True or False
When to consider
Details Required for Referral
Misc Facts
100

Avg. cost of an MRI is between $600-$700

The average cost of an MRI is $900-$1200

100

What can diagnostic imaging determine for the PM?

Treatment options. 

100

What types of diagnostic tests can a DCM refer for?

MRI, CT Scan, X-Ray, and U/S

100

What is Nick's favorite treat?

Dilly Bars or snickers

200

A PM does not need provide a requestion for a DCM to make a referral?

False. 

The plan member needs a requisition form for the test from a physician.

200

Will the investment in a referral shorten the duration of the claim?

YES!!!! 

 

200

What does the PM need from their specialist or AP?

A requisition for the test. 

200

What is Brett's favorite saying? 

IT DEPENDS :) 

300

Testing can be used for a secondary condition?

False.

The test should be for the primary disabling condition. 

300

When would a DCM request a rush refferal? 

PM is reporting financial hardship.

The timing of the service have a negative impact on the plan member?

You consider the standard service time unreasonable for the current situation?  

300

Can a PM decline the option for diagnostic imaging from a private clinic?

Yes

The DCM needs agreement from the PM to engage in privately funded diagnostic imaging service.

300

What is Elizabeth's favorite saying

Persnickety :)

We will also accept Shenanigans! 

400

The report from the test should be received within 5 business days?

False.

The report should be received within 10 business days of the appointment.

400

A PM has requested an out of country referral. 

No, out of country referrals are not available at this time

400

Do all provinces allow for private diagnostic testing?

No

Bonus points if you can name which provinces do/do not allow.

400

What craft did Steve take up last week?

Diamond dot paintings. 

500

DCM would refer if a PM is in Tx, Rehab program or engaged in a GRTW?

False.

Refer when the plan member is not able to participate in treatment, rehabilitation programs and/ or gradual return to work without the test.

500

What would Steve say is the most important thing we need to check on the plan member statement form when considering a referral?

That we have a signed and valid PM statement on file!!!!!!!!!!!!!!!!!!!!!

500

Who is everyones favorite RC?

Steve 

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