AOPUM

Imasis/MISC

100

This is the application name under Web Links -Environment Links for AOPUM

General  UM

200

This is the tab you click to start a case from a live call

Interaction Tab

300

 What are the 3 pieces a RN should obtain to verify HIPAA?

What is Patient Name, DOB, and Member ID. 

400

Sub products of AOPUM

 

What are Transportation, Hematology, Nutrition, and Other Misc Procedures?

500

If you hit "Review" in any of the boxes, this pulls up. 

All Tabs version of Case Viewer

Nutrition

100

 

Continued home parenteral nutrition must be reviewed how often?

What is every 6 months?

200

This type of nutrition is given outside the digestive tract.

What is parenteral nutrition? 

300

This type of nutrition is given through the digestive tract.

What is enteral nutrition?

400

Describe a nutrition care plan.

A detailed plan of interventions or actions to achieve nutrition goals. 

500

 

What 3 things must be in a request for the continuing use of home parenteral nutrition 

 

What are:

1. A physician certifies that the criteria for initial treatment (A,     B, and C above) continue to be met; and
2.  A physician     certifies that there has been benefit from the treatment; and
3.  An updated     nutrition care plan is provided

Hematology

100

Type of apheresis that includes cell removal or exchange.

What is cytapheresis?

200

Plasma exchange 

What is Plasmapheresis

300

This is the separation of platelets.

What is thrombocyapheresis? 

400

What are the different components that make up blood?

RBCs, WBCs, plasma, and platelets.

500

What are medically necessary diagnoses to use cytapheresis, RBC exchange?

Sickle cell, erythropoietic protoporhyria, liver diseases, babesiosis.

Transportation

100

This is the code a provider will request for BLS ambulance transport.

What is A0428?

200

Basic Life Support acronym 

What is BLS?

300

Non-emergency EMS transports are provided by this type of vehicle. 

What is an ambulance?

400

 

Where can a patient be transported via ambulance per Elevance GL CG-ANC-06?

 What is transportation to or from

 -Hospital to Hospital or Medical Facility

- Medical facility to another hospital or medical facility, skilled nursing facility, or free-standing dialysis center in order to obtain medically necessary diagnostic or therapeutic services is required (for example magnetic resonance imaging, computed tomography scan, acute interventional cardiology, intensive care unit [ICU] services [including neonatal ICU], Cobalt therapy, etc.) provided such services are unavailable at the facility where the individual initially resides; or

- from an acute care facility to an individual’s home or a skilled nursing facility.

500

 What is the manual used for Medicare review for EMS Ground Transportation?

 CMS Pub. 100-02, Medicare Benefit Policy Manual, Ch.10 

Fertility

100

 

Is there always a cause for someone's infertility?

What is no?

200

How many semen analysis must be performed prior to be categorized infertile?

What is 2?

300

 If the patient does not have IVF benefits then they have ICSI coverage.

T/F

What is false?

400

 

This chart is what you check to see if the state has any mandates for IVF

What is the State Mandate Chart?

500

 

MD has ordered cryopreservation of ovarian tissue over cryopreservation of mature oocytes for these indications

 What is patient is having to have immediate gonadotoxic treatment or prebuteral- faces infertility  from medical or surgical treatment, including chemotherapy, radiation therapy, other gonadotoxic therapies, or bilateral oophorectom