Banner Aetna Trivia July 2022
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.
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.
10
9
8
7
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?
8
7
10
9
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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