Show:
My Brain Hurts!
Empower Me
Aerial Aneurysm
If I Wasn't a Nurse...
All Bandaged Up
100
This always-stylin’ leader was born in Santa Clara, California.
Who is Rex McCully?
100
This is the section in Aerial which provides a member’s claims history.
What is the Health Summary?
100
In order to work with our members, we must have this either written or verbal.
What is consent.
100
A member who’s feeling “BLUE” is referred to this person.
What is a BH referral?
100
Name the company that provides our DME to members.
What is Edgepark?
200
The place in BAM which assists members and clinicians with locating physicians covered under your plan.
What is Provider Finder.
200
Essentials of case management are: Assessment, Planning, __________ , Coordination, Monitoring, Evaluation, Outcomes & General.
What is Implementation?
200
This is the minimum number of musicians a band must have to be considered a “big band.”
What is ten.
200
When the member obtains all of his/her care with BCBSIL, except specified external vendors, it is considered this.
What is a carve out?
200
This is the process of confirming dosages’ and scripts.
What is medication reconciliation?
300
The platform where you might find a copy of the denial letter, additional member information and POA.
What is ECM?
300
An outreach program that provides claims resolution to members who are dealing with a loss of a loved one.
What is Seasons of Life.
300
This clinician assists members who have limited financial resources?
Who is Jane Ziegler? What is a Social Worker?
300
This is the minimum amount of time a clinician can look back in the member’s history to take a claim for cost savings for no readmissions or ER.
What is 3 months?
300
What is a way to identify an alternative to services not covered by the members self-funded benefit plan?
What is Marketing Exception Program (MEP)
400
The length of time from discharge that a clinician has to complete medication reconciliation.
What is 14 days?
400
This was the first planet to be discovered using the telescope.
What is Uranus?
400
According to URAC standards, this is the length of time you have for a follow-up call.
What is 30 days?
400
This is the person to whom you refer when your program has been opened greater than 6 months.
Who is the Medical Director.
400
This is what you do when working on a program that meets the high dollar mark.
What is “don’t close” or What is “keep open”?
500
The 5 principles of case management include: Autonomy, Beneficence, _____________, Justice and Veracity.
What is Nonmalficence?
500
The duty “To promote good and be the patient’s advocate” refers to _____.
What is beneficence?
500
This is the person to whom you would refer a pediatric transplant case with claims over $100k.
Who is Lori Duncan?
500
This Alfred Hitchcock movie’s lead character’s hobby was stuffing birds.
What is “Psycho”?
500
Accenture, AT&T, Office Depot, Kraft and Northern Trust have this in common.
What is the Blue Focus Team?