Provider Tab | Prior authorizations | Drug Assistance Programs | Assessment/ Plan | Miscellaneous knowledge |
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Cornea
If the doctor states the patient has guttata, which section would this go in the provider section?
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Send a email to the PA group and scribe group, then call Jessica
How do you obtain a same day PA?
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Eylea 4 U Copay card
If a pt has BCBS HMO without a secondary and gets Eylea, what patient assistance program would they be enrolled in?
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No. H43.12 can not be used for injection. Would need to use another code (if diabetic, use that code)
If a patient had diagnosis code of H43.12 (vitreous hemorrhage), and needed an injection, would H43.12 be used for PA?
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A least once a year
How often do notes need to be sent to a PCP for diabetic patients?
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White Without Pressure
What does the abbreviation WSP stand for?
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True. PA is required for Medicare advantage plans but not straight Medicare.
True or False: PA is required for patients on Medicare Advantage.
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No, enroll in CDF
If a patient has Humana Gold, does the pt need to be enrolled in Eylea 4 U?
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Yes, this shows they are controlling BP
If a patient has a systemic history of hypertension, but BP is normal on visit, would you still use I10 in assessment plan?
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True. This is something we can get audited on.
True or False: drug waste for injections must be documented on the chart note
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Neovascularization of the Disc. listed under Disc
What does NVD stand for and which section would it be listed under?
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Same day PA
When obtaining a PA for an injection in 2 weeks or less, what is the name of the spreadsheet you add the details to?
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False.
True or False: If a patient has medicare with a secondary, the patient needs to be enrolled in CDF.
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No, It would need to be changes to proliferative diabetic retinopathy (E11.3591)
If a patient has a previous diagnosis if E11.3491 (nonproliferative diabetic retinopathy without edema) and the doctor states the patient has NVE with vitreous hemorrhaging, would the diagnosis code stay the same?
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vitreous clear post vitrectomy
If a patient has a vitectomy and the gas bubble has resolved, what should be listed in the vitreous section?
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Once the chart note is generated. Do no delete from the provider tab
If only 1 eye is dilated and the doctor does not look in the other eye, where does the info from the provider tab need to be deleted?
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ext. 234
What extension can Jessica be reached at?
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make a copy of the consent and place in MG's box
If a pt specific drug is used, how is Marsha notified?
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False.
True or false: When an order set is ordered and generates on the chart note, leave it so that we know it was done.
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Assessment/ Plan
What tab is the History and Physical document generated from?
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Subretinal hyper-reflective material
What does the abbreviation SRHM stand for?
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write on the bottom of the super bill diagnosis and PCT code.
If a patient is coming back for a laser in 1-2 weeks, do you write on the bottom of the superbill, email the PA group, and/ or add to the same day PA spreadsheet?
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2020 updated/ Patient Assistance Programs/ Copay assistance
What is the name of the spreadsheet where you can check to see if a patient is enrolled into a patient assistance program?
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True.
True or False: If a patient is switching from Avastin to Eylea, a reason is needed for why we are switching medications in the plan.
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When we are asking a patient to follow up with another doctor, when we are referring to a doctor, fax to PCP for diabetic patients, when the patient or doctor specifically request notes to be faxed.
What are the 4 instances that we should we fax to another doctor?
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