Part B Knowledge Quiz

Sending a determination (approval, denial and peer to peer)

• via Outlook

• via MCO

• via Fax

• bia ISTA email

Authorization can be requested through?

• Fax

• Phone call

• Portal

• All of the above

Choose a plan type that we do not handle

• Federal

• Medicare Advantage

• Mainstream

• Commercial

Medicaid plan for people with Medicare and Medicaid, or Medicaid only, who need community based long term care services and supports (CBLTSS).

• Managed Long Term Care (MLTC)

• Short Term Care (ST)

• Medicaid HMO

• Straight Medicaid

Authorization that covers room and board

• Part B/Outpatient

• SNF

• Custodial

• Retro

Form submitted by the facility to request an authorization

• Authorization Form

• Evaluation Form

• Payer Source Verification

• Part B Form

Tool that can be used to check the patient’s eligibility

• PCC

• NetHealth

• MCO

• Seek

Primary payer is the payer that we used for Part B authorization

• True

• False

Tool where we can add ancillary authorization

• NetHealth

• Seek

• MCO

Mr. Jon Snow has been approved on PT for 12 visits from 8/1/2024 - 8/30/2024 under Humana.

13 visits were consumed as of 8/18/2024. Patient was discharged on 8/18/2024. What will you do?

• Discharged the patient

• Request for additional 1 visit

• Advised the facility that we cannot request an additional visit because the patient was already discharged.

• Let it be