P-SYNCH
You would call one of these people if you forget your password or get locked out.
Who is Jan or Stacey?
Discharge Planning Survey 10.0
What must be created initially and updated after each clinical review?
Immediately done after initial clinical review is completed
What is change the PENDED status of the authorization?
Peer-to-Peer request
What must be offered prior to a decision being made by the RMD?
The onsite nurse does this once a week.
What is Face to face visit?
To save changes made to the queue screen
What is the GEAR icon?
You do this after you change your password.
What is CTRL-ALT- Delete?
From Day 1
When does discharge planning start?
Fields needed to be completed on a PACR during the initial review lifting the pend.
What are the clinical information and criteria screens?
Action needed to forward PCPD (Pre-Claim Provider Dispute) to RMD
What is Reopen the case?
Clinical review time frame
What is once every 5-7 days?
A2O is documented here
What is the redirection field on the details screen?
You will be notified ______ number of days before your password is going to expire.
What is 14 days?
Within 72 hours of discharge
How long do we have to enter a DC date into CGX?
Copy and paste prior review
What I must do prior to writing up my concurrent review?
After denial, acute facility may request
What is a Pre-Claim provider dispute?
This is when a nurse would issue a NOMNC.
What is no fewer than 2 days and no more than 5 days prior to anticipated discharge?
Needs to be the same as what is in the MCG criteria box
What is the primary diagnosis code on the details screen?
These are the ways that you can login to P-Synch even if you forgot your password.
What is answer your security questions and login with a 4 digit pin texted to your personal cell phone?
Remove ownership
What you need to do to close out an authorization once DC date is entered?
Consultation Tab
Where you document your clinical rounds information?
At the beginning of the Clinical Review
Where you document the acceptance or declination of a P2P?
You would issue this to a member 10 days prior to their 100th day.
What is the Exhaustion of Benefits letter?
The location I should check for 99999999s every time I open up a new authorization?
What is the facility field?
The way to get to P-synch
What is go to HI page, click on Workday & Apps and then click on P-synch?
Confirm DC destination and date
What must be done before removing ownership of an authorization in order to avoid being on the auth audit report?
Completed clinical review
What must be in CGX before you can route a case to the RMD?
2 places to document a P2P offer
What is a communication record and the review comments box on the details screen?
6 pieces of information needed for a medication carve out
What are the 1) DX code; 2) cost per day for medication on pharmacy invoice; 3) J-code; 4) NDC number; 5) dosing information and 6) the time frame member is to be on the medication?
3 ways to get credit from Operational Excellence for "touching" a case?
What are 1) entering a Communication Record and selecting Contact reached as a contact result; 2) adding a clinical review and 3) creating or updating a DPS 10.0