Provider Tab Prior authorizations Drug Assistance Programs Assessment/ Plan Miscellaneous knowledge
100
Cornea
If the doctor states the patient has guttata, which section would this go in the provider section?
100
Send a email to the PA group and scribe group, then call Jessica
How do you obtain a same day PA?
100
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?
100
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?
100
A least once a year
How often do notes need to be sent to a PCP for diabetic patients?
200
White Without Pressure
What does the abbreviation WSP stand for?
200
True. PA is required for Medicare advantage plans but not straight Medicare.
True or False: PA is required for patients on Medicare Advantage.
200
No, enroll in CDF
If a patient has Humana Gold, does the pt need to be enrolled in Eylea 4 U?
200
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?
200
True. This is something we can get audited on.
True or False: drug waste for injections must be documented on the chart note
300
Neovascularization of the Disc. listed under Disc
What does NVD stand for and which section would it be listed under?
300
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?
300
False.
True or False: If a patient has medicare with a secondary, the patient needs to be enrolled in CDF.
300
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?
300
vitreous clear post vitrectomy
If a patient has a vitectomy and the gas bubble has resolved, what should be listed in the vitreous section?
400
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?
400
ext. 234
What extension can Jessica be reached at?
400
make a copy of the consent and place in MG's box
If a pt specific drug is used, how is Marsha notified?
400
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.
400
Assessment/ Plan
What tab is the History and Physical document generated from?
500
Subretinal hyper-reflective material
What does the abbreviation SRHM stand for?
500
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?
500
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?
500
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.
500
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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