Medical Management Crossword

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Across
  1. 2. Houses documents such as job aids, workflows, and BQG's
  2. 4. Decision made regarding the status of the authorization
  3. 5. Interpreter services
  4. 8. Used to determine Care Coordination/Case Management needs
  5. 9. Conduct home visits and community events
  6. 12. Type of review that is sent to the Medical Director
  7. 14. Authorization process that does not require clinical review
  8. 15. IM software used at Centene
  9. 16. Provides UM and CM services for mental health, PT and OT
  10. 17. Can be manual or system generated
  11. 18. Software that is used to determine medical necessity
  12. 19. Authorization _________ must always be open and used when building and processing authorizations
  13. 20. Centene's Intranet site
Down
  1. 1. Staff member that is the initial contact in the authorization process
  2. 3. Centene's Learning Platform
  3. 6. After hours advice/triage service
  4. 7. Clinical Data System
  5. 10. Meets criteria to receive healthcare
  6. 11. Can be free text, structured or hybrid
  7. 13. Type of clinical review that is done when a member is in the hospital