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Yakap Upskilling

Total questions: 25

Worksheet time: 11mins

Name
Class
Date
1.

The following are the components of YAKAP program, EXCEPT:

a)

PhilHealth GAMOT or Outpatient Medicines

b)

In-Patient Hospitalization

c)

Outpatient Laboratory and Diagnostics

d)

YAKAP Clinic Services

2.

If a PhilHealth YAKAP beneficiary receives a positive result from a cancer screening, to which specialized PhilHealth benefit package are they typically referred for comprehensive disease management?

a)

Outpatient Emergency Care

b)

All Case Rates

c)

Cancer Screening Tests Benefit Packages

d)

Z- Benefit Packages

3.

The following are primary roles and responsibilities of a PhilHealth YAKAP-Accredited Clinic, Except:

a)

A. Prescribe screening for cancers as indicated.

b)

B. Provides health promotion and education to patients.

c)

C. Prescribes appropriate laboratory or diagnostic examinations

d)

D. Providing the full annual Z-Benefit package of financial coverage for catastrophic illnesses like cancer and kidney failure.

4.

Who is eligible to register and avail the PhilHealth YAKAP benefits?

a)

Only employees from government and private sectors

b)

Indigent Members and Pantawid Pamilyang Pilipino Program (4PS) beneficiaries

c)

All Filipinos (under UHC Act) and their dependents

d)

Only members aged 60 and above

5.

How does PhilHealth financially reimburse an accredited YAKAP Clinic for its service?

a)

By paying for each test screening done

b)

By providing a fixed annual payment per registered number (capitation)

c)

By reimbursing only the cost of medicines and supplies used during a visit

d)

By paying only after the patient is referred to a Z-Benefit hospital.

6.

What is the annual benefit limit (ABL) per beneficiary for PhilHealth GAMOT?

a)

Php 10,000.00

b)

Php 15,000.00

c)

Php 20,000.00

d)

There is no limit

7.

What is the GAMOT Availment Slip (GAS)?

a)

A form used by physician to apply for access to the GAMOT App

b)

The application form for a pharmacy to become a GAMOT Facility

c)

A form generated for each transaction showing dispensed drugs and the remaining benefit coverage

d)

A monthly report submitted by the GAMOT Facility to PhilHealth

8.

When a PRO AQAS GAMOT Focal validates a Pharmacist’s account, what key detail must they verify?

a)

The validity of the Pharmacist’s PRC license

b)

The signature on the Application Account Authorization Form (3AF)

c)

The Pharmacist’s affiliation with a YAKAP Facility

d)

The Pharmacist’s PhilHealth Employee ID

9.

In addition to being a licensed and PhilHealth-accredited physician, what other key affiliation is required to become an “Authorized Physician” in the GAMOT App?

a)

They must be a member of the Philippine Medical Association

b)

They must be affiliated with a YAKAP facility

c)

They must be the head of a GAMOT-accredited facility

d)

They must have a registered account in the OS ticket system

10.

Effective care coordination excludes direct communication with hospitals and specialists.

a)

True

b)

False

11.

Patient navigation instructions for emergencies and special cases are outside the scope of care coordination in the YAKAP clinic.

a)

True

b)

False

12.

Is the inclusion of drugs in the prescription that are not in the current GAMOT list reimbursable?

a)

True

b)

False

13.

YAKAP doctors should self-prescribed.

a)

True

b)

False

14.

YAKAP doctors shall provide prescriptions before a medical consultation.

a)

True

b)

False

15.

Facilities that signify intent to provide the selected screening test for cancer may charge co-payment for patients that are not NBB eligible.

a)

True

b)

False

16.

DOH LTO is a mandatory requirement for accreditation of YAKAP clinic.

a)

True

b)

False

17.

Continuity of care includes mechanisms for tracking patients lost to follow-up.

a)

True

b)

False

18.

One of the specific objectives of the Health Care Provider Performance Assessment System (HCPPAS) is to __________ reporting, recording, and analysis of HCP performance monitoring results.

a)

STANDARDIZE

b)

IGNORE

c)

COMPLICATE

d)

LIMIT

19.

Findings with quality of care concerns that are not refuted by the concerned HCP are issued with __________.

a)

NOTICE OF CORRECTIVE ACTION (NCA)

b)

NOTICE OF SUSPENSION (NOS)

c)

NOTICE OF TERMINATION (NOT)

d)

NOTICE OF WARNING (NOW)

20.

The Health Care Provider Performance Assessment System (HCPPAS) feedback mechanism allows the concerned health care provider to submit a justification __________.

a)

WITHIN 10 WORKING DAYS

b)

WITHIN 5 WORKING DAYS

c)

WITHIN 15 WORKING DAYS

d)

WITHIN 20 WORKING DAYS

21.

4. Findings with __________ are endorsed to the regional legal office for appropriate legal process.

a)

LEGAL ISSUES

b)

ADMINISTRATIVE MATTERS

c)

FINANCIAL REPORTS

d)

TECHNICAL ERRORS

22.

5. __________ is the analysis of claims data through utilization review.

a)

CLAIMS REVIEW AND PROFILING

b)

MEDICAL CODING

c)

PATIENT SCHEDULING

d)

BILLING INQUIRY

23.

6. To avoid delays during PCU verification, your personal details must exactly match your __________ record.

a)

PHILSYS

b)

SSS

c)

TIN

d)

VOTER'S

24.

One of the main objectives of the Health Care Provider Performance Assessment System (HCPPAS) is to ensure __________ delivery to our members.

a)

QUALITY OF CARE

b)

TIMELY PAYMENTS

c)

INCREASED PAPERWORK

d)

REDUCED STAFF

25.

8. __________ is the document submitted by an accredited health facility to offer the selected screening tests for cancer.

a)

LETTER OF UNDERTAKING (LOU)

b)

SCREENING REQUEST FORM

c)

PATIENT CONSENT FORM

d)

HEALTH FACILITY ACCREDITATION FORM