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Case Manager Certification Exam Questions and Correct Answers
Case Manager Certification Exam Questions and Correct Answers
[Show more]Case Manager Certification Exam Questions and Correct Answers
[Show more]Which of the following is NOT an "outcome measure" of cost? 
Ans--Denials 
What are "soft savings"? 
Ans--The possibility of dollars to the bottom line in the future 
The choice which is FALSE concerning HCFA Common Procedural Coding System 
(HCPCS) 
Ans--States coding system for medical proced...
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Add to cartWhich of the following is NOT an "outcome measure" of cost? 
Ans--Denials 
What are "soft savings"? 
Ans--The possibility of dollars to the bottom line in the future 
The choice which is FALSE concerning HCFA Common Procedural Coding System 
(HCPCS) 
Ans--States coding system for medical proced...
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 w...
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Add to cartfunction 
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 w...
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 service...
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Add to cartAcuity 
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 service...
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. Entail...
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Add to cartAccreditation 
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. Entail...
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 c...
Preview 4 out of 39 pages
Add to cartTarget 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 c...
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 whole...
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Add to cartAncillary 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 whole...
clinical guidelines 
Ans--statements to help make decisions about health specific circumstances. 
clinical pathway 
Ans--structured multi-disciplined plan of care to support clinical guidelines and 
protocol to improve continuity and coordination. 
4 parts of clinical pathway 
Ans--1. timeline 
2. ...
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Add to cartclinical guidelines 
Ans--statements to help make decisions about health specific circumstances. 
clinical pathway 
Ans--structured multi-disciplined plan of care to support clinical guidelines and 
protocol to improve continuity and coordination. 
4 parts of clinical pathway 
Ans--1. timeline 
2. ...
Which of the following statements best describes the definition of Present 
Dangers and Impending Dangers? 
A) present danger is immediate, significant, and observable; impending danger is 
imminent 
B) present danger is immediate but not observable; impending danger is pending 
reports 
C) pres...
Preview 4 out of 87 pages
Add to cartWhich of the following statements best describes the definition of Present 
Dangers and Impending Dangers? 
A) present danger is immediate, significant, and observable; impending danger is 
imminent 
B) present danger is immediate but not observable; impending danger is pending 
reports 
C) pres...
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