Case Notes
What note type do we use when checking clinical?
Clinical Received - Attachments
For OP cases, where do we look up codes?
Hint: 3 answers.
NPL Tasking Tool, NPL QuickBase, IP only List
Where do we go in MedCompass to check for members Active, Discontinued, or Future insurance?
Insurance Tab
When the Vendor is par, what unit of measure should we use?
Per Vendor Contract
ESA plans have the same benefits in and out of network
True or False
True
What note type do we use when tasking to a RN queue?
Precert Status
For OP cases, if a case is approved there should be no open tasks.
True or False
True
Where do we go to get to CEC?
How long do wheelchair cases get approved for?
13 months
When making a call to request clinical, who do we contact?
The requestor
What note type do we use when the system find a provider flag?
E & E Override - AA Retrigger
Would OP cases have a co surgeon or assistant surgeon added to the service auth?
No
Where do we go to check for duplicates?
Utilization Management
What do we look for in the clinical when looking to add additional codes for wheelchair cases?
Standard Written Order
When we receive an approved case, what are we checking for in the letters?
Codes, Quantity, and Date Range