WorksheetsPart B Knowledge Quiz
Total questions: 15
Worksheet time: 11mins
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
Pending authorization should be follow up every
48-72 hrs
7 days
Every 15th and 30th of the month
Never
Fax can be submitted through email (outlook)
False
True
Therapy services are covered in Episodic authorization
True
False
Therapy services rendered can be found in
MCO
PCC
Insurance Portal
NetHealth
Patient’s primary payer is Medicaid-WV (active) and secondary is Aetna-MCR (termed).
What payer will you use to request an authorization?
Aetna-MCR
Medicaid-WV
Invalid
I don’t know
