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Questions and Answers
Which user role can create only PCCA cases in the Provider Portal?
Which user role can create only PCCA cases in the Provider Portal?
- Ordering user (correct)
- Hp-rep user
- Servicing user
- RS user
What does PCCA stand for?
What does PCCA stand for?
- Post Clinical Care Appropriateness
- Post Clinical Claim Appropriateness
- Post Care Clinical Appropriateness
- Post Claim Clinical Appropriateness (correct)
To create a prospective case, the date of service cannot be greater than what duration?
To create a prospective case, the date of service cannot be greater than what duration?
- 60 days
- 30 days
- 120 days
- 90 days (correct)
Which role has the privilege to deny a case if it is not met at the initial intake?
Which role has the privilege to deny a case if it is not met at the initial intake?
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In the 'facility' tab, users can view a list of previously selected providers. What is this screen identified as?
In the 'facility' tab, users can view a list of previously selected providers. What is this screen identified as?
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Study Notes
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.
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