Texas Hcn Quiz

!!PLEASE READ BEFORE YOU BEGIN!!Use the scroll bar on the right side to scroll through the training document, once you have reviewed the training guide then click 'Next'. If you click 'Next' first it will take you directly into the quiz and you will be unable to review the training guide.

There are two types of networks that relate to Durable Medical Equipment (DME) and Home Health, which are Informal Networks and Voluntary Networks.

• A.

  True

• B.

  False

When you receive a referral with an injury state AND service state of Texas, what do you need to verify?

• A.

  Verify authorization

• B.

  Verify the HCN

• C.

  Verify the patient's address

• D.

  Verify orders

ESIS, Hartford CMS, Sentry, TPCIGA, Travelers, Tristar, and Zurich NA are carriers participating in One Call's Durable Medical Equipment and Home Health Networks.

• A.

  True

• B.

  False

If a carrier participates in One Call's DME and Home Health Network, you will need to verify the HCN for the claim.

• A.

  True

• B.

  False

When you ask the first question "Is the employer a subscriber to the workers' compensation?" and they reply No, you move forward and price your referral following the standard pricing rules.

• A.

  True

• B.

  False

Once you have completed the Health Care Network (HCN) validation process a note should be entered into CSRD. What note type in CSRD should you ALWAYS document the Texas HCN validation under?

• A.

  DME Billing

• B.

  Your Department/Product Line

• C.

  Alert

• D.

  Accounts Receivable

When documenting the Texas HCN validation in CSRD Alert notes, which format(s) shown below are correct?

• A.

  A) HCN =Yes, HCN = Coventry

• B.

  B) Subscriber = Yes, HCN = Yes, HCN = Coventry, per Adjuster John Doe

• C.

  C) HCN = No, HCN = NA

• D.

  D) Subscriber = No, HCN = NA, HCN = NA, per Adjuster John Doe

• E.

  E) Both B and D

• F.

  F) Both A and C

If the carrier is Sedgwick, where should you first try to validate the Texas HCN for you referral?

• A.

  Using the 'Sedgwick TX HCN/CA MPN Master List by Client' located in SharePoint

• B.

  Calling the Adjuster/Case Manager

• C.

  Emailing the Adjuster/Case Manager

• D.

  Calling the Patient