Express Enrollment Quiz-express Agents

20 Questions | Total Attempts: 35

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Express Enrollment Quiz-express Agents

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Questions and Answers
  • 1. 
    Express Enrollments should be completed for applicants that have the following application status:
    • A. 

      Open, Processing, Verification Needed

    • B. 

      Pending, Denied, Confirmed

    • C. 

      Processing, Verification Needed, Closed

    • D. 

      Enrolled, Verification Needed, Open

  • 2. 
    Which applicant below will be directed to use the Express Enrollment website?
    • A. 

      KidCare Applicants

    • B. 

      DCF Applicants

    • C. 

      SSA Applicants

    • D. 

      WIC Applicants

  • 3. 
    Express Enrollment agents will explain Medicaid eligibility requirements and benefits.
    • A. 

      True

    • B. 

      False

  • 4. 
    Express Enrollments will be effective
    • A. 

      When Medicaid is approved. The effective date can be any day of the month.

    • B. 

      When Medicaid is approved. The effective date is always on the first of the month.

    • C. 

      As soon as the applicant applies for Medicaid, even if the status is "Processing".

    • D. 

      The following month. The recipient will have FFS for the first month.

  • 5. 
    Recipients will have  __________ days to change the plan without a Good Cause Reason.
    • A. 

      180

    • B. 

      90

    • C. 

      120

    • D. 

      30

  • 6. 
    Which call action should be selected if an applicant calls back to change their initial express enrollment?
    • A. 

      Express Enrollment-Referral

    • B. 

      Express Enrollment-Transfer

    • C. 

      Express Enrollment-Initial Enrollment MMA

    • D. 

      Express Enrollment-Plan Change MMA

  • 7. 
    An 'Active' status on the Express Enrollment Search means:
    • A. 

      The Medicaid application is active, it's just not reflecting in HealthTrack yet.

    • B. 

      Medicaid is active and the recipient can use FFS while they wait for the plan to start.

    • C. 

      The plan is active and the recipient can start receiving services.

    • D. 

      The Express enrollment request is active and waiting for eligibility to be approved by DCF.

  • 8. 
    An applicant who has an application status of "processing" chooses a plan.  The applicant becomes eligible and is categorized as Voluntary because of other criteria.  The express enrollment will still become effective.
    • A. 

      True

    • B. 

      False

  • 9. 
    Scenario:  Applicant calls to check on their express enrollment, they cannot remember which doctor they picked.  How do you proceed?
    • A. 

      Tell the caller you don't have the information, they will receive a letter with the plan and PCP information in a couple of days.

    • B. 

      Tell the caller to verify on the Express Enrollment website.

    • C. 

      Use the Express Enrollment Search to confirm the plan and PCP chosen.

    • D. 

      Use the Call Search to find out when the caller last called us and read the notes.

  • 10. 
    Scenario:  You complete an Express Enrollment for an applicant.  At the end of the call the caller requests you provide case information for another family member not mentioned before, how do you proceed?
    • A. 

      Go ahead and assist the caller since they are already on the phone with you.

    • B. 

      Tell the caller you cannot assist because you only complete express enrollments.

    • C. 

      Tell the caller you can call them back at a later time.

    • D. 

      Tell the caller to visit the SMMC website for more information.

  • 11. 
    When does the 120 day change period start?
    • A. 

      It starts on the first of the month of when the managed care plan becomes effective.

    • B. 

      It starts on the initial effective date of the managed care plan.

    • C. 

      It starts the following month after the managed care plan becomes effective.

    • D. 

      It starts after the 30 day change period.

  • 12. 
    To get recipients in the managed care plan faster, you will process Express Enrollments for reinstatements.
    • A. 

      True

    • B. 

      False

  • 13. 
    You will use the __________ and ____________ to search in the DCF Provider View.
    • A. 

      Social Security Number and Medicaid ID

    • B. 

      Tax ID and Date of Birth

    • C. 

      Medicaid ID and Date of Birth

    • D. 

      Social Security Number and Date of Birth

  • 14. 
    Scenario:  You are assisting a caller with an express enrollment.  The caller tells you they have a special condition and would like to enroll in a specialty plan.  How do you proceed? 
    • A. 

      If the special condition is active and on file, then the specialty plan will be available on the express website. If not on file, then tell the caller how they can have the special condition added to their file.

    • B. 

      All specialty plans will be available to all applicants regardless if the special condition is on file.

    • C. 

      Specialty plans will not be available on the express website. Once eligible, the recipient will have 120 days to change to a specialty plan.

    • D. 

      To enroll in a specialty plan on the express website, the applicant must first fax documentation of their condition to DCF. DCF will add the special condition to the Medicaid application.

  • 15. 
    If you are unable to locate the applicant in HealthTrack or the DCF Provider View, you should:
    • A. 

      Complete the Express Enrollment because the caller states they were approved for Medicaid.

    • B. 

      Refer the caller to the Affordable Care Act Helpline to apply for benefits.

    • C. 

      Refer the applicant to DCF to check on their application.

    • D. 

      Place the information on the discrepancy log for further research.

  • 16. 
    The personal information entered on the Express website and the Medicaid application must match in order for the enrollment to become effective. 
    • A. 

      True

    • B. 

      False

  • 17. 
    Scenario:  The recipient is confused because they chose a plan on the express website and it never started.  They got assigned to a different plan that they don't want.  How do you proceed? 
    • A. 

      Tell the caller they didn't choose a plan, therefore they were assigned to a plan. Explain they have 120 days to change the plan.

    • B. 

      Check the Express Enrollment Search in HealthTrack to determine if the caller chose a plan on the express website. Double check the personal information to determine if there was a typing error when the information was submitted and explain to the caller.

    • C. 

      Complete another express enrollment; it will override the current enrollment.

    • D. 

      File a complaint against the system. The enrollment should have processed.

  • 18. 
    When will the recipient receive a confirmation letter with the plan name and effective date?
    • A. 

      A confirmation letter will be sent as soon as the express enrollment is completed.

    • B. 

      A confirmation letter will be sent when the plan becomes effective.

    • C. 

      A confirmation letter will be sent on the first of the month.

    • D. 

      A confirmation letter will be sent after 30 days.

  • 19. 
    A status of 'Converted' on the Express Enrollment Search means
    • A. 

      The Express Request was converted to a MMA Pending Enrollment Request because the Recipient gained MMA eligibility.

    • B. 

      The Express Request was converted to an auto assignment because it took too long to receive eligibility.

    • C. 

      The Express Request was converted to inactive because the applicant was approved for KidCare.

    • D. 

      The Express Request was converted to a comprehensive plan since the applicant was eligible for MMA and LTC.

  • 20. 
    When completing an express enrollment, you will provide the plan name and effective date.
    • A. 

      True

    • B. 

      False

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