Referral Life Cycle Communication Quiz

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| By Catherine Halcomb
Catherine Halcomb
Community Contributor
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  • 1/12 Questions

    You verify carrier rules and UR guidelines per ICON before processing/staffing a referral or sending a manual authorization request to the Adjuster/Case Manager for products/services.

    • True
    • False
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About This Quiz

The Referral Life Cycle Communication Quiz evaluates understanding of effective communication strategies with customers, vendors, and healthcare providers in managing referrals. It focuses on verifying rules, confirming service capabilities, and maintaining regular updates, essential for professionals in client management roles.

Referral Life Cycle Communication Quiz - Quiz

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  • 2. 

    Who do you communicate with to confirm they can provide the requested products/services to the injured worker and provide/confirm with you the Delivery/Start of Care time frame for the products/services?

    • Vendor

    • Attorney

    • Hospital

    • UR Department

    Correct Answer
    A. Vendor
    Explanation
    To confirm the availability of the requested products/services for the injured worker and to establish the Delivery/Start of Care time frame, you would need to communicate with the vendor. Vendors are the ones responsible for providing the products/services and can confirm their availability and coordinate the delivery or start of care. Attorneys may be involved in legal matters, hospitals primarily focus on medical treatment, and the UR (Utilization Review) department typically reviews and authorizes medical services, but the vendor is the most appropriate contact for confirming the provision and timing of the requested products/services.

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  • 3. 

     If product or service is not available, who do you internally escalate this to?

    • HR

    • Helpdesk

    • The person that sits next to you

    • Your Manager

    Correct Answer
    A. Your Manager
    Explanation
    When a product or service is not available, it is best to escalate the issue to your manager internally. Your manager is responsible for overseeing your work and can provide guidance on how to handle the situation. They may have the authority to make decisions or escalate the issue further to higher levels of management. By involving your manager, you ensure that the problem is addressed and resolved in a timely and appropriate manner.

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  • 4. 

    What do you contact the Physician and/or Discharge Planner for?

    • Confirm orders

    • Obtain prescriptions when necessary

    • Confirm delivery specifics if items are for discharge

    • All of the Above

    Correct Answer
    A. All of the Above
    Explanation
    You contact the Physician and/or Discharge Planner for all of the above reasons. This includes confirming orders, obtaining prescriptions when necessary, and confirming delivery specifics if items are for discharge.

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  • 5. 

    Who do you contact immediately if you come across any barriers/issues during the referral life cycle,?

    • Adjuster/Case Manager

    • Attorney

    • Doctor's Office

    • Caregiver

    Correct Answer
    A. Adjuster/Case Manager
    Explanation
    If you come across any barriers or issues during the referral life cycle, you should contact the Adjuster/Case Manager immediately. This is because the Adjuster/Case Manager is responsible for managing and overseeing the referral process, including addressing any obstacles or problems that may arise. They have the knowledge and authority to resolve issues and ensure a smooth referral process.

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  • 6. 

    What is the purpose of communication to our customers throughout the life cycle of the referral?

    • Answers questions before they're asked

    • Provides a Better Customer Experience

    • Dissolves complaints before they happen

    • All of the Above

    Correct Answer
    A. All of the Above
    Explanation
    All of the above options are correct because communication plays a crucial role in the life cycle of a referral. By answering questions before they're asked, it ensures that customers have all the necessary information and reduces any confusion or doubts they may have. Providing a better customer experience is achieved by maintaining regular communication, keeping customers informed, and addressing their concerns promptly. Additionally, proactive communication can help dissolve complaints before they even arise, as it allows for open dialogue and quick resolution of any issues.

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  • 7. 

    Who do you contact to verify delivery demographics required to process a request?

    • Adjuster

    • Injured Worker

    • Vendor

    • Case Manager

    Correct Answer
    A. Injured Worker
    Explanation
    To verify delivery demographics required to process a request, you would contact the Injured Worker. The injured worker is the person who has been injured and is receiving medical treatment or compensation as a result. They would have the necessary information regarding their location and other details needed for processing the request.

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  • 8. 

    Within how many days prior to the Delivery Date or Start of Care (SOC) would you contact the injured worker and our vendor?

    • 3 day business days

    • 4 business days

    • 2 business days

    • 1 business day

    Correct Answer
    A. 1 business day
    Explanation
    The correct answer is 1 business day because it is important to contact the injured worker and the vendor as soon as possible to ensure a smooth delivery or start of care. Waiting any longer than 1 business day may result in delays or complications in the process.

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  • 9. 

    How often do you follow-up on Vendor and Product load requests?

    • Bi-weekly

    • Every 24 hours or 1 business day

    • Every 2 business days

    • Weekly

    Correct Answer
    A. Every 24 hours or 1 business day
    Explanation
    The correct answer is "Every 24 hours or 1 business day." This means that the follow-up on Vendor and Product load requests is done either on a daily basis or within one business day. This ensures that there is regular communication and progress tracking for these requests, allowing for timely updates and resolution of any issues that may arise.

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  • 10. 

    For Home Health ongoing communication, how often do you make calls to the injured worker for stable long term care files?

    • Weekly

    • Monthly

    • Every 30 Days

    • All of the Above

    Correct Answer
    A. Every 30 Days
    Explanation
    In home health ongoing communication, calls are made to the injured worker for stable long-term care files every 30 days. This frequency ensures regular check-ins and updates on the injured worker's progress and care. It allows for monitoring their condition and making any necessary adjustments to the care plan. Making calls on a monthly basis strikes a balance between staying connected with the injured worker and giving them enough time to adjust and stabilize in their care routine.

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  • 11. 

    For Complex Services when contact is made to the Adjuster/Case manager for authorization or any barriers/issues, who do you always carbon copy?

    • Your Manager

    • Sales Representative

    • Sales Representative and your Manager

    Correct Answer
    A. Sales Representative
    Explanation
    When dealing with complex services and contacting the Adjuster/Case manager for authorization or to address any barriers or issues, it is important to always carbon copy the Sales Representative. This is because the Sales Representative is responsible for managing the sales process and maintaining a good relationship with the client. By carbon copying the Sales Representative, they can stay informed about any communication or challenges that may arise with the Adjuster/Case manager and provide necessary support or follow-up actions if needed. Carbon copying the Manager may not be necessary in this scenario as the Sales Representative is the primary point of contact for the client.

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  • 12. 

    For all vendor directed referrals, how often will you communicate with the vendor until an ETA or purchase order is issued?

    • Every 30 days

    • Every 24 hours or 1 business day

    • Weekly

    • Every 2 business days

    Correct Answer
    A. Every 2 business days
    Explanation
    The correct answer is "Every 2 business days". This means that for all vendor directed referrals, the communication with the vendor will occur every two business days until an ETA or purchase order is issued. This ensures regular and timely updates between the company and the vendor, allowing for efficient coordination and progress tracking.

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Quiz Review Timeline (Updated): Jul 20, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Jul 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Apr 23, 2015
    Quiz Created by
    Catherine Halcomb
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