Exam (elaborations)
CDMS EXAM 2023
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Exam of 13 pages for the course CDMS at CDMS (CDMS EXAM 2023)
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CDMS EXAM 2023Psychiatric claims categories: Answer- peer review Answer- review by committee of similar practitioners, looks at quality and utilization criteria
Dictionary of Occupational Titles Answer- provides standardized occupational information based on on-site job analyses
Job analysis Answer- develops work samples that are realistic/responsive to local employment
Marketing Answer- process of creating, planning, and executing conception, pricing,
promotion and distribution of ideas, goods, and services
Work hardening Answer- simulated real work in clinical setting
Residual impairment after MMI reached Answer- leads to transition from temporary to permanent disability benefits
Guides to the evaluation of permanent impairment Answer- Used to provide employer with degree of impairment that impacts compensation due to a claimant
Work station layout Answer- should position items to be lifted between hand and shoulder height (to accommodate differently sized employees)
Apprenticeship Answer- formal instruction plus on the job training
Cross-functional Answer- input and output relationships among organization's departments
productivity Answer- includes # lost workdays, rates of RTW after injury/illness, rates of employee turnover, amount of overtime
ADA Answer- requires reasonable accommodations that do not cause undue hardship (cost, nature of business)
ADA company size Answer- 15+ employees
ADA cause for denying employment Answer- very low risk but severe consequences, or severe risk and minor consequences
ADA does NOT require Answer- provide treatment, waive uniform disciplinary standards, provide stress-free environment, eliminate performance evaluations, eliminate essential job functions, provide irregular/indefinite leave, reduce performance standards, create a new position, or arrange a transfer when no positions are available
ADA eligibility Answer- SUBSTANTIALLY impaired to be eligible for ADA protection.
Includes conditions that cause differential treatment but do not otherwise impact job (e.g. burn victims).
ADA requires employers to approach employees about accommodation when: Answer- knows about disability, knows it is causing problems on the job, and knows that disability prevents employee from requesting accommodation.
Most common conditions for discrimination complaint: Answer- 1) Orthopedic problems (16%) 2) Depression 3) Hearing/vision impairments 4) Diabetes 5) Bipolar 6) Cancer
SSA categories of functioning Answer- 1) ADLs 2) Social Functioning 3) Concentration, Persistence, Pace 4) Deterioration in work-like settings. *Significant impairment in any one domain qualifies
SSA Claim Denial Reasons Answer- Impairment does not prevent individual from doing past relevant work; impairment does not prevent individual from doing other work; impairment is not defined as severe by SSA
AMA disability definition Answer- Disability defined as persisting 12+ months, OR after treatment has been exhausted (MMI)
HIPAA (Health Insurance Portability and Accountability Act) Answer- - Created a program for detecting fraudulent health plans
- Protects health insurance coverage after losing jobs (does not waive pre-existing conditions); may qualify after COBRA runs out. Limits exclusions for pre-existing conditions (can't exclude for more than 12 months). Allows enrollment if health insurance lost, marriage, new dependent, separation, divorce, death. - Guarantees availability of health insurance coverage for small employers
- preserves states' role in regulating health insurance
- HIPAA National Security Rule sets standards for electronic PHI protection
- HIPAA Breach Notification Rule
Nursing Home Reform Act (passed 1987, enacted 1990) Answer- - minimum staffing requirements for long term care facilities
Patient self-determination act (1990) Answer- Requires giving patients written summary of healthcare decision-making rights at time of admission and facility policies on advance directives; ask about and document advance directives; cannot discriminate based on advance directives; cannot require or prohibit advance directives; educate staff about advance directives.
Consolidated Omnibus Budget Reconciliation Act (COBRA), 1985 Answer- - established standards for transfer and discharge of Medicare and Medicaid recipients
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