Registration/Insurance
What tool should be used to determine participation status for many managed Medi-Cal plans?
The Payor List/Contracted Payor List.
Which POD handles Cardiology, Oncology, and Dermatology?
POD 2
Where can you view a patient's future appointments?
What is Appointment Desk?
True or False: Every insurance plan requires prior authorization for the same services.
What is False?
What can travel around the world while staying in one corner?
What is a stamp?
What SmartPhrase is used when no active insurance is on file?
.PPOINSNEEDED
Which POD handles Orthopedics, PT/OT, and Neurology?
POD 1.
This work queue provides visibility to appointments scheduled within 30 calendar days.
What is the Patient WQ
A patient changes insurance after an authorization is approved. What should be reviewed?
What is whether a new authorization is needed under the new insurance
The more you take away from me, the bigger I get.
What is a hole?
For CCAH patients, how often should PCP/group assignment be verified?
Once per calendar month when processing a new referral
Which POD handles Pediatric services,Pulmonary Medicine, Urology and Sleep Medicine?
POD 3
What feature within Epic would gather clinical documentation for you?
AI insights
What is the difference between a referral and an authorization?
A referral directs care to a specialist, while an authorization is insurer approval for a service.
September's birthstone is this blue gemstone.
What is a sapphire?
This term describes the amount a patient must pay out of pocket before their insurance begins covering most services.
What is a deductible?
What does SHSO stand for?
Sutter Health System Office
What has replaced our WIKI page?
Our NEW Sharepoint
Name three reasons an authorization may be denied.
What are lack of medical necessity, missing documentation, and non-covered services?
What annual event occurs around September 22-23 when day and night are nearly equal in length?
What is the autumnal equinox?
When a patient has Medicare and a supplemental secondary insurance, which coverage should be entered as primary?
What is Medicare (unless coordination of benefits indicates otherwise)?
What does CAOP stand for?
Centralized Access Optimization Program
What should be reviewed before creating a new referral to avoid duplicate work?
What are existing referrals and authorization records?
Name three examples of clinical documentation commonly needed for authorization requests.
Written order/referral, chart notes, treatment plans, imaging results, lab results, diagnostic testing.
I have keys but no locks, space but no rooms, and you can enter but not go inside. What am
What is a keyboard?