Show:
It's Quality
It's the Core Block
Your guess is as good as mine
Just another HUM
URAC for Dummies
100
Dr. Kulleni Gebreyes
Who is the chairperson of the QA/UR Committee?
100
No
Does your company have a financial incentive (bonus) system?
100
Who is the Corporate Compliance Officer?
Who is the Corporate Compliance Officer?
100
InterQual
What are the company's primary UM criteria?
100
Robin Revels-Fitzhugh
What is the name of the Project Director for the DCMA Contract?
200
Quality Assurance Utilization Management
What does the acronym QA/UM stand for?
200
1. Name 2. Title 3. Company
What three things must you provide when answering the phone?
200
BIGS
The URAC auditor wants to see what training you received at Delmarva. What website do you take her to?
200
1. email 2. Office phone 3. Cell phone
How can you reach your medical director? (3 answers)
200
OPI
What is the name of our complaint handling process?
300
1. Reduction of administrative denials for emergency admissions for Medicaid fee-for-service beneficiaries in facilities in the District of Columbia. 2. Pacemaker Study of Medicaid fee-for-service beneficiaries in nursing homes in the District of Columbia
What two QIP (quality improvement programs) did Delmarva start in 2009?
300
Hit crtl+alt+ delte to lock your computer.
You are going to lunch. What do you do to your computer/laptop?
300
email, cell phone, office phone
In what ways can you access a supervisor? (Hint..3 answers)
300
1. Danelle Luckenbaugh 2. Operations Coordinator
Who audits the work for project support and what is their title?
300
24 hours or same day
What is your timeframe for returning calls to consumers?
400
QA/UM Committee
Where is the formal process for evaluating, selecting, approving clinical guidelines performed?
400
1. Confidential printer 2. Confidential fax (Right fax) 3. Printers are locked to secure Printers 4. Lock laptop computers in desk at night 5. Shredder box for paper
Confidentiality: Patient specific information is maintained in a confidential manner. Please describe at least three of the safeguards in place to keep PHI safe.
400
UR Consumer Safety Mechanisms Policy Stay calm and attempt to obtain, as quickly as possible, some basic demographic information such as name, address, and phone number.
You pick up the phone, and the person on the other end said, “I have a gun and I’m going to shoot myself. I can’t take it anymore.” What policy tells you what to do?
400
Department of Health Care Finance
Who is the owner of the criteria used for LTAC's?
400
Thom Jackson
What is the name of the CEO of DFMC?
500
1. Who: Karen or Danelle 2. What: All work 3. When: Once every quarter 4. How: Paper audit
Who, what, when and how is your work audited?(you must get all four answers to receive credit)
500
a. Yes b. Yes
Your favorite brother-in-law owns a durable medical equipment company in the District. You recently accepted a partnership in the business. a. Should you have reported that your brother in law has a DME company? b. Should this be reported as a conflict of interest?
500
Lighthouse
What is the name of the anonymous reporting provider used report compliance concerns anonymously?
500
QA/UM Committee
What governing body approves criteria and policy and procedures for DCMAA contract use?
500
https://intranet.qualityhealthstrategies.org/
Where are the P&P’s for HR, Finance, and IT.?