Access
What is the name of the Portal for Humana?
Carebook
True or False
A CPT II Code will close a gap?
True
When can you bill an AWV for a Medicare Advantage member?
1 per calendar year
Within how many days should a patient be seen post- discharge?
7-14 days
What is the NEW UHC portal called?
UHC CareConnect
How many CPT II codes are available for A1C reporting?
3
Name 2 methods that can be used to close Colorectal Cancer screening.
Colonoscopy, FOBT, Cologuard, or Sigmoidoscopy
What CPT II code do you use to close the medication reconciliation post- discharge?
1111F
What is the name of the button to upload your CCD file?
Continuity of Care Document
Name one procedure for a gap which is closed without using a CPT II code.
Colonoscopy, Osteoporosis, or Mammogram
True or False
Can you document two blood pressures on one encounter, and only report the lowest systolic and diastolic?
TRUE
Name a common diagnosis of a Potentially Avoidable ER visits.
UTI, Cellulitis, Hypertension, Pressure Ulcers, or Uncontrolled Diabetes etc.
What is the name of the Portal you use to access BCBS?
Availity
Name one of the two codes which can be used for osteoporosis management for women with fracture.
3095F or 4005F
Name one of the newest code categories for exempting care gaps. (Title not CPT II Code)
Frailty or Advanced Illness
What CGMCN tool has been recently implemented to decrease hospital/ER utilization?
Gold Card
Where do you access Utilization in UHC Care Connect?
Census Tab
What is the CPT II code for an A1C between 7-9?
3045F
When should you wait to upload a manual document vs using CPT II codes?
Never!
What facility does CGMCN prefer for you to refer a patient to who needs Urgent Care?
AlphaMed