CCM EXAM WITH COMPLETE SOLUTIONS 100%
2023/2024
Community ALternatives
Agenicies, outside an institutional setting, which porovide care, support, and/or services to people
with disabilities.
developmental disability
any mental or physical disability that has na onset before age 22 and may continue indefinately.
mental retardation, CP, autism, epilepsy, sensory impairment, TBI, MDystrophy, polio may be
considered developmentally disabled.
care managment
a health care delivery process that helps achieve better health outcomes by anticipating and linking
clients with services they need more quickly. It helps avoid unnecessary services by preventing
medical problems from esclating.
case management
a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the
options and services required to meet an individual healthneeds using communication and resources
to promote quality, cost effective outcomes.
clinical pathway
timeline of patient care activities and expected outcomes of care that address the plan of care of each
discipline involved in the care of a particular patient.
Minimum Data Set MDS
assessment tool used in skilled nursing facility settings to place patients into RUGS or resource
utilization groups. which determines the facilities reimbursement rate.
risk management
the science of the identification evaluation and treatment of financial and clinical loss. a program that
attempts to provide positive avoidance of negative results.
sub acute care facility
a healthcare facility that is a step down from an acute care hospital and a step up form a conventional
SNF intesity of services.
actuary
a trained insurance professional who specializes in determing policy rates calculating premiums and
conducting statistical studies.
capitiation
fixed amt of money per member per month (PMPM) paid to a care provider for covered services
rather than based on specific services provided. Used by HMOs.
DRG Diagnosis related group
2023/2024
Community ALternatives
Agenicies, outside an institutional setting, which porovide care, support, and/or services to people
with disabilities.
developmental disability
any mental or physical disability that has na onset before age 22 and may continue indefinately.
mental retardation, CP, autism, epilepsy, sensory impairment, TBI, MDystrophy, polio may be
considered developmentally disabled.
care managment
a health care delivery process that helps achieve better health outcomes by anticipating and linking
clients with services they need more quickly. It helps avoid unnecessary services by preventing
medical problems from esclating.
case management
a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the
options and services required to meet an individual healthneeds using communication and resources
to promote quality, cost effective outcomes.
clinical pathway
timeline of patient care activities and expected outcomes of care that address the plan of care of each
discipline involved in the care of a particular patient.
Minimum Data Set MDS
assessment tool used in skilled nursing facility settings to place patients into RUGS or resource
utilization groups. which determines the facilities reimbursement rate.
risk management
the science of the identification evaluation and treatment of financial and clinical loss. a program that
attempts to provide positive avoidance of negative results.
sub acute care facility
a healthcare facility that is a step down from an acute care hospital and a step up form a conventional
SNF intesity of services.
actuary
a trained insurance professional who specializes in determing policy rates calculating premiums and
conducting statistical studies.
capitiation
fixed amt of money per member per month (PMPM) paid to a care provider for covered services
rather than based on specific services provided. Used by HMOs.
DRG Diagnosis related group
