Coverage for this type of specialist includes an initial visit, testing, and the prep and administration of serum.
What is an allergist?
100
All scheduled inpatient procedures most go through this process. (Sheena)
What is precertification?
100
This is defined as the sudden unexpected onset of a change in a person’s physical or mental condition. (Yenny, Takima)
What is an emergency?
100
This dog got swept away with Dorothy.
Who is Toto?
100
This is the treatment for mental illness and behavioral disturbances. (Latisha)
What is psychotherapy?
200
MRI/MRA, CT Scan, and PET Scan are examples of this type of imaging. (Kesi)
What is complex imaging?
200
Precertification is waived for this. (Casey, Janycea, Sheena)
What is maternity?
200
Services for conditions that are non-preventive or non-routine and are used to prevent serious deterioration are called this. (Takima, Yenny) Hint: Not quite an emergency
What is urgent care?
200
This dog was a pro at basketball.
Who is Buddy?
200
This is a medical device which replaces all or part of an internal body organ or an external body part lost or impaired as the result of disease or injury. (Latisha)
What is a prosthetic device?
300
These are the three recognized types of therapy. (Tamala)
What are speech, physical, and occupational therapy?
300
Pre-scheduled inpatient surgery must be precertified by this group. (Janycea)
What is patient management?
300
Ambulance services are provided based on regulations and licensing by who? (Yenny)
What is the local/state government
300
This dog was one of Woody's friends.
Who is Slink?
300
Psychotherapy, Drug Rehabilitaion, & family counseling are examples of this. (Candice)
What is behavioral health?
400
Alzheimer's and dementia may be considered as this type of condition instead of as a behavioral one.
What is a medical condition?
400
We consider a condition to be emergent if the care could not safely and adequately be provided anywhere other than this type of facility. (Princess)
What is a hospital?
400
This animated dog was voiced by John Travolta.
Who is Bolt?
400
Nursing rendered in a patient's home by an RN or LPN for the purpose of performing specific skilled nursing tasks is called this. (Candice)
What is private duty nursing (PDN)?
500
Service rendered by a physician who is not identified as the member’s PCP are subject to this benefit provision. (Tamala)
What is a specialist?
500
This system is used for patient management. (Sheena)
What is Active Advice?
500
One part of the criteria for an emergency is that the loss of a this, impairment to this, or permanent this could occur without emergency treatment. (Princess)
What are life or limb, bodily function, dysfunction?
500
This dog was friends with Milo the cat.
Who is Otis?
500
This is designed to withstand repeated use and is customarily used for a medical purpose as prescribed by a physician.