HIPAA
Documentation
Process
Random
Brand vs Generic
100

NO COGNITIVE IMPAIRMENT: If a member is not available, can we proceed with call? Why?


NO COGNITIVE IMPAIRMENT 

1.    In instances where no cognitive impairment is indicated for the member, caregivers may assist member and complete CMR jointly. 

a.    If a member is not available, clinician cannot proceed with CMR and should schedule appointment at a time when member will be available.   

100

How would you verify and document this medication?

LANTUS SOLOS INJ 100/ML

TYPE 2 DIABETES

INJECT [ ] SUBCUTANEOUSLY UNDER THE SKIN ONCE DAILY AS NEEDED

See live response.

100

What does CPP stand for? 

Clinical Products Platform

100

A member takes lisinopril and losartan. What MTM concern should be evaluated?

 Potential duplicate therapy (ACEI + ARB). Assess whether concurrent use is intentional and address/document appropriately.

100

Give me at least 3 Brand names of Metformin.

Glucophage, Glumetza, Fortamet, Riomet

200

Who is the recipient of Consultation if member has CI but member did the review?

Beneficiary/Member

200

Select appropriate Actions for DTP Review.

When to use Verified?

When to use Verified and Send to Prescriber?

Select appropriate Actions for DTP Review: 

  1. If discussed select Verified, then select Reason For Not Contacting Prescriber. If reason for not contacting prescriber is not one of the options, select “Other” and document the reason in text box.

  1. If intervention is needed, select Verified and Send to Prescriber. If unable to discuss, select Verified and Send to Prescriber and note reason for not discussing in case notes. 

200

Show us how to search member and authorized representative in Advocate Central.

Share screen.

200

A member takes Metoprolol ER 100 mg BID and Metoprolol ER 50 mg BID. What should you clarify?

Determine if both strengths are being used together intentionally to achieve the prescribed total dose.

200

What is the Generic name of Qbrelis?

Lisinopril

300

CI Pathway: Provide who can lead the medication review.

a.    GPS/AC Authorized Representative

b.    Verbal Consent  

c.    Non-Verbal Consent where caregiver is not healthcare provider (i.e. spouse, friend, daughter/son)

d.    Non-Verbal Consent where caregiver is a healthcare provider (i.e. nurse in LTCF, home health nurse)  

a.    GPS/AC Authorized Representative

       i.    Clinician can lead with medication list. 

b.    Verbal Consent

        i.    Clinician can lead with medication list. 

c.    Non-Verbal Consent where caregiver is not healthcare provider (i.e. spouse, friend, daughter/son) 

         i.    Caregiver must lead with medication list.  

d.    Non-Verbal Consent where caregiver is a healthcare provider (i.e. nurse in LTCF, home health nurse)

          i.    Clinician can lead with medication list. 

          ii.    Ensure LTCF name is documented in  caregiver section when applicable.

300

How would you document this medication?

Insulin Lispro: 100 units/mL

  • Blood glucose < 150 mg/dL: Do not administer insulin.
  • Blood glucose 150-200 mg/dL: Inject 4 units.
  • Blood glucose 201-250 mg/dL: Inject 8 units.
  • Blood glucose ≥ 300 mg/dL: Inject 12 units

Insulin Lispro: 100 units/mL

Direction: Inject subcutaneously under the skin three times daily based on the sliding scale: Inject [4 units] for 150-200 mg/dL, Inject [8 Units] for 201-250 mg/dL and Inject [12 units] for >300 mg/dL. Do no administer if < 150 mg/dL.

300

Which medication does NOT belong?

  • Losartan
  • Valsartan
  • Olmesartan
  • Lisinopril

Lisinopril (ACEI). The others are ARBs.

300

Which medication would most likely be taken on an empty stomach?

A. Metformin

B. Levothyroxine

C. Atorvastatin

B. Levothyroxine

300

Give me at least 3 Brand names of Albuterol?

Ventolin HFA, ProAir HFA, Proventil HFA, AccuNeb

400

Show us how to search member in GPS. Check if member has an authorized representative.

Share screen

400

What is the Generic name of Seroquel?

Quetiapine

500

Give me an SSRI drug and provide it's generic and brand name.

Generic: Sertraline Brand: Zoloft

Generic: Escitalopram Brand: Lexapro