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Service Connection/Special Authority

100

The diagnosis of Diabetes Mellitus is covered under this type of Special Authority

What is Agent Orange?

200

This Special Authority covers Gulf war veterans that served between 8/2/1990 to present and were exposed to a wide variety of hazards and potentially harmful substances

What is Southwest Asia conditions (SWA)/Gulf War Illness?

300

This condition is associated with or aggravated by a service connection condition

What is adjudicated or secondary? 

400

Name 3 conditions that are covered under Camp Lejeune Special Authority

Bladder cancer, breast cancer, esophageal cancer, female infertility, hepatic steatosis, kidney cancer, leukemia, lung cancer, miscarriage, multiple myeloma, myelodysplastic syndromes, neurobehavioral effects, non-hodgkin's lymphoma, renal toxicity, scleroderma

Documentation

100

This key stroke option in VisTa displays the claims tracking menu

What is ^ct

200

This is the area in claims tracking where the nurse would locate the option to add an "R" to a claims tracking entry to denote prospective review or Non-VA care

What is RI (review information)?

300

This is the process of obtaining prior authorization for a scheduled, elective hospital admission from a third party payor prior to the scheduled admission.

What is Pre-Admission review?

400

This is the evaluation of each hospital day of care against standard third party review criteria and the gathering and communicating of pertinent clinical information to the third party payer

What is continued stay reviews?

UR Nurse Role

100

This is the primary claims  tracking tool used by the RUR nurse to communicate with Accounts receivable

Third party Joint Inquiry

200

The Revenue Utilization Nurse falls under what specialty career path in the VA

What is Consultant Path

300

The RUR nursing department reports to what office? 

What is Office of Finance? 

400

The objective of this process is to change a third party payer's decision regarding claim denial and attempt to obtain payment for all or part of the clinically denied services

What is an appeal's process?

Revenue Cycle

100

This is the process for determining the existence of a third party payer that is responsible for covering a portion of the cost of providing medical care to the veteran

What is insurance identification/verification?

200

The VA can not bill for this type of treatment

What is service connected?

300

This is our fiscal year goal

What is $385 million?