Name: COHE Provider Annual Training Quiz 2014-2015 Please answer the following questions in relation to the PowerPoint presentation you just reviewed. To ensure that you receive credit for the 2014-2015 Annual Provider Training, please print this document, answer the following questions, sign and fax to the Renton COHE at (425) 656-5593 or scan the completed, signed document and email it to cohe _ [email protected].

1) Which is NOT a goal or mission of a COHE?

 Promote Patient Dissatisfaction  Enhance Clinical Efficiency  Improve Employment Outcomes  Reduced Worker Disability

2) Which of the following is NOT an Occupational Health Best Practices?

 Provider contact with HSC.  Identification of Barriers to Return to Work.  Two-way communication between AP & employer.  A complete ROA that is submitted to L&I within 2 business days.  An APF completed on the first office visit and when restrictions change.

3) What qualifies as a COHE claim?

 There are no time limits on COHE claims.  A claim that is filed by any L&I Medical Network Provider.  A claim that is within the first 90 to 180 days of treatment with a COHE provider.  None of the above.

4) Check all that pertain to an occupational disease claim.

 APP review of work history is needed to help determine causality.  Occurs after a specific incident at work.  Worker complete Occupational Disease Work History forms.  Worker has two years from date of onset to file claim.

5) True or False: Pain ICD codes are appropriate to use when completing a ROA.

 True  False COHE Provider Annual Training Quiz 2014-2015 Page 2

6) When completing a Report of Accident, what sections need to be completed?

 Causality – Yes, No, Probably, Possibly  Objective Findings  Referred to another healthcare provider  Diagnoses  Estimated missed work days  Provider signature & date  None of the above  All of the above

7) What are appropriate objective findings to use when completing a ROA and/or APF? Check all that apply.

 Decreased ROM  Swelling  Tenderness  Pain with palpation  Findings on x-ray, MRI or other diagnostic tests

8) True or False: On the APF, if a worker is released to light/modified duty or taken off of work, the objective findings box must be completed.

 True  False

9) When in your clinical opinion a worker is capable of light duty but they tell you the employer does not have light duty, do you take the worker off of work?

 Yes  No

10) True or False: When completing an APF, only check restrictions that apply to the conditions related to the injury diagnoses.

 True  False

11) Which does NOT qualify for a Barriers to Return to Work Assessment?

 A standard exam and SOAPER note.  A medical case conference.  An extensive exam and SOAP-ER note completed by a COHE Advisor.  An extensive exam and SOAPER note by AP. COHE Provider Annual Training Quiz 2014-2015 Page 3

12) True or False: An HSC completion of an Initial Evaluation & Coordination is one way an AP can meet Best Practice #3 – Two Way Communication Between AP & Employer.

 True  False

Provider Signature Printed Name Date

Email Address