Express Enrollment Quiz-express Agents
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- 1.
Which applicant below will be directed to use the Express Enrollment website?
- A.
KidCare Applicants
- B.
DCF Applicants
- C.
SSA Applicants
- D.
WIC Applicants
Correct Answer
B. DCF ApplicantsExplanation
DCF stands for the Department of Children and Families. The Express Enrollment website is likely a platform specifically designed for DCF applicants to streamline the enrollment process. Therefore, DCF applicants will be directed to use the Express Enrollment website to complete their application.Rate this question:
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- 2.
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.
Correct Answer
A. When Medicaid is approved. The effective date can be any day of the month.Explanation
The correct answer is "when Medicaid is approved. The effective date can be any day of the month." This means that once an individual's Medicaid application is approved, their coverage will become effective on any day of the month, rather than being limited to the first day of the month. This allows for more flexibility in terms of when the individual can start using their Medicaid benefits.Rate this question:
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- 3.
Recipients will have __________ days to change the plan without a Good Cause Reason.
- A.
180
- B.
90
- C.
120
- D.
30
Correct Answer
C. 120Explanation
Recipients will have 120 days to change the plan without a Good Cause Reason. This means that within a period of 120 days, recipients can make changes to their plan without having to provide a valid reason for doing so. This allows flexibility and gives recipients the opportunity to adjust their plan according to their needs or preferences within this timeframe.Rate this question:
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- 4.
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
Correct Answer
A. Open, Processing, Verification NeededExplanation
The correct answer is Open, Processing, Verification Needed. This is because Express Enrollments should only be completed for applicants whose application status is Open, Processing, or Verification Needed. The other options listed in the question (Pending, Denied, Confirmed and Processing, Verification Needed, Closed) do not meet the criteria for Express Enrollments.Rate this question:
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- 5.
Express Enrollment agents will explain Medicaid eligibility requirements and benefits.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Express Enrollment agents will not explain Medicaid eligibility requirements and benefits.Rate this question:
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- 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
Correct Answer
D. Express Enrollment-Plan Change MMAExplanation
If an applicant calls back to change their initial express enrollment, the appropriate call action to be selected would be "Express Enrollment-Plan Change MMA". This indicates that the applicant wants to modify their initial enrollment plan.Rate this question:
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- 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.
Correct Answer
D. The Express enrollment request is active and waiting for eligibility to be approved by DCF.Explanation
The correct answer is the Express enrollment request is active and waiting for eligibility to be approved by DCF. This means that the individual has submitted an application for enrollment and it is currently being reviewed by the Department of Children and Families (DCF) to determine if they meet the eligibility requirements. Once the eligibility is approved, the individual will be able to start receiving services.Rate this question:
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- 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
Correct Answer
A. TrueExplanation
The given statement is true. Even though the applicant's application status is "processing," if they meet the criteria to be categorized as Voluntary, they will still be eligible for the express enrollment. The express enrollment will become effective for the applicant, regardless of their application status.Rate this question:
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- 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.
Correct Answer
C. Use the Express Enrollment Search to confirm the plan and PCP chosen.Explanation
The correct answer is to use the Express Enrollment Search to confirm the plan and PCP chosen. This is the most efficient and direct way to find the information that the caller is looking for. By using the Express Enrollment Search, the representative can quickly access the applicant's enrollment details and provide them with the necessary information about their chosen doctor and plan. This approach avoids unnecessary delays in waiting for a letter or directing the caller to another platform for verification.Rate this question:
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- 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.
Correct Answer
A. Go ahead and assist the caller since they are already on the phone with you.Explanation
In this scenario, the correct answer is to go ahead and assist the caller since they are already on the phone with you. This is the appropriate course of action because the caller is already engaged in conversation and it would be helpful to provide assistance to their family member as well. It is important to prioritize customer service and address the caller's needs to the best of your abilities.Rate this question:
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- 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.
Correct Answer
B. It starts on the initial effective date of the managed care plan.Explanation
The 120 day change period starts on the initial effective date of the managed care plan. This means that any changes or adjustments to the plan can be made within 120 days from the date the plan becomes effective. It does not start on the first of the month or the following month after the plan becomes effective, nor does it start after the 30 day change period. The initial effective date is the key factor in determining when the change period begins.Rate this question:
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- 12.
To get recipients in the managed care plan faster, you will process Express Enrollments for reinstatements.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
To get recipients in the managed care plan faster, it is not true that you will process Express Enrollments for reinstatements. The statement suggests that processing Express Enrollments for reinstatements is a method to expedite the enrollment process, but the answer indicates that this is not the case. Therefore, it is false.Rate this question:
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- 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
Correct Answer
D. Social Security Number and Date of BirthExplanation
In order to search in the DCF Provider View, you will need to use the Social Security Number and Date of Birth. These two pieces of information are commonly used to identify individuals and ensure accurate search results. The combination of Social Security Number and Date of Birth provides a more specific and reliable search criteria compared to other options such as Medicaid ID or Tax ID.Rate this question:
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- 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.
Correct Answer
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.Explanation
If the caller's special condition is already active and on file, they will be able to enroll in a specialty plan through the express website. However, if the special condition is not on file, the caller should be informed about the process of adding the special condition to their file. This suggests that the availability of specialty plans on the express website is dependent on the special condition being active and on file.Rate this question:
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- 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.
Correct Answer
C. Refer the applicant to DCF to check on their application.Explanation
If the applicant cannot be found in HealthTrack or the DCF Provider View, it is best to refer them to the Department of Children and Families (DCF) to check on their application. This is because DCF is responsible for processing and managing Medicaid applications, so they would have the most accurate and up-to-date information regarding the applicant's status. Referring the applicant to DCF ensures that they can get the necessary assistance and information regarding their application.Rate this question:
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- 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
Correct Answer
A. TrueExplanation
The personal information entered on the Express website and the Medicaid application must match in order for the enrollment to become effective. This means that the details provided, such as name, address, and contact information, should be consistent on both platforms. If there are any discrepancies or inconsistencies between the information entered, the enrollment may not be processed or become effective. Therefore, it is important to ensure that the personal information matches on both the Express website and the Medicaid application.Rate this question:
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- 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.
Correct Answer
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.Explanation
The correct answer is to check the Express Enrollment Search in HealthTrack to determine if the caller chose a plan on the express website and double check the personal information to determine if there was a typing error when the information was submitted and explain to the caller. This is the appropriate course of action because it allows the representative to gather necessary information to understand the situation and provide an accurate explanation to the caller. It also helps identify any errors or misunderstandings that may have occurred during the enrollment process.Rate this question:
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- 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.
Correct Answer
B. A confirmation letter will be sent when the plan becomes effective.Explanation
The correct answer is "A confirmation letter will be sent when the plan becomes effective." This means that the recipient will receive the confirmation letter once the plan they enrolled in becomes active or starts. It suggests that the confirmation letter is not sent immediately after enrollment or after a specific number of days, but rather when the plan is ready to be implemented.Rate this question:
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- 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.
Correct Answer
A. The Express Request was converted to a MMA Pending Enrollment Request because the Recipient gained MMA eligibility.Explanation
The status of 'Converted' on the Express Enrollment Search means that the Express Request was converted to a MMA Pending Enrollment Request because the recipient gained MMA eligibility.Rate this question:
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- 20.
When completing an express enrollment, you will provide the plan name and effective date.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
When completing an express enrollment, you are not required to provide the plan name and effective date. This means that the statement is false.Rate this question:
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