EIMs
How many days do you have to submit a critical incident to remain in compliance?
25 days
What does UTR stand for?
Unable to reach!
What are the four components needed before submitting an SAA?
Interrai, POC, Progress note, PSST
What apocalyptic 1978 zombie movie takes place in a mall?
Dawn of the Dead
Within the EIM.
Name all of the outreach calls needed to maintain the UTR process!
1. Participant, 2. Caregiver/family member, 3. PCP 4. PAS or any active provider.
Post discharge how many days do you have to complete a requested trigger?
14 days!
From top to bottom, what are the three colors in candy corn?
White, orange and yellow
How many extensions are allotted for an APS EIM, before going to a paper extension?
Three extensions! Death is the only other type of eim where 3 can be asked for before we go to paper!
1. Letter within ELTSS Unable to reach/or renew.
2. Certified letter of no response in sharepoint.
If a participant requires same day service on their back up plan and lists their PAS provider as the plan what is needed to stay compliant?
Confirmation of the PAS providers back-up pool must be documented in the notes.
What are the names of the three Sanderson sisters in the movie “Hocus Pocus”?
Winifred, Mary and Sarah
What are the six different ways to obtain cause of death?
There are 6 Ways to Obtain the Manner & Cause of Death: death certificate, hospital, hospice, funeral home, pcp, Medical Examiner
How long do you have to complete the UTR process before it expires...starting over?
30 days from the initial call.
True or false: When a UM review reflects a different outcome to the original plan of care, the plan of care must be updated, but a new letter does not need to be sent out.
FALSE! Anytime a change is made to the plan of care a letter must be sent out to the participant and PCP.
How many bones are in the average human skeleton?
206
What are the 3 steps for submitting a compliant trend analysis?
1. Trend analysis is sent for review at least 5 days before 25 day deadline.
2. Sharepoint reflect a yes for sending.
3. Approved and signed TAF is uploaded into eltss and eim with note.
What is the process for a newly eligible participant?
Day 1 call, day 2 call (call must be to person on IEB paper work) letter, day 3 pop up. You may then start traditional UTR process.
When completing the NFI, which of the three color indicators queue you that UM well want medical documentation?
Green! Any section in green is a helpful indicator to prepare your participant to gather more information for their review!
Where does the quote “Double, double toil and trouble” come from?
William Shakespeare's “Macbeth”