PACS QUESTION BANK 2024/2025 COMPLETE QUESTIONS WITH VERIFIED ANSWERS GUARANTEED PASS | RATED A+

PACS QUESTION BANK 2024/2025 COMPLETE QUESTIONS WITH VERIFIED ANSWERS GUARANTEED PASS | RATED A+ _______ processes are layers of testing that must be done before others. - Answer>>> step What is documented in the patient medical records? - Answer>>> • Laboratory and other studies are ordered as appropriate • Working diagnoses that are consistent with findings • Treatment plans that are consistent with diagnosis True or False: Biologics can be tiered to a lower tier that also contains other biologic products. - Answer>>> True What staff members are not involved in processing a medication prior authorization request at an insurance company? Medical review officer, Pharmacist, Pharmacy technician, Veterinarian? - Answer>>> Veterinarian Information needed to verify insurance eligibility: - Answer>>> NPI number and insurance policy identification number Medical records may contain copies of: - Answer>>> flouroscopy and MRI Authorizations are required: - Answer>>> • to save money • to determine proper utilization of medical services • to protect the patient Medicaid is: - Answer>>> A coordination of health insurance benefits between the federal government and state government Most gap waivers cover the plan in network provisions of what is called the ______charges. - Answer>>> customary Locations in which patients might receive outpatient infusion: - Answer>>> • physician or provider's office • hospitals • infusion centers • home infusions Evaluation & Management (E&M) coding - Answer>>> is defined as a process where a physician-patient encounter or appointment is translated into CPT codes for billing purposes Formulary exceptions are: - Answer>>> requests that are for medications on the plan formulary but do not meet specific criteria When writing an appeal letter, you should include: - Answer>>> • Your identification • The reason for the denial that they explained in the denial letter • The correct information ICD-10 codes - Answer>>> Provide an alpha numeric reference for the diagnosis If a gap waiver is approved, ___________________________ - Answer>>> Inform the patient, physician and scheduler A calendar year policy is from January 1 to December 31 - Answer>>> True What is expected to happen as life expectancy trends upwards? - Answer>>> • higher medication cost • higher medication use A PA request can take more than 3 days in order to hear an initial response. - Answer>>> True Pharmacist, nurse, and medical assistants: - Answer>>> Are some of the healthcare personnels who play the most important role in the PA process A fast track for authorization is called _______. - Answer>>> urgent Medigap coverage: - Answer>>> • medigap can be bought for any age person who is enrolled in traditional medicare