Referrals
Referral is a request or written order from the primary care provider to a specialist to obtain additional services for their patient. Auth the permission from a health insurance company for a patient to receive specialized services.
Timeframe for a high priority t/e
no more than 30 min
This is consider an abnormal b/p reading
>140/90
This has to be put in when patient complains of discomfort
Pain scale
How many days are for prepping in advance
4 days prior to appt
Patient has Aetna whole health insurance, where do you go to see if specialist is in patient insurance network
QPIC Preferred provider network
This has to be in a controlled medication refill script for provider to send
DX code, qty, day supply, refills
Discharge 2 does what in hedis schedule
Look at future occults orders and make sure they have an appt
This part has to be asked every time when triaging in the social history portion
What is patient care team
This form needs to be given to our patients at the beginning of every year
HRA form
Which insurances do you need to obtain authorization?
BCBS HMO/ Healthselect, UHC Nexus
What is considered FDA flush list for the medication destruction bag?
FDA Flush List includes any drug containing opioids
Screening for diabetes eye exam is important because of this
Diabetic retinopathy causes blindness
You have to ensure these are added before doing any discharge
Procedure/ Order of test in patient chart
This appt slot is only to be used within 24 hrs on the provider schedule and with the provider approval
SDA
This needs to be faxed when clinic receives a referral request for UHC MA HMO pt
What is redirect cru letter
Which t/e should you not send to the provider? Name 3
Web message saying thank you, basic refills that has been filled before, billing information
EGFR and MICRO
In order for us not to put DNBM, what is consider valid for patient meds
Pic, med list, bottles
Extended hours has these restrictions
Restrictions: No new patients, pre-op clearances, transfers of care, or telehealth visits
When completing referral for UHC MA PPO how many visit are you putting in visit box?
12
If patient has not been seen by a Provider within the last twelve (12) months but is requesting refills. What do you do?
If future appt can send 90 days no refill, if no future appt, needs appt within 30 days, send refill for 30 days no refill
Signatures are needed for this order
What is advance directives/ MPOA
Explain the correct order of positions in doing orthos
Supine, sitting, standing
N/S/C is put in for which patients
All patients who n/s