Trivia Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Trivia flashcards as text
Which transitional care model, developed by Mary Naylor, focuses on preventing hospital readmissions in elderly patients?
Answer: Transitional Care Model (TCM)
The Transitional Care Model (TCM), developed by Dr. Mary Naylor at the University of Pennsylvania, uses advanced practice nurses to coordinate care transitions for high-risk elderly patients.
A case manager notices a client's cultural beliefs conflict with the recommended treatment plan. The BEST first action is to:
Answer: Explore the client's beliefs to identify culturally acceptable alternatives
Cultural competence requires the case manager to first understand the client's cultural perspective and then collaborate to find solutions that respect beliefs while meeting medical needs.
What does 'subrogation' refer to in the context of workers' compensation or insurance?
Answer: The right of an insurer to recover costs from a liable third party
Subrogation allows an insurer that has paid a claim to pursue reimbursement from the party legally responsible for the loss or injury.
Under HIPAA, a 'covered entity' includes all of the following EXCEPT:
Answer: Employers who only self-administer a health plan internally
Employers acting solely in their capacity as employers (not as health plan administrators transmitting PHI electronically) are not HIPAA covered entities.
The Case Management Society of America (CMSA) was founded in which year?
Answer: 1990
CMSA was founded in 1990 and serves as the leading professional membership organization for case managers, setting standards of practice.
Which type of disability insurance replaces a percentage of income when a worker cannot perform the duties of ANY occupation?
Answer: Any-occupation disability
Any-occupation disability policies only pay benefits if the insured cannot perform the duties of any occupation for which they are reasonably suited by education, training, or experience.
In a post-acute care setting, which outcome measurement tool is mandated for Medicare-certified home health agencies?
Answer: OASIS (Outcome and Assessment Information Set)
OASIS is the standardized data collection instrument required for all Medicare-certified home health agencies to measure patient outcomes and determine reimbursement.