CMSA Final Exam – Questions & Answers (Graded A+)
CMSA Final Exam – Questions & Answers (Graded A+)
A component of case management that ensures smooth transitions of uninterrupted care is called: - ANSWER - Care Coordination
A systems oriented approach to case management which focuses on...
a component of case management that ensures smooth
a systems oriented approach to case management whi
what do care coordination cas
Geschreven voor
CMSA
CMSA
Verkoper
Volgen
conceptialresearchers
Ontvangen beoordelingen
Voorbeeld van de inhoud
CMSA Final Exam – Questions &
Answers (Graded A+)
A component of case management that ensures smooth transitions of uninterrupted care is called: - ANSWER - Care Coordination
A systems oriented approach to case management which focuses on health insurance plans and management of member benefits: - ANSWER - Managed Care
What do care coordination, case management and managed care have in common? - ANSWER - The patient, coordination of services and a goal of cost-effective care
The approach to case management that deals with the hospitalized patient is: - ANSWER - Within the Ways Case Management
The approach to case management that deals with patients in the outpatient setting is called: - ANSWER - Beyond the Walls Case Management
Current case management practice and models as we know them today came about following the implementation of: - ANSWER - Fee-for Service Plans
Capitation Factors that impact models of case management include: - ANSWER - The patient population, the care provider, the reimbursement method, the context of the care
setting
Roles of the case manager include: - ANSWER - -Patient Advocate
-Protector of Privacy
-Coordinator of Care
Costs that are clearly saved or avoided in a case are the: - ANSWER - Hard Savings
A positive fiscal outcome of optimal case management is: - ANSWER - Decreased length of stay
The __________ is the case manager's most important obligation. - ANSWER - patient
Utilization Management includes which of the following: - ANSWER - -Monitoring of intensity of service
-Monitoring severity of illness
-Monitoring of medical necessity and the appropriateness of level of care
The two main types of insurance companies in the United States are: - ANSWER - Commercial and Governmental Government insurance plans are public programs and include: - ANSWER - Medicare, Medicaid and Military
_____________ is a set amount of money specified by each health plan that the member must pay at the time healthcare services are rendered. - ANSWER - Copayment
The monthly fees that insurance companies charge the member for services is the ________________. - ANSWER - Premium
A "Stop Loss" protective strategy: - ANSWER - Is purchased by the insurance company to protect itself against extremely expensive cases
The Prospective Payment System (PPS) provides that hospitals are reimbursed according to: - ANSWER - Diagnosis-Related Groups (DRG's)
Diagnosis -Related Groups (DRG's) were originally designed as: - ANSWER - A Patient Classification System
The method of reimbursement which pays the healthcare provider based on the submitted claim is the ________________ and is considered an old method of payment. - ANSWER - Fee-For-Service Reimbursement
An individual eligible for health benefits under a health plan is a/an: - ANSWER - -
Participant
-Beneficiary
-Member
Medicare eligibility is based on: - ANSWER - Age, work history, certain disabilities and Kidney Failure
Renal patients on hemodialysis for 3 months are eligible for Medicare: - ANSWER - Regardless of age
Medicare Part A includes coverage for: - ANSWER - Inpatient hospital care
Examples of Medicare Part B coverage include: - ANSWER - Physician visits, blood tests, outpatient surgical services
Medicare Part D provides coverage for: - ANSWER - Prescription Medications
Which of the following statements is/are true regarding Medicare Lifetime Reserve Days? - ANSWER - -The beneficiary has the right to choose when to use a reserve day
-It is one of the 60 extra days of hospital care for which Medicare pays
-There are only 60 reserve days in a beneficiary's lifetime
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper conceptialresearchers. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €10,80. Je zit daarna nergens aan vast.