Resource Management

3. type of care when chronic condition or injury is likely result in death in "near" future.
4. type of nursing when patient requires one-on-one care.
6. series of evidence-based guidelines serves as a tool that describes best practices for treating common conditions and delivering chronic care and behavioral health services in a variety of settings.
7. philosphy of this type of care is to provide members access to care in a timely and cost-effective manner.
8. example of social service agency.
9. type of case managers who work with the elderly population.
11. military insurance.
12. process of identifying,confirming, coordinating, and negotiating resources to meet the individual needs of a person.
14. the right of an insurance company or self-insured empolyer to be repaid for the cost of medical care or wage-loss benefits.
15. example of medical equipment.
16. pricing formula established by Medicare
17. UR ensures that the patient's _____ are observed.
20. carriers aslo known as stop-loss carriers.
22. _____ policies are legal contracts that detail the scope of servies and benefits provided within a policy.

1. _____ discharge is the most important element of successful discharge planning.
2. type of organization that is a fundamental component of communtity resources
5. ______ of care refers to the movement of the patient form one setting or level of care to another.
6. enacted in 1965 under title XIX of the social security act.
10. setting where many patients recieve care after an injury/illness that affects their ability to care for themselves and perform ADLs.
13. urgent appeal when provider feels there is a need for treatment.
18. provides health care for people in a specified geographic area.
19. age until children are eligible for SCHIP.
21. role is to collect data, verify that the request meets clincial criteria, and ensure that the patient has a benefit to cover the request.
23. largest segment of healthcare settings.