This screen is the default screen (first screen after pulling up the case)
What is the case summary screen
When entering the PCR decision be sure to match the ___ and the _____
What is the PCR's outcome and decision
These are bolded
What are recovery milestones
What are GRG's
PG, MG, SC, PUL are examples of which guidelines
What are GRG's (PG- problem, MG -Medical, SC- surgical)
Pend / Peer Clinicial Review
What message reflects everything is in order and ready to create the review?
What is A physician review is needed
Extended Stay and Common Complications are found in which type of guidelines?
ISC's
What is a max of 2 ISC's at any given time
Another term for ORG
What is an ISC (ORG:M-190 ISC)
This time zone is used for TAT
What is Eastern Time Zone
What is the ACMP Reference Tool 2.0
Name the 4 variances
Positive, Potential Avoidable, Medically Necessary, Does not apply
W0018
What is an Anthem Customized guideline
Maximum number of GRG's you can use at any given time
What is 1
Where would you look for attached medical records
Notes tab, fax log, fax summary, or the orange icon on case summary tab.
The two ways to search a diagnosis code
0-17 yr's old
What is the pediatric age range for guidelines
Why would you use Extended Stay or Common Complications and Conditions?
When there are variances, or other health issues during the course of care, and additional days / guidelines may be needed
The guidelines we license
What is ISC, GRG, RFC, CCG, BHG
Eligibility is noted on which two screens
Where do you add/update a servicing facility or doctor
Case Details > provider tab > add/update provider
The preferred Anthem guidelines
What are ISC's
This type of guideline uses Stages
What are GRG's
anthem9 / nine
What is the log in / password for Anthem Historical Guidelines