Healthcare Management Flashcards
What two requirements must be met in order for rehab services to be covered?
Care must be reasonable and necessary with respect to duration, frequency, efficacy, and amount and also be necessary to be provided in an inpatient setting.
What type of unit most often requires the services of a case manager?
A medical unit
These are structured as yes no and support the use of clinical pathways.
Algorithms
What are the four components of a critical pathway?
Timeline
Identified care categories and their interventions
Outcome criteria
Allowance for deviation
This model applies to aging population and patients with chronic conditions.
Chronic care model.
Both _____ and _______ facilities provide intravenous care.
Sub acute, rehab
Who should the care manager establish relationship with when discharged from and acute care facility?
Staff of skilled nursing, home
Health, sub acute care, rehab facilities etc.
What are critical access hospitals exempt from?
DRG payment for acute care.
In life care planning what is not considered a collateral source?
Clients assets (insurance and benefits are)
What is the most important aspect of a hospice program?
They focus on family as well as client.
What is the best resource for information regarding personal care attendants?
A local center for independent living.
What is the most common setting for telehealth or telemedicine?
The clients home.
Does Tricare have managed care?
Do they provide disability?
Do they covered people who have retired?
Yes, no, yes
Which of the following do Medicare hospice benefits not cover which of the following?
Dietician, therapeutic recreation, medications, physician
therapeutic recreation
No fault auto insurance is also known as:
Personal injury protection policies
