QC
PMR
FUs
0820
FCs
100
If recs were received and FU letter was created, what date determines if the letter was created in error
What is close date
100
If request was previously closed as a non response, what needs to be changed on the original request when recs come in?
What is response category to request complete
100
What are the steps to be taken when a PHP states that the mailed request wasn’t received?
What is 1. Verify mailing address 2. Check initial PHP mail date 3. Change PHP FU status to letter QA'd (if its been 7 days)
100
What response category is used when the Vets signature date is typed instead of hand written?
What is Other
100
How do we process a request if the Vet is listed and his wife is also listed as the claimant?
What is 1. Ask provider if the Vet or his wife was seen at the facility 2. If refused always put Vets info, never both
200
What should the letter status index be set to for Unredacted 4142s?
What is No Letter
200
How can you tell when records were sent by the Veteran rather than the provider?
What is envelope
200
When are you allowed to check the 2nd call date at the time of an incoming call?
What is If its been seven days and no FU was made and the IC confirmed the receipt of the request
200
What date is used for the DOC on a verbal negative?
What is Last journal entry
200
What do we do if we find out at the time of the first call that the Vet is deceased and there is no claimant?
What is Return
300
What steps does QC CSR take when QAing a letter with claim id=Verify
What is Delete the letter is it hasn't been called on, if it has & its for DOB Qa the letter, if for claim id/ssn do not QA until RO responds
300
What indexes do you have to manually enter when the barcode is not read?
What is All indexes up to the Hospital, provider status, response category, csr/date
300
What are the steps to be taken when the PHP states that they have already provided us with records?
What is 1. Check Icharts to confirm receipt 2. Ask when & where the records were sent 3. Ask them to resend the recs 4a. If refused set the request to 0820 needed if recs were sent to RO 4b. If recs were sent to DOMA & php refused to resend, leave request open until 40 day mark
300
In what cases do we close a request with the category already supplied to VA?
What is 1. Non-exact Dups 2. If PHP isn't willing to resend recs that were previously provided 3. If Vet picked up their records
300
Which signature date should be used on a merged request with 2 different signature dates?
What is the most recent date
400
What date does the VBA date index match on PMR Negative?
What is Todays Date
400
When do we consider a response a reversion?
What is Prev Negative or Prev Non response
400
When following up on a negative faxed response and the PHP gives us a different negative reason than what was stated in the fax, what negative reason would we go by?
What is the verbal response
400
Can you close a request as unreachable if after faxing it out there were 3 unsuccessful follow up attempts?
What is NO
400
How do we process a request with the doctor name listed on the 4142 along with the hospital where the doctor practices, but the address listed is for the doctors’ private practice?
What is 1. Contact both locations to see where the recs are kept 2. If kept separately split the 4142 3. Process request separately
500
What are the 3 journal note errors we hit for but do not kick back for?
What is verify patient, turnaround, journal codes
500
Describe the steps when merging PMR batches
What is 1. Search the caller id 2. select pmr batches 3. Click on merge documents 4. index info/barcode, place it in PMR folder 5. Merge documents 6. verify indexes have been populated 7. move merged docs to merges folder
500
When are you allowed to check the 2nd call date when the follow up call is unsuccessful?
What is After the second NR
500
How do we close out a request if the PHP states that the doctor has relocated and we need to contact his new office?
What is Request should be left open and we need to contact the new location
500
If there is no DOB on the 4142 and the one that is indexed from share does not match what the PHP has in their system, do we still process the request?
What is yes
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