2018 Smmc Dental Quiz

15 Questions | Total Attempts: 254

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2018 Smmc Dental Quiz - Quiz

This quiz is to test your knowledge of the SMMC & Dental Implementation Training.


Questions and Answers
  • 1. 
    The recipient is Mandatory for both MMA and LTC. Which SMMC plan types will be available to them?
    • A. 

      MMA Plans, the LTC+ Plan, Comprehensive Plans and Dental Plans

    • B. 

      The LTC+ Plan, Comprehensive Plans and Dental Plans

    • C. 

      Only Comprehensive Plans and Dental Plans

    • D. 

      All SMMC and Dental plans will be available to the recipient

  • 2. 
    The recipient is Excluded for MMA and Mandatory for LTC. Which SMMC plan types will be available to them?
    • A. 

      The LTC+ Plan, Comprehensive Plans and Dental Plans

    • B. 

      MMA Plans, the LTC+ Plan, Comprehensive Plans and Dental Plans

    • C. 

      Only the LTC+ Plan and Dental Plans

    • D. 

      All SMMC and Dental plans will be available to the recipient

  • 3. 
    A recipient needs more information about what kind of dental surgery DentaQuest will cover. What can you inform them?
    • A. 

      Inform the recipient, “If you need more information about what DentaQuest will cover, contact your dentist. They will inform you what is and is not covered through your plan.”

    • B. 

      Advise the recipient, “If you need more information about what DentaQuest will cover, contact your health plan. They are responsible for coordinating care for your dental services.”

    • C. 

      Tell the recipient, “If you need more information about what DentaQuest will cover, contact AHCA. They will inform you which services will be covered and will provide a list of providers for dental.”

    • D. 

      Tell the recipient, “If you need more information about what DentaQuest will cover, contact DentaQuest directly. They will provide more information regarding services and expanded benefits.”

  • 4. 
    Miranda Lee asks, “If my plan is still available after everything changes, will I still need to change?” What can you advise Miranda?  
    • A. 

      “Even if your plan is available, all recipients will be required to change the plan, or a new plan will be auto-assigned.”

    • B. 

      “If your plan is still available, you will not be required to change but you will have the opportunity to change.”

    • C. 

      “None of the old plans will be available so all recipients will have the opportunity to change.”

    • D. 

      “Since you will have the opportunity to change, you should choose one of the new plans in your area. You will receive more coverage through the new plans.”

  • 5. 
    A recipient states, “I don’t want to enroll into a dental plan! My dental provider only accepts Straight Medicaid and I have a dental surgery scheduled for next month.” What can you inform the recipient?
    • A. 

      "All recipients through Fee-For-Service and enrollees through SMMC will be required to be enrolled in a dental plan. Dental plans will provide Continuity of Care for up to 60 days for any prescheduled services through prior coverages.”

    • B. 

      "Since all recipients are required to enroll into the new plans, all dentists will be required to take at least one of the plans in your area. You can call them to check which one they will take.”

    • C. 

      "You can file a complaint about having to enroll into a dental plan through AHCA. They will contact your dentist and make them cover you anyways.”

    • D. 

      "If you do not want to be enrolled, then you must not need Medicaid anymore. Contact DCF/SSA to disenroll from Florida Medicaid.”

  • 6. 
    Gerald Jones states, “I received a letter for myself and my children. My name only has the dental plan information, but my kids have an MMA plan and a dental plan. Where is my MMA plan information?” What can you tell Gerald?
    • A. 

      "Recipients are only enrolled in dental plans if they have MMA eligibility. If you do not see information for your MMA plan this means you will not be auto-assigned and will be able to choose any available MMA plan.”

    • B. 

      "If you only have dental plan information this means you are not eligible for any Medicaid services. Contact DCF/SSA to apply for Medicaid.”

    • C. 

      "Dental plans are required for most recipients with Fee-For-Service and SMMC eligibility. MMA, LTC and Dental sections are on all letters and will be blank if you do not have the eligibility to enroll in those programs.”

    • D. 

      "MMA, LTC and Dental will be available to all recipients with Fee-For-Service and SMMC eligibility. If the information is not listed, it will be sent in a separate letter that will come at a later date.”

  • 7. 
    An enrollee is upset and states, “I didn’t get the letter telling me everything was changing and now you’ve changed my plan and put me in this random dental plan! I don’t even know if I can see my doctor anymore, what am I supposed to do?” What can you advise this enrollee?
    • A. 

