Certified Case Management 2024 Edition Questions and Correct Answers

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 Directives Ans--Legally executed document that explains the consumer's healthcarerelated wishes and decisions. It is drawn up while the patient is still competent and is used if the patient becomes incapacitated or incompetent. Adverse Events Ans--Any untoward occurrences, which under most conditions are not natural consequences of the patient's disease process or treatment outcomes. Advocacy Ans--Acting on behalf of those who are not able to speak for or represent themselves. It is also defending others and acting in their best interest. A person or group involved in such activities is called an advocate. Algorithm Ans--The chronological delineation of the steps in, or activities of, patient care to be applied in the care of patients as they relate to specific conditions/situations. Alternate Level of Care Ans--A level of care that can safely be used in place of the current level and determined based on the acuity and complexity of the patient's condition and the type of needed services and resources