anticipated future out- comes. a set of expectations (norms) about a social position, defining how those in the position ought to...

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18 pages

Written in 2023/2024

Grade A+

Clayjohnson