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Across
  1. 4. What Reference or Procedure column heading would you look under to see if MCG and/or InterQual is used?
  2. 6. For Washington Medicaid, if you receive a request for outpatient Dialysis, no prior authorization is required for what type of provider?
  3. 7. For Maryland Medicaid, if Intake receives a request for 1 to 1 Sitter- Skilled Nursing Facilities, where would Intake refer the requestor?
  4. 9. For Arizona Medicare, you receive a request for a orthotic brace costing $1500. Where would this case be tasked to?
  5. 11. For New York Medicare, if a caller is requesting a Peer-to-Peer, whose phone number would the CAC refer them to?
  6. 12. For Rhode Island, for a TOC, the member has up to how many months to change to INN provider?
  7. 14. For Arizona Medicare, what link would you use to search for In-Network Providers?
  8. 15. Information/Under the Reference or Procedure column heading, where would you go to give a member the number to Member Services?
  9. 17. For Nebraska Medicaid, Wound Vacs can be authorized for how many months at a time?
  10. 18. For TN Medicare, if no INN Provider is found and Service Request does not require Clinical Review, Administratively Approve request up to how many days?
Down
  1. 1. For Maryland Medicaid, if a request is for a cardiology service, what CPT code list will the PA nurse refer to?
  2. 2. For Michigan Medicare, if a Standard request is Approved, what type of Notice is not required?
  3. 3. For Texas STAR, what grade level should letters be when sent to the member?
  4. 5. For New Jersey Medicaid, what will the CAC request if member is asking for medical supplies that cost more than $1000?
  5. 8. Director For Ohio Medicaid, the PA nurse gets a request for surgery for cosmetic reasons. Who would they task the case to?
  6. 10. For Wisconsin Medicaid, if a DME rental is greater than $500, what code list will you refer to determine if the code is listed?
  7. 13. For FL Medicaid, for hearing aid requests, PA nurse can approve up to how much?
  8. 16. For New Jersey Medicaid, if a parent is requesting a private duty nurse for their 15 year old, what work queue would the CAC task the case to?