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Banner Aetna Trivia July 2022

An infographic that illustrates healthcare protocols and member support processes, featuring elements like hospital admission, PCP notifications, and medication management in a visually appealing style.

Aetna Knowledge Challenge

Test your understanding of key Aetna practices and protocols with our engaging quiz! This trivia is designed to help you recall vital information that can enhance patient care and improve your knowledge of essential processes.

Evaluate your comprehension of hospital admission procedures.
Learn about member referral criteria and support resources.
Challenge yourself with specific protocol knowledge.

15 Questions4 MinutesCreated by CaringNurse57

True or False: You have to notify the PCP when your member is admitted to the hospital and when the member is discharged?

True

False

To refer to Banner Total Care, your member must score ___ or above on the PHQ9 done by the social worker.

This is the maximum allowed to be given to a member for support with NWOB

499.00

399.00

599.00

300.00

This resource provides support to members who have type 2 diabetes to help them get off of their medications.

Hello Heart

Virta

Hinge Health

NWOB

This is the amount of time that a nurse has to complete TOC after a member is discharged from the hospital

3 business days

2 business days

1 business day

5 business days

Which diseases require an automatic referral to the Pharm D? (select all that apply)

CHF

Depression

Cancer

CKD

What is the process when a member goes inpatient to the hospital? (check all that apply)

Notify PCP

Call member/rep

Notify leadership via email template

Outreach inpatient team

Assess patient medications

Which pool do you send a referral to for pharmacy after a member is discharged home?

Population Health Pharmacist Pool

AZ AMB Pharmacy- Clinical

True or false: a FE assessment must be done on every member who is over 65?

True

False

As part of a NCQA requirement, we are to ask about grooming for ADLs?

True

False

How will the pharmacist notify you they have completed a medication reconciliation?

It will be in their notes

You will get a msg for review in the message center

You will get an email

You will get an IM

True or false: It is a requirement under TOC to review the plan of care every time a member is admitted to the hospital

True

False

We can close the A1C care gap if the A1C is below what percent?

How can we close the BMI Care Gap?

Look in hospital documents

Request records from PCP office

Ask the member their BMI

Ask the member their height/weight

What is it called when a member needs an out of network provider prior authorization?

Physician exception

Out of Network Approval

Gap Exception

None- just request Prior Auth

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