Healthcare Case Review Process Quiz

Which user role can create only PCCA cases in the Provider Portal?

What does PCCA stand for?

To create a prospective case, the date of service cannot be greater than what duration?

Which role has the privilege to deny a case if it is not met at the initial intake?

In the 'facility' tab, users can view a list of previously selected providers. What is this screen identified as?

Case Review Types

Urgent cases can be created for retrospective, prospective, and PCCA review types.

Creating Prospective Cases

The date of service for a prospective case cannot exceed 30, 60, 90, or 120 days.

Role Privileges for Case Denial

The RN user has the authority to deny a case if it does not meet criteria during initial intake.

User Roles in Provider Portal

Only the RS user role can exclusively create PCCA cases within the Provider Portal.

Meaning of PCCA

PCCA stands for Post Claim Clinical Appropriateness.

Acronym "MAC"

"MAC" can refer to:
- Mycobacterium avium complex
- Monitored Anesthesia Care
- Media Access Control
- Medicare Administrative Contractor

Surgical and RBM Tabs

The surgical and RBM tabs have similar names, differing only in the procedure and facility aspects, as well as the exam and provider sections.

Current Surgical Clients

There are currently 10, 11, 12, or 9 clients associated with the surgical department.

Facility Tab Functionality

In the "facility" tab, users can view a list of previously selected providers, identified as the Last selected provider screen.

Test your knowledge on the healthcare case review process and the roles involved in creating urgent cases. This quiz covers key terminologies and the guidelines for creating prospective cases. Challenge yourself and see how well you understand case types and user roles in the Provider Portal.