SWAGB
Starting with a Good base is understanding what details are _________________ and what details we are ___________ in the claim.
Available, Missing
The role of the Case Manager and Medical Coordinator is to determine what is medically necessary or _________ based on medical information.
Emergent
At GEM, we are _________ specialists
Risk Management
GEM Medical Guidelines are guides that outline _____
Best Practice
Town in which Gem was founded
Sherbrooke
When a claim is created at the time of the medical emergency (the claimant is at destination and actively seeking treatment), this is known as a _________________ claim.
Full Assistance
1. Refers to the standard care we receive at home.
2.Refers to the care required at travel, during an acute injury or illness.
what are the terms for 1 and 2, respectively?
Healthcare Medicine
What does risk mean?
Possibility of loss or _______.
Something that creates or suggests a ________.
Possibility of loss or injury, Something that creates or suggests a hazard.
The categories of the Medical Guidelines are organized for the most part by body ______ with some exceptions.
Systems
Current CEO of our company
Reg Allat
True or False
Assistance Team manually creates the Special note - VOC task during claim opening
Policy Validation Team
True or False: Rescue missions and evacuations are managed by Case coordinators only.
False
The GEM note will become your anchor to any claim and will help you determine the risk.
True
GEM guidelines are a _____ or _____ for you to use daily
Resource, Tool
How many locations do we have in North America?
4
(Windsor, Sherbrooke, Miami, Mexico City)
____________________ note indicates important coverage details of the claimant.
VOC
____ risk cases can sometimes be escalated to a High-Risk claim.
Medium
Choose Correct Answer:
Which pillar takes the precedence if claimant is unable to return home?
Claimant Safety
The first part of the guideline is labeled ____
Claim Information
Who is our department's Vice President?
Darlene Ostrogonec
Managed Care team takes care of the claim reserves.
True
What Pillar(s) need(s) to be considered when it comes to determining the End of the Emergency?
All 4 pillars.
hen we are managing a claim, it is our responsibility to consider all the risks to the __________ and to the ______ ______.
Claimant, Corporate Client
Once you have your “_________,” and a diagnosis or symptom, you can refer to the _________ Guidelines and find the corresponding guideline for that diagnosis or symptom.
Good Base, Medical Guidelines
Who is the best training facilitator this side of the Mississippi?
Jennifer!!!!