Name the Acronym
COC
Continuity of Care
Scripting for Approval Fax
What is the SNF Approval Facility Notification and Letter Process?
True or False:
IV antibiotics ALWAYS meet for SNF?
FALSE - they need to be scheduled for at least 7 days and a minimum of daily.
How you add an episode
Reach out to your leader or submit a ticket.
This band sings the iconic 90s song Stacey's Mom.
CPAN
Comprehensive Post Acute Network
Members plan changed from one Humana plan to another
What is the SNF Clinician Split Authorization process?
The number of reviews with no progress resulting in member not meeting SNF criteria.
What are 2-3 reviews?
For a fully integrated facility - how do you change the LCD to match the NOMNC?
Close the initial NOMNC task and reopen a new NOMNC task with correct LCD.
Hg is the chemical symbol of this element.
What is Mercury?
AANOD
Automated Approval Notice of Decision
When to route to RMD
What is the Clinical Review Template Process?
Days per week needed for nursing services to meet criteria vs therapy services.
What are 7 days a week for nursing services to meet and 5 days a week for therapy services.
How do you change an admission date?
Ask your leader if unable to update the date under the Care Journey tab.
This country produces the most coffee in the world.
What is Brazil?
BIPA
Benefits Improvement and Protection Act
Clinicals state member revoked Hospice.
What is the Hospice Guidance process?
Additional information that is important for lack of participation.
Member is sick or there is a change in condition.
What can the managers magic wand do in Anna?
Remove a discharge!!! (sometimes)
The painting "La Giocanda" is more commonly known as this.
What is the Mona Lisa?
LOA
Name the three types
DAILY DOUBLE
Letter of Agreement
The three types of LOA are: HMO Exception, PPO Waiver, and High-Cost Drug Carve Out
Member has used 85/100 SNF Days.
What is the Exhaustion of Benefits Process?
Does this meet for CSR or PEND or both?? Is this a mandatory route?
PLOF: MOD I w/SPC, lives alone in single level apartment with level entry.
CLOF: Postop R hip IMN. Bed mobility: MIN A, Transfers: MIN A, Ambulating 2 hops w/MAX A x2 and 4WW.
Meets for both
Would be a mandatory route for a PEND due to MIN A for transfers and bed mobility if not graduated.
Would NOT be a mandatory route for a CSR.
Which clinicals need to be sent from Anna to CGX?
What a phrase from the little boy in Jerry Maguire about the human head and Chewbacca's costume have in common.
Do they both weigh 8 pounds?