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WorksheetsMCG Review 1
Total questions: 11
Worksheet time: 6mins
This review is completed either before the member enters the hospital or while the member is in the ER.
Extended Stay
Retroactive Reviews
Pre-Admission/Admission
A procedure chosen by the physician or member that is beneficial but not urgent.
Emergent
Urgent
Elective
This review takes place while the "head is in the bed".
Retrospective
Concurrent
Pre-Service
Immediate, unscheduled, and potentially life-saving health service are required.
Emergent
Urgent
Elective
Which policy/guideline hierarchy comes first?
Member Benefits
Medical Policies
MCG
Clinical Guidelines
Provides evidence-based criteria, goals, care pathways, and other decision-support tools
ISC
GRG
ORG
CG
Which MCG includes Goal Length of Stay?
GRG
GRG
ORG
CG
What does MPTAC stands for?
Medical Program and Technology Assessment
Medical Policy and Technology Assessment
Medical Pre-Service and Technology Assessment
Medical Post-Service and Technology Assessment
Which MCG will you use when no ISC is applicable?
GRC
ISG
WGS
ISC
The BLOS is associated with which type of guidelines?
GRC
ISC
Anthem Customized Guideline
The Optimal Recovery Guidelines are the same as GRG
TRUE
FALSE
