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HCA 416 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++ CA$15.11   Add to cart

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HCA 416 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++

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HCA 416 FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++ OLAP, OLTP Where Does Data Come From? ( 2 terms Acronyms) Health related event Where is Healthcare Data Created From? Patients health record Where Does Healthcare Data Come From? (primary source) Healthcare informa...

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  • November 10, 2024
  • 10
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
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HCA 416 FINAL EXAM QUESTIONS AND ANSWERS WITH

COMPLETE SOLUTIONS GRADED A++


OLAP, OLTP

Where Does Data Come From? ( 2 terms Acronyms)

Health related event

Where is Healthcare Data Created From?

Patients health record

Where Does Healthcare Data Come From? (primary source)

Healthcare information database

Where Does Healthcare Data Come From? (secondary)

Provides additional care for patients with complex needs or posthospital services

What is Case Management do?

Medicare COP and TJC standards

What is Case Management Required by?

Ensure that facilities and resources are being used properly

What is Utilization Management?

Unmet patient needs

What is Underutilization?

Care or services not medically necessary

What is Over Utilization?

Maintain or increase quality of care

, What is the Goal for Utilization Management?

Measurement of how organizations and providers use resources, assessment of

how well those resources are being used, improvement of resource use

What are the 3 Familiar building blocks of performance management?

Oversight committee

What are Hospitals required to have as a part of Utilization Management?

CMS and state insurance comission

Who governs UM health plans? (2 terms, "and")

Prospective Review, Concurrent Review, Discharge Planning/Case Management,

Retrospective Review

What are the names of the 4(5) activities UM function involves in? "/"

Initiated before patient actually receives health services

What is Prospective Review?

Intensity of services, Severity of illness

What is IS/SI criteria? (2)

UM activity that is conducted at the time a patient is admitted usually within 24

hours

What is Concurrent Review?

Non-physician, UM staff

Concurrent Review has a 2 stage review process:

____-____ personnel conduct initial and subsequent reviews

________ screens patient health record for documentation to establish compliance with

medical necessity criteria

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