
Outpatient Prior Authorization Program (Part A)
Other
12th Grade - Professional Development
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10 questions
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1.
MULTIPLE SELECT QUESTION
45 sec • 1 pt
What services require prior authorization with the OPD PA program? Check all that apply.
Blepharoplasty
Botulinum toxin injection
Panniculectomy
Rhinoplasty
Vein ablation
2.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Who is required to submit Prior Authorization request?
Hospital Outpatient department
Physician
Beneficiary
Family member
3.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Hospital outpatient departments need to obtain Prior Authorization and what TOB (Type of Bill) do they submit?
TOB 83X
TOB 33X
TOB 13X
4.
MULTIPLE SELECT QUESTION
45 sec • 1 pt
Botulinum toxin injection documentation submission for the prior authorization request requires. Check all that apply.
Documentation of specific site and frequency
Support of the clinical effectiveness of injection (for continuous treatment)
A history of migraine and experiencing frequent headaches on most days of the month
Support of the clinical effectiveness of the injections
5.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
True or False. Documentation submission for Blepharoplasty requires visual field studies or photos?
True
False
6.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
True or False. Vein Ablation prior authorization request require submission of tests validating the location and level of varicostities.
True
False
7.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
Expedited requests can be submitted for:
Situations that could jeopardize the life or health of the beneficiary
Scheduling convenience
Beneficiaries who ask for expedited
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