Hcqm - Study guides, Class notes & Summaries

HCQM Clinical Resource Management Exam | Questions & Answers (100 %Score) Latest Updated 2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions

4 elements dictating scope of case management model - Answer 1. Care setting 2. Health conditions and needs of population served 3. Reimbursement methods 4. Health Care Discipline of the case manager 14 groups commonly targeted for case management - Answer 1. High medical costs/ER use/admissions 2. High prevalence of mental illness/substance abuse 3. Diagnosed with a chronic condition 4. Complex medication/treatment regimen 5. Age related risk due to medically complex or serious conditions...

The percentage of unplanned returns to the operating room would be collected to measure procedure performance and patient monitoring. This would be an example of? - Answer outcome measure The final results of care, treatment, and services concerning a patient are included in what area of performance measurement? - Answer outcome

HCQM PATIENT SAFETY EXAM WITH ALL QUESTIONS AND ANSWERS ...

Comprehensive error rate testing CERT - Answer randomly selects a statistically-valid sample of Medicare FFS claims and reviews those claims and related medical records for compliance with Medicare coverage, payment, coding, and billing rules. Used to ID high- risk areas. Refers errors to MAC. More importantly, used for focused reviews. Payment Error Rate Measurement (PERM) program - Answer measures improper payments in the Medicaid program and the State Children's Health Insurance Program...

PHYSICIAN ADVISOR ROLE IN HCQM EXAM ...

HCQM - Quality Improvement, Management, & Assurance

HCQM – CASE MANAGEMENT EXAM WITH ALL QUESTIONS AND ANSWERS...

HCQM – REGULATORY ENVIRONMENT EXAM LATEST UPDATE