Expedited
Facility calls in to request a fast case on member that is being transferred to their Skilled Nursing Facility.
advise caller they are unable to request a case to be expedited must come from Physician, member or member rep
i got assigned a case in denied status what does that mean for me as a UMAC?
what is start the denial process
i receive a case to create authorization what is first steps when member in focus in cgx?
what is verification in scope or out of scope
Doctor calls in to request Expedite what is the first thing you do
What is must state Applying the standard timeframe for making a determination could seriously jeopardize the Enrollee's life, health, or the ability to regain maximum function
i start the denial letter and i need to send to and copy to who?
what is send to member and copy to Facility
you pulled an Member in focus and verified that member has a MES policy
what is do not create auth
i confirm a case is expedite and i go into details page than continue to my communication record correct and why?
what is incorrect must do communication record first than details page to capture the time
i am updating the Dynamic Fields and jump to the merge fields what will i need to update?
What is nothing should Auto Populate
in the provider fields we input which providers where?
what is SNF Facility in requesting and facility provider field and Attending in the treating provider field
what is the most important thing when doing a case that is expedited.
What is time
i have a case that is day 13 do i need to send any letters through Veritas
what is no go through fulfillment
the difference between SNF Admit Post hospital vs SNF Admit Direct
What is SNF Admit Post Hospital is post discharge from acute facility and SNF Admit Direct is admission from home.
i have updated my auth to be urgent and now i am emailing my Leader and clinical manager
What is incorrect use the sharepoint site
when i am sending the letter through fulfillment it automatically wants to send to member and facility
what is incorrect only send to member fax to facility
Member admitted to SNF Facility on 9/28/2024 and this request type is chosen while member has not been discharged
What is Request Type Concurrent