IDT Assessments/POC
What (3) disciplines are required to complete the following assessments: semi-annual, initial, change of condition?
What are PCP, RN, and MSW?
How can a PACE staff member receive a grievance?
What is verbally or in writing?
PACE staff must be cleared from what before engaging in direct participant contact?
What is communicable diseases?
Where does funding from PACE participants come from other than Medicare and Medicaid?
What is participants? Out-of-pocket.
How many days after an in-person assessment must careplanning occur?
What is 30 days?
What is the timeframe for responses to, and resolution of, appeals after an appeal is received?
What is as expeditiously as the participant's health condition requires, but no later than 30 calendar days?
The PACE organization's staff must meet be legally authorized via _____ (if applicable) to practice in the State in which he or she performs the function/action?
What is licensed or certified?
What platform can you view our policies on?
What is PolicyStat?
What disciplines are required to complete in-person assessments for the initial plan of care?
What are the 8 disciplines: PCP, MSW, RN, PT, OT, RD, AC, HCC?
How long does a participant or their designated representative have to initiate an internal appeal?
What is 20 calendar days from the day they are notified of the denial/reduction (verbally or in writing, whichever happens first)?
PACE staff members must meet a standardized set of _________ for the specific position description established by the PACE organization before working independently.
What is competencies?
What is the term for a fixed amount, regardless of changes in the participant's health status that is an all-inclusive payment for Medicare benefits provided to participants?
What is capitated payments?
What is the maximum timeframe for the IDT to complete in-person assessments and complete (review and revise) the care plan for unscheduled reassessments (change in condition/status)?
What is 14 calendar days?
Who can receive the information from a PPT or their DR on an appeal?
What is any PACE staff member? This does not need to be an Interdisciplinary Team (IDT) member.
A PACE organization must not employ individuals or contract with organizations or individuals who have been excluded from participation in what programs?
What are Medicaid and Medicare?
What does the acronym SAA stand for?
What is State Administering Agency?
Safety plans are part of _______, therefore should be evaluated during care planning sessions?
What is the plan of care?
After an individual has exhausted the internal appeal process, they have the right to an external appeal through what agency?
What is Medicare or Medicaid?
How does the PACE organization determine if an individual if excluded from participation in Medicaid and Medicare programs?
A review of the excluded individuals list maintained by the OIG?
For what SDR determination outcome is an in-person assessment required?
What is if the interdisciplinary team expects to deny or partially deny a service determination request?