General
Questionnaires/Documentation
Plan of Care (POC)
100

Severity level for Catastrophic

What is High

100

Catastrophic Assessment Questionnaire should be completed within

What is 60 days

100

POC should be started

On the 1st call

200

Task completion reason for CCM evaluation if closing prior to 90 days

What is task created in error

200

Catastrophic Assessment Questionnaire should be initiated within

What is 30 days

200

Goals, interventions, and ___ are required in the POC (plan of care)

What are barriers

300

CCM evaluation task initially auto-fires for completion when

When is 90 days from program acceptance

300

The 2 questionnaires required for catastrophic programs are

What are the NCQA Questionnaire and the Factor Summation Questionnaire

300

POC should include 1 ___ and 1 ___

What is short term goal and long term goal

400

If unable to complete the Catastrophic Assessment Questionnaire, the CM must

What is document the reason(s) and actions taken to complete the assessment

400

Self-management template documentation is to be completed at least

What is monthly

400

Each goal should have a separate

What is priority rating (High, moderate, or low)

500

NCQA stands for

What is National Committee for Quality Assurance

500

Documentation template needed in either Aerial note or POC note

What is self-management template

500

SMART stands for

What is Specific, Measurable, Attainable, Relevant, and Timebound

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