Moonyeen Hontanosas, FNP BC
Georgetown,TX
Summary
Dedicated and talented nurse practitioner with extensive clinical experience. Successful in providing fast and accurate assessments, and working calmly under pressure. Recognized for collaborating well with supervisors and co-workers to maintain top-notch production. Worked as a practicing pediatrician in the Philippines for more than 10 years, went into a 3-year residency for pediatrics, and worked as a family nurse practitioner for 7 years. Has utilization review experience for seven years. Has excellent communication skills, with attention to detail, and critical thinking. A good team worker, hardworking, and has good work ethics.
Overview
13
13
years of professional experience
Work History
Nurse Analyst
Health and Human Services Commission
Austin, TX
04.2023 - Current
- I extensively review appeals from different hospitals in the state of Texas on cases with adverse determinations, as initially reviewed by OIG/HMS.
- I recommend my decisions to the supervisory doctor on whether to overturn, uphold the OIG decision, or recoup the whole DRG payment made to the hospital based on the guidelines and processes of the department.
- I use the ICD-10-CM and ICD-10-PCS tools to formulate the appropriate DRG (using 3M) based on the clinical validation of the entire hospital stay.
- I uphold, when appropriate, the OIG/HMS adverse decision on appeals that do not meet medical necessity, and do not comply with the requirements of an appeal.
- I coordinate with OIG and HMS on selected cases that are questionable.
- I collaborate with two other MDs and an administrative assistant on the trend of incoming cases.
- I assist in preparing to educate providers on the process of appeals.
Utilization Review RN
Ascension Seton (Dells Children Hospital)
Austin, TX
04.2018 - 04.2023
- I reviewed admissions to make sure that the requirements are met for inpatient or observation level of care according to the policies of different private insurances, Managed Care Organizations and Medicare.
Family Nurse Practitioner
Avicenna Medical Center
Leander, TX
08.2015 - 05.2018
- I was a provider for the pediatric population. I saw, examined, treated, and collaborated their care with other medical providers. I was seeing an average of 30 patients a day.
Family Nurse Practitioner
Carousel Pediatrics
Austin, TX
11.2012 - 06.2015
- I examined, treated, and collaborated care for patients mostly with managed care insurances, of an average of 32 patients a day.
Education
Master of Science - Family Nurse Practitioner
The University of Texas Rio Grande Valley
Edinburg, TX05-2012
Bachelor of Science - Nursing
Adventist University of The Philippines
Philippines05-2003
M.D. - Pediatric Residency (3 Years)
Metro Cebu Community Hospital
Philippines06-1989
M.D. - Doctor of Medicine
Cebu Institute of Medicine
Philippines04-1983
Affiliations
- For the past 15 years, I have been an active benefactor and volunteer for a charitable organization that focuses on marginalized and vulnerable population here in the US and in the Philippines.
- Serving different local churches since 2004
- Volunteered as a provider for 4 years - Hope Medical Clinic, Austin
- Past member of Panoramic Voices of Austin
- Enjoys gardening, playing the piano,cooking
- Speaks 3 languages
Timeline
Nurse Analyst
Health and Human Services Commission
04.2023 - Current
Utilization Review RN
Ascension Seton (Dells Children Hospital)
04.2018 - 04.2023
Family Nurse Practitioner
Avicenna Medical Center
08.2015 - 05.2018
Family Nurse Practitioner
Carousel Pediatrics
11.2012 - 06.2015
Master of Science - Family Nurse Practitioner
The University of Texas Rio Grande Valley
Bachelor of Science - Nursing
Adventist University of The Philippines
M.D. - Pediatric Residency (3 Years)
Metro Cebu Community Hospital
M.D. - Doctor of Medicine
Cebu Institute of Medicine
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