Podcast
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?
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?
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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Description
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.
