ACMA Case Management Certifican study help
1. Prior to admission for elective procedure - 30-90 days after discharge.: When does care coordination begin and end
2. Value based purchasing, readmission, Hospital acquired conditions: Pay for performance models have a greater emphasis on
3. quality of care,, reduce adverse events/safety, improving patient experience, efficiency/delivering low cost care.: What factors
effect value based purchasing?
3. LENGTH of Stay, ACUITY of Admission, COMORBIDITY, EMERGENCY Deoartment Visits.: What does the Acronym LACE stand
for in the Lace Assesment tool..
4. Problems with Medications, Psychological,
Principal Diagnosis,
Physical Limitations,
Poor Health Literacy,
Patient Support,
Prior Hospitalization,
Palliative Care: What are the 8 ps in The Society for Hospital Medicines Project Boost Risk Assesment -
Readmission Assement
5. Asses need for translator, sched f/u appointments, f/u on outstanding test results, coordinate post d/c out-patient services,
obtaining medications national d/c
guidelines, d/c teaching,
educate on what to do if problems arise, assess pt understanding, d/c summary to
outside providers, d/c follow up call.
After Hospital Care Plan (AHCP): Components of RED ( Reengineered discharge)
6. mortality: In regards to Value Based Pricing/payments, What factors weigh heavily in clinical care outcomes?
7. staff communication,
receiving written d/c information, warning signs, explanation of medications,
pain management,
overall experience.: In regards to Value Based Pricing/payments, what factors are considered in Patient experience of Care
8. spending per beneficiary, 3 days prior to admission to 30 days post d/c. Resource utilization, length of stay,
post acute services.: In regards to Value Based Pricing/payments, what factors are used to determine payout based on efficiency.
9. Various patient safety factors and infection rates: In regards to Value Based Pricing/payments, what factors are used to
determine payout for safety?
10. the degree to which individuals have the capacity to obtain, process and understand basic health information and services
needed to make appropriate health decisions.: What is the definition of health literacy ?
11. The structural determinants and conditions in which people are born, grow, live, work, and age which have a significant
impact on health outcomes.: What are social determinants of health?
, ACMA Case Management Certifican study help
12. family composition, education, occupation, psychological and/or psychiatric functioning, living siuation, support system,
transportation concerns, life changes or stressor, cooing skills, social/ community involvement, spiritual
aspects and concerns, self care, cognitive or perception problems, financial concerns.: What are the components of a psychosocial
history
13. Federal Pre-Admission Screening and Resident Review. Some states may
require additional screening tools.: What is the required assessment for admission to a nursing home for a patient with a
diagnosis of mental retardation or mental illness to assure appropriate placement
14. economic stability, neighborhood and built environment, education, food, community and social context, health and
health care.: What factors effect social determinents of health?
15. Federal Pre-Admission Screening and Resident Review. Some states may
require additional screen in ng tools.: Required assessment for admission to a nursing home for a patient with a diagnosis of
mental retardation
16. reviewing patients clinical condition and providing decis I on support to MD on bed and billing status. ie observation, Out
Pt, In-Patient. and being prepared to justify medical necessity. Additional certification is required for admission Ions longer
than 20 days.: What is utilization and review?
17. family composition, education, occupation, psychological and/or psychiatric functioning, living siuation, support system,
transportation concerns, life changes or stressor, cooing skills, social/ community involvement, spiritual aspects and concerns,
self care, cognitive or perception problems, financial concerns.: components of the psychosocial history 19. 20 days.
Reason for hoslitalization estimated length of continued stay, post acute plans, if patient is only waiting on SNF placement must
indicate reason for delay.: Physician certification or recertification for admissions longer than ____ days requires what
documentation?
20. For Medicare services, when a UM review team has determined that an order for inpatient admission is not medically
necessary. Order can be changed to observation. The admission will be billed under part B Medicare only: What is a condition
code 44?
21. The change must be made prior to discharge.
The claim has not been submitted, The MD concurs with the UM decision,
occurrence is documented in the medical record.: What requirements must be met to bill a Condition Code 44?
22. Patient engagement,
dynamic process (ability to change plan as needed), patient centered, collaborative
(team), fiscally responsible.: What are the key elements of CM planning?
23. Clinical treatment and diagnosis, Comfort and Supportive Care, Restorative/rehabilitative care, Discharge or transitional
planning.: Patient Goals
24. INCLUDE the patient and family as full partners in the discharge planning process.
DISCUSS with the patient and family key areas to prevent problems at home. EDUCATE the patient and family in plain language
about the patients condition, the discharge process and next steps at every opportunity throughout the hospital stay.
