Goulash
Assessments
Credentialing
SARs
AOI
100
When will the "self - appointing" option for Veteran go into effect?
What is TODAY 12/20/2019.
100
When in communication with a provider by call, email, or chat about specific authorization(s), what assessment must be entered?
What is Provider Contact
100
What website do I use to verify that a provider is Medicare participating?
What is medicare.gov; If the provider is not found on Medicare.gov, Provider Services will NOT be able to load the requested provider.
100
Why would a SAR be submitted?
What is for continuation of care or additional services.
100
Where can the Job Aide for AOI be located?
What is Knowledge Central
200
What programs are offered to assist with searching/locating providers?
What is VC, CR, provider directory and Medicare.gov
200
When requesting a referral or authorization be cancelled or returned back to VA, what assessment must be entered?
What is Return Review assessment.
200
What is the approved website to research the provider's NPI?
What is NPPES; the approved website to research the provider's NPI.
200
What is the general processing timeframe for a SAR request? Specify BOTH routine and urgent request timeframe?
What is 10 business days for ROUTINE requests and 24 hours for URGENT request.
200
TRUE or FALSE- All authorizations will have AOI that need to be added.
What is FALSE- List of specialties can be found in KC that required AOI update.
300
Which form can be submitted to allow TW to speak with someone OTHER than the Veteran?
What is the Authorization to Disclose form
300
When granting an up to 7-day retro or up to 60-day extension, to a provider, on modified authorizations, what assessment must be entered?
What is the Grace period assessment
300
True or False; All specialties required Medicare eligibility to be loaded into Anchor point?
What is FALSE
300
What program will be used to locate the TIFF #?
What is the Xtrax Browser
300
What is the reason AOI should be updated?
What is to help narrow down a list of providers or facilities to those who are best choices to deliver the specialized level of care or service to the patient.
400
How would the Veteran get a new address updated?
What is through the VA. Veteran is able to reach out to VA, to do this you will need to contact 1-877-222- VETS (8387) or visit www.ebenefits.va.gov
400
What three assessments must be entered to modify the auth once appointment has been made and veteran is contacted?
What is the provider contact, veteran contact and appointment information assessments.
400
Name 4 (out of 18) specialties that do NOT require Medicare eligibility?
What is Acupuncturists, Audiologists, Behavioral Health Professionals, Behavioral Health Facilities (except Psychiatric Hospitals), Chiropractors, Clinic/Center, Birthing, Clinic/Center, Genetics, Family Medicine, Geneticists, Neonatologist, Nurse Anesthetist, Nurse Midwife, Nurse Practitioner, OB/GYN, Optometrists, Pastoral Counselors, Pediatrics, Physicians Assistants
400
Where would the provider submit SAR request forms?
What is Triwest; Completed forms MUST be submitted to TriWest to TriWest via fax to (866) 259-0311.
400
TRUE or FALSE- Leaving the AOI blank when it's required MAY result in a Critical error from QA.
What is TRUE- this may cause a critical error and score will be dropped to ZERO.
500
What must the Veteran verify to satisfy HIPAA?
What is Full Name (first and last name) of the Veteran, and one of the following: DOB, Last 4 of their SSN or Member ID
500
When collecting scheduling preferences for a Veteran on CT, Mammogram, and MRI referrals/authorizations (used in conjunction with the Veterans Preferences assessment).
What is Pre-Schedule (CT, Mammogram, MRI)
500
Who should the email be addressed to for request and what must be included in order to start credentialing request?
What is the manager and email must include a snip it of Medicare eligibility, Providers name, Tax ID and NPI, Address, phone number, fax number and pending appointment date and time.
500
Where can the SAR/TIFF be located?
What is the RESPONSE NOTES or the DOCUMENTS HISTORY (located on the Documentation tab in CareRadius), gen info/auth main or add'l faxes
500
Where in CR, are you able to update AOI?
What is under the SERVICES TAB, then by clicking SERVICE MAIN, then by clicking SERVICE PREFERENCES.