2017 Test Prep: Quiz 4

7 Questions | By AHSFLTrainer | Updated: Mar 19, 2022 | Attempts: 194

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Answer the questions below. This will help you meet the new requirement of 86% passing grade. You may utilize available resources (ie. SMMC Tool Kit, Script, etc. )

Questions and Answers

1.

Mother calls on 9/20/2016 and states that her child was born on 09/18/2016. She just reported her birth yesterday. You try and access the case with the Medicaid ID and the gold card, but no case is found in HealthTrack. You should transfer to Express to process an Express enrollment.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False
2.

What is the procedure when a member is listed with "R"?
- A.
  
  Inform the member their Medicaid is going to be restored and should call back within 24-48 hours.
- B.
  
  Inform the member they are eligible for an express enrollment and you will transfer them accordingly.
- C.
  
  Inform the member they may be reinstated back into the plan they had previously, once Medicaid is approved and they are eligible to enroll. Any Questions and concerns on eligibility refer them to the DCF or SSA.
Correct Answer
C. Inform the member they may be reinstated back into the plan they had previously, once Medicaid is approved and they are eligible to enroll. Any Questions and concerns on eligibility refer them to the DCF or SSA.
3.

Recipient calls to process and enrollment. You access the case and see the member has an "A" for MMA and a "A" for LTC. How do you proceed?
- A.
  
  Inform the member that they currently display with application pending for both MMA and LTC and will need to contact the department in which they applied for further assistance.
- B.
  
  Inform the member that they currently display with application pending for both MMA and LTC and will transfer them to express to complete an express enrollment for both MMA and LTC.
- C.
  
  Inform the member that you can process an Application pending enrollment for the LTC and would have to transfer them to express for the MMA enrollment.
Correct Answer
C. Inform the member that you can process an Application pending enrollment for the LTC and would have to transfer them to express for the MMA enrollment.
4.

Recipient states they have already processed an Express enrollment and would only like to know the status of their Medicaid eligibility and why the process is taking so long to get approved for Medicaid. How do you proceed?
- A.
  
  You ask the member to please hold while you transfer them to express.
- B.
  
  You state you will contact Escalation to have them verify.
- C.
  
  Inform caller for any questions and concerns on their Medicaid eligibility they will need to contact DCF or SSA.
Correct Answer
C. Inform caller for any questions and concerns on their Medicaid eligibility they will need to contact DCF or SSA.
5.

Members who are eligible for Express will display an "A" or "N".
- A.
  
  True
- B.
  
  False
Correct Answer
A. True
6.

What does Temporary Loss mean?
- A.
  
  Temporary Loss only refers to MMA because the member will be Reinstated.
- B.
  
  Temporary Loss only refers to LTC because the member can still receive services for 60 days.
- C.
  
  Temporary Loss means Medicaid ended for a period of time. MMA -180 days (6 months) or less and LTC- 60 days or less. There are different processes for each program.
Correct Answer
C. Temporary Loss means Medicaid ended for a period of time. MMA -180 days (6 months) or less and LTC- 60 days or less. There are different processes for each program.
7.

If a member has a temporary loss of 180 days (6 months) or less under ______________,then they may be reinstated into the previous plan if they are approved for full Medicaid and are eligible to enroll.
- A.
  
  MMA
- B.
  
  LTC
- C.
  
  MediKids
Correct Answer
A. MMA

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Current Version
Mar 19, 2022

Quiz Edited by
ProProfs Editorial Team
Oct 20, 2016

Quiz Created by
AHSFLTrainer

2017 Test Prep: Quiz 4

Mother calls on 9/20/2016 and states that her child was born on 09/18/2016. She just reported her birth yesterday. You try and access the case with the Medicaid ID and the gold card, but no case is found in HealthTrack. You should transfer to Express to process an Express enrollment.

What is the procedure when a member is listed with "R"?

Recipient calls to process and enrollment. You access the case and see the member has an "A" for MMA and a "A" for LTC. How do you proceed?

Recipient states they have already processed an Express enrollment and would only like to know the status of their Medicaid eligibility and why the process is taking so long to get approved for Medicaid. How do you proceed?

Members who are eligible for Express will display an "A" or "N".

What does Temporary Loss mean?

If a member has a temporary loss of 180 days (6 months) or less under ______________,then they may be reinstated into the previous plan if they are approved for full Medicaid and are eligible to enroll.