What is the document format type required for uploading clinical information on the portal?
PDF
100
What are the three steps you should do before creating and uploading clinical documentation?
1. Verify 3 patient identifiers
2. All clinical submitted is for one patient
3. Triple check
100
What states are going live 5/1?
NY, GA, CT, VA, and MO
200
Date change requests should be routed to?
Clinical Review
200
You received a verbal order from a LPN for SN 2wk2. The order has the MD information listed as well as a date and time stamp.
Would this be considered a valid order?
No, this is not a valid order unless it is co-signed by a RN.
200
What is the email we should use to send portal inquiries to?
portalsupport@mynexuscare.com
200
What should you do if there is a PHI breach?
Notify your Team Lead/Supervisor immediately so he/she can contact myNexus’ Privacy Officer, Martee Harris, immediately.
200
What is the toll free number for myNEXUS?
844-411-9622
300
A second RE-AUTH request would have an effective from and thru date to reflect how many days/weeks?
2 weeks
300
You have an order written on a script pad for Home Health. It is signed by the doctor.
Is this a valid order?
No. The order MUST note the discipline(s) requested.
300
Who can use the portal to submit HH precert requests?
Health Plan Case Managers
Home Health Agencies (HHA)
MD Physicians
MD Physician Groups
Skilled Nursing/Rehab Facilities
Hospitals
300
How many individual identifiers are there to link a patient to their PHI?
18
300
What is myNEXUS fax number?
844-834-2908
400
A member has a subscriber ID number with a pre-fix of XYP. Is this an eligible member?
No. XYP is not a pre-fix we precert for.
400
You have an initial request for MSW. The order you have is a face to face document with an electronic signature from the MD.
No. MSW cannot be a standalone discipline.
400
What is the first step a user must do in order to use the portal?
Register as a user
400
How many categories of "sensitive" health information are there?
8
400
You received a 485 on 3/1 for SN 2wk2 as the INITIAL request. The cert period for the 485 is 3/1 - 6/1.
On 3/15, the agency submits a re-auth request for more SN visits (total of 4 more).
Do you have a valid order for the additional visits?
No. The 485 order is only good for the 2wk2 order. Additional visits would require another order.
500
You have a RETRO request for SN. The Agency is an Episodic provider. Should the service line be labeled as an INITIAL or a RETRO
INITIAL
500
You have an electronic verbal order for PT. It was obtained by a RN. The MD's information is listed (Name, address, NPI, fax, number) as well as an electronic signature from the MD.
How long as is the order good for?
30 days
500
What information is needed to create a request on the portal?
Member information: homebound status and location
Diagnostic information about the member’s condition requiring care
Ordering physician information
Ordering facility information
Service provider information
Service location
Required documentation including signed order, verbal orders, face-to-face orders and clinical documents
500
We are allowed to save electronic PHI to our laptop. True or False
False.
Faxes, e-mails and computer printouts may contain patient information. Take precautions to ensure that these types of communications get to their intended destination. DO NOT SAVE ANY ELECTRONIC PHI ON YOUR LAPTOPS.
500
A member wants to start a home health request. Can Intake accept this request?
Yes. We can build the shell of the authorization and would then pend for MD orders.