      "All plans will cover the same services and doctors are required to take all of the available plans, so you should be fine.”

    • B. 

      "You will have 120 days to change the health and Dental plan for any reason. You can contact your providers to see which plans they accept.”

    • C. 

      "You will have a 60-day Open Enrollment where you will be able to change. Contact your current plans for assistance until your plan can be changed.”

    • D. 

      "Since you have missed the time to let us know which plan you want to change to, you are locked in and need a state-approved good cause reason to change.”

  • 8. 
    Emelia Shaw states, “My doctor advised me that the plans will be changing, but you just told me that they aren’t available for my area yet. How will I know when the new plans are available to me?” What can you inform Emelia?
    • A. 

      "Once the new plans become available in your area, you will receive a call from the Statewide Medicaid Managed care helpline to inform you the plans are available.”

    • B. 

      "Once the new plans become available in your area, you're just going to be auto-assigned and you won't be able to change the plan.”

    • C. 

      "Once the new plans become available in your area, you will receive a letter informing you that you can change your plan and to enroll into a dental plan.”

    • D. 

      "Once the new plans become available in your area, you will receive a call from AHCA to inform you the plans are available.”

  • 9. 
    Marcus Roberts calls in and states, “I got this letter telling me I will need to enroll into a dental plan, but the information I received from my MMA plan also says something about dental coverage. Will more dental services be covered by my dental plan? Which plan covers more?” How can you assist Marcus?
    • A. 

      Advise Marcus to contact the MMA plan because they will cover the more expensive services

    • B. 

      Advise Marcus to contact AHCA to see which plan will provide more services

    • C. 

      Advise Marcus both the MMA plan and the Dental plan will provide the same services

    • D. 

      Advise Marcus to contact the MMA plan and the Dental plan to see which services each plan will cover

  • 10. 
    Which enrollment selection will allow you to process a dental enrollment?
    • A. 

      Both MMA Enrollment and SMMC Enrollment

    • B. 

      MMA Enrollment Only

    • C. 

      SMMC Enrollment Only

    • D. 

      MMA, LTC and SMMC Enrollment

  • 11. 
    What types of plans are available for this enrollee if they have an active HIV special condition?
    • A. 

      MMA Plans, Comprehensive Plans and Dental Plans

    • B. 

      MMA Plans and Dental Plans only

    • C. 

      MMA Plans and Specialty Plans only

    • D. 

      MMA Plans, Comprehensive, Specialty Plans and Dental Plans

  • 12. 
    What plan types will this recipient be able to enroll into?
    • A. 

      MMA-only plans, the LTC+ Plan, Comprehensive Plans and Dental Plans

    • B. 

      Only the LTC+ Plan and Dental Plans

    • C. 

      The LTC+ Plan, Comprehensive Plans and Dental Plans

    • D. 

      All SMMC and Dental plans will be available to the recipient

  • 13. 
    If the dentist does not populate in HealthTrack, how should the agent proceed?
    • A. 

      Inform the caller that their dentist does not participate with the SMMC plans and a new dentist will be auto-assigned by the plan

    • B. 

      Advise the caller to contact the plan after it becomes effective to add the dentist to the enrollment

    • C. 

      Tell the caller that they will need to choose a new dentist and ask for their preferences to search for a different dentist in HealthTrack

    • D. 

      Refer the caller to the AHCA Medicaid Helpline to get a list of dental providers

  • 14. 
    An enrollee from Region 5 calls on October 20th and wants to make a plan change for now, and also wants to choose the plan through the new program. How should you proceed in HealthTrack?
    • A. 

      Create a task for the current plan change, then choose the new plan by using the new enrollment wizard

    • B. 

      Place both enrollment requests in the discrepancy log to be completed by the Resource Desk team

    • C. 

      Process the current plan change in the old wizard, then create a task for the new plan request

    • D. 

      Complete the current plan change in the old wizard, then choose the new plan by using the new enrollment wizard

  • 15. 
    The recipient is Mandatory for MMA, excluded for LTC and has an active SMI on file. Which SMMC plan types will be available to them?
    • A. 

      Only Specialty Plans and Dental Plans

    • B. 

      Specialty Plans, Comprehensive Plans and Dental Plans

    • C. 

      MMA Plans, Specialty Plans, Comprehensive Plans and Dental Plans

    • D. 

      All SMMC and Dental plans will be available to the recipient

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