Clearway Jeopardy

LOCATION

100

Name the 5 states located in the Mid-Atlantic region

Maryland (MD), Delaware (DE), Pennsylvania (PA), New Jersey (NJ), Virginia (VA)

200

What are the two provider groups that we will work with at Clearway Pain Solutions?

Clearway Pain Solutions LLC

Gulf Coast Pain Consultants LLC

300

What resource could we use to help a patient find a specific office location(s)?

Clearway Pain Solutions website. 

www.clearwaypain.com

Click the Locations Tab

400

Which states offer Self-Pay Options and what are the prices for each? 

Texas, South Carolina, Virginia

Addison, TX:
- New Visit $165
- Follow up Visit $127

Flower Mound, TX:
- New Visit $160
- Follow up Visit $123

South Carolina:
- New Visit: $375 (Includes labs)
- Follow up Visit $175 (Includes labs)

Virginia:
- New Visit: $375 (Includes labs)
- Follow up Visit $175 (Includes labs)

CLEARWAY HISTORY

100

What year did Kuresmart Pain merge with Clearway Pain Solutions?

2019

200

When did Clearway pain management begin? Through the years we have merged with different companies and rebranded.

19 years

300

What are the 3 sister locations connected to Clearway Pain Solutions?

1. Relievus

2. The Center for Pain

3. ***

400

What are the names of all the MA and SE former names?

Advance Pain Management Specialists

Kure Pain Mgmt

Smart Pain Mgmt

Kure Smart Pain Mgmt 

  

HIPAA

100

If an existing patient's spouse calls to reschedule an appointment, what should you do?

1. Check for Authorization: Look at the patient's file. Did they sign a form specifically allowing you to discuss appointments or medical info with their spouse?
   • If YES: You can proceed with rescheduling.
   • If NO: Technically, you cannot even confirm the patient has an appointment, as that is Protected Health Information (PHI).
2. The "Professional Judgment" Exception: If there is no form on file, but the spouse already knows the date and time (proving they are involved in the patient's care), HIPAA allows you to use professional judgment.

200

If a transportation company calls to ask what time a patient's appointment is, are we allowed to provide this information? Why?

Yes.

Under the HIPAA Privacy Rule, healthcare providers can disclose Protected Health Information (PHI) without specific patient authorization for Treatment, Payment, and Healthcare Operations

300

True or False: If a patient has an urgent medical need, it is HIPAA-compliant to leave a voicemail stating their specific diagnosis or test results so they get the information as quickly as possible."

False

Even if the information is urgent, you should never leave sensitive clinical details like diagnoses, specific medications, or lab results on a voicemail.

400

Who is our compliance officer and what is her phone number?

Amy Rice
317-446-8628

THINGS TO REMEMBER

100

Name the 4 different type of providers that are able to see our patients?

(DO) - DOCTOR OF OSTEOPATHIC MEDICINE

(MD)- MEDICAL DOCTOR 

(NP)- NURSE PRACTITIONER

 (PA)- PHYSICIAN ASSISTANT

200

What is the difference between a Referral and a Authorization?

Referral: is a formal recommendation from one healthcare professional to another

Authorization: An authorization is a decision by the health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary

300

List 4 different ways you can use the alert notes for. 

1. Alerts for call attempts

2. Alerts for schedule details

3. Alerts for insurance details

4. Alerts for discharged patients

400

List the steps to the CALL FLOW

1. Greeting 

2. Repeat back the reason why the patient are calling

3. Ask for a phone number incase they get disconnected

4. Confirm whether they are a NEW or EXISITING patient

5. Ask the 4 MUST ASK QUESTIONS

6. Register the patient

7. Ask for the insurance information and repeat it back

8. Schedule the patient and accommodate their benefits 

9. Go over what was discussed and what the resolution was

10. ASK if there anything else I can help with? Or “Do you have anymore questions or concerns?"

11.Thank the caller and tell them to have a great day

EMG'S

100

What are the arrival times for a NP EMG and Existing patient EMG?

New Patient EMG- 30 mins

Existing Patient EMG- 10 mins

200

What are the MUST ASK QUESTIONS BEFORE SCHEDULING AN EMG?

1. Is your case related to an open Worker’s Comp or Motor Vehicle Accident claim?

2.Who is the referring provider who ordered this test?

3. In which area is the test going to be conducted on?

4. Do you have a pacemaker?

300

Name the providers that offer EMG/NCS test

• Dr. Ehsan Abdeshahian

• Dr. Enrique Aradillas Lopez

• Dr. Inai Mkandawire 

• Dr. Mariam Hameed 

• Dr. Robin Medic

• Dr. Timothy Yoon

• Dr. Jesse Lou

• Dr. Sargoon Nepau

400

Name the two types of patient cases we may have to create for EMG's and why?

1. Precert Patient Case

- We must send a patient case to the pre-certification department. If the EMG/NCS test was booked less than a week out.

2. Pacemaker Patient Case

-  So that the provider can provide specific instructions for the patient prior the visit/testing.