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Humana Refresher! Flashcards | StudBud
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Humana Refresher!
Humana Refresher!
12 terms
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StudBud Administration
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40 plays
Imported from external platform
Flashcards
12 cards
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Practice quiz
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Host live
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Questions
12
Answers
1
What do you use to document the alert in the SOAP notes field?
SOAP NOTE - Plan Sent Specific Alerts
SOAP NOTE - Wellcare COA - Pain Assessment
SOAP NOTE - Patient Intervention Tracking Titles
SOAP NOTE - System Generated Alerts
2
What do you do when clinical alerts come through if you are a technician?
TRANSFER CALL TO RPH & UPDATE SETTINGS TO REVIEW-PHONE CALL ONLY-NEEDS AUTH
IGNORE THE ALERT AND SAVE TO MEDICATION MANAGEMENT CENTER
ATTEMPT TO COMPLETE THE CLINICAL ALERT, OUT OF YOUR SCOPE OF PRACTICE
3
What do you do with the med list?
LEAVE MED REC ALONE AND ONLY ADDRESS ALERT
UPDATE MEDICATION RECONCILIATION
4
How do you save the case if there are NO clinical alerts or questions?
SAVE TO TQ
REVIEW-PHONE CALLONLY - SUCCESSFULLY COMPLETED-MEDICATION MANAGEMENT CENTER
SAVE TO PCB
5
INTERNS: How do you save the case whencompleting a clinical alert or the patient has questions?
SAVE TO TQ
SAVE TO PCB
REVIEW-PHONE CALL ONLY-NEEDS AUTHORIZATION-FL PQ
6
What type of alert is this - Standard star or plan sent?
Standard Star
Plan Sent
7
Where do you find the plan name?
WITHIN THE MED REC
UNDER THE PLAN TAB
UNDER THE CMS TAB
8
What does contact history documentation look like under Contact History - STAR or TMR? Which section should you use?
Completed Medication Reconciliation (Add alerts)
No Medication Reconciliation (Adherence alerts and Plan Sent programs)
Provider Outreach (PO) Quick-Clips
9
Do you run the rules?
YES
NO
10
Do you update the allergies?
NO
YES
11
If you're a tech, how do you save the case if the patient or caregiver has questions or clinical alerts are present?
SAVE TO PQ
REVIEW-PHONE CALL ONLY-NEEDS AUTHORIZATION-TRANSFER
SAVE TO CALL BACK QUEUE
12
Is there claims history?
YES
NO