1. Prior to admission for elective procedure - 30-90 days after discharge.: When does care coordination begin and end
2. Value based purchasing, readmission, Hospital acquired conditions: Pay for performance models have a greater emphasis on
3. quality of care,, reduce adverse events/safety, improving patient experience, efficiency/delivering low cost care.: What factors
effect value based purchasing?
3. LENGTH of Stay, ACUITY of Admission, COMORBIDITY, EMERGENCY Deoartment Visits.: What does the Acronym LACE stand
for in the Lace Assesment tool..
4. Problems with Medications, Psychological,
Principal Diagnosis,
Physical Limitations,
Poor Health Literacy,
Patient Support,
Prior Hospitalization,
Palliative Care: What are the 8 ps in The Society for Hospital Medicines Project Boost Risk Assesment -
Readmission Assement
5. Asses need for translator, sched f/u appointments, f/u on outstanding test results, coordinate post d/c out-patient services,
obtaining medications national d/c
guidelines, d/c teaching,
educate on what to do if problems arise, assess pt understanding, d/c summary to
outside providers, d/c follow up call.
After Hospital Care Plan (AHCP): Components of RED ( Reengineered discharge)
6. mortality: In regards to Value Based Pricing/payments, What factors weigh heavily in clinical care outcomes?
7. staff communication,
receiving written d/c information, warning signs, explanation of medications,
pain management,
overall experience.: In regards to Value Based Pricing/payments, what factors are considered in Patient experience of Care
8. spending per beneficiary, 3 days prior to admission to 30 days post d/c. Resource utilization, length of stay,
post acute services.: In regards to Value Based Pricing/payments, what factors are used to determine payout based on efficiency.
9. Various patient safety factors and infection rates: In regards to Value Based Pricing/payments, what factors are used to
determine payout for safety?
10. the degree to which individuals have the capacity to obtain, process and understand basic health information and services
needed to make appropriate health decisions.: What is the definition of health literacy ?
11. The structural determinants and conditions in which people are born, grow, live, work, and age which have a significant
impact on health outcomes.: What are social determinants of health?
, ACMA Case Management Certifican study help
12. family composition, education, occupation, psychological and/or psychiatric functioning, living siuation, support system,
transportation concerns, life changes or stressor, cooing skills, social/ community involvement, spiritual
aspects and concerns, self care, cognitive or perception problems, financial concerns.: What are the components of a psychosocial
history
13. Federal Pre-Admission Screening and Resident Review. Some states may
require additional screening tools.: What is the required assessment for admission to a nursing home for a patient with a
diagnosis of mental retardation or mental illness to assure appropriate placement
14. economic stability, neighborhood and built environment, education, food, community and social context, health and
health care.: What factors effect social determinents of health?
15. Federal Pre-Admission Screening and Resident Review. Some states may
require additional screen in ng tools.: Required assessment for admission to a nursing home for a patient with a diagnosis of
mental retardation
16. reviewing patients clinical condition and providing decis I on support to MD on bed and billing status. ie observation, Out
Pt, In-Patient. and being prepared to justify medical necessity. Additional certification is required for admission Ions longer
than 20 days.: What is utilization and review?
17. family composition, education, occupation, psychological and/or psychiatric functioning, living siuation, support system,
transportation concerns, life changes or stressor, cooing skills, social/ community involvement, spiritual aspects and concerns,
self care, cognitive or perception problems, financial concerns.: components of the psychosocial history 19. 20 days.
Reason for hoslitalization estimated length of continued stay, post acute plans, if patient is only waiting on SNF placement must
indicate reason for delay.: Physician certification or recertification for admissions longer than ____ days requires what
documentation?
20. For Medicare services, when a UM review team has determined that an order for inpatient admission is not medically
necessary. Order can be changed to observation. The admission will be billed under part B Medicare only: What is a condition
code 44?
21. The change must be made prior to discharge.
The claim has not been submitted, The MD concurs with the UM decision,
occurrence is documented in the medical record.: What requirements must be met to bill a Condition Code 44?
22. Patient engagement,
dynamic process (ability to change plan as needed), patient centered, collaborative
(team), fiscally responsible.: What are the key elements of CM planning?
23. Clinical treatment and diagnosis, Comfort and Supportive Care, Restorative/rehabilitative care, Discharge or transitional
planning.: Patient Goals
24. INCLUDE the patient and family as full partners in the discharge planning process.
DISCUSS with the patient and family key areas to prevent problems at home. EDUCATE the patient and family in plain language
about the patients condition, the discharge process and next steps at every opportunity throughout the hospital stay.
