Medical Management Privacy Practices

9 Questions | Total Attempts: 54

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Medical Quizzes & Trivia

This is a brief quiz to test your knowlegde of privacy practices as they relate to Medicare Advantage and Medical Management.


Questions and Answers
  • 1. 
    What are the required elements that must be acquired from a caller identifying themselves as an ADVANTAGE Medicare Solutions member before releasing any information containing PHI or making any changes to their set up in Facets?
    • A. 

      Full name, children's name, pet's name, favorite color

    • B. 

      Name and date of birth

    • C. 

      Full name, date of birth, member ID number, and one additional piece of information such as SSN, address, phone number, effective date(s), if they have Part A and/or B Medicare coverage.

    • D. 

      None of these options

  • 2. 
    By law, ADVANTAGE Medicare Solutions must have our members' verbal or written authorization to release their protected health information (PHI).
    • A. 

      True

    • B. 

      False

  • 3. 
    You initiate a call to a member's provider to discuss a case. Do you need to go through the caller authentication procedures?
    • A. 

      Yes

    • B. 

      No

  • 4. 
    Which screen in Facets would you view to see if a member has a POA on file?
    • A. 

      Members/Responsible Person

    • B. 

      Members/Medicare Verification

    • C. 

      Subscriber/Memo Field

    • D. 

      None of the above

  • 5. 
    A member provides verbal authorization for you to speak with his/her sibling. How long does this authorization last?
    • A. 

      45 days

    • B. 

      30 days

    • C. 

      20 days

    • D. 

      14 days

    • E. 

      None of the above

  • 6. 
    If an ADVANTAGE Medicare Solutions member wants to allow someone to call in and receive information that contains PHI on their behalf for an extended period of time, is there a form they can request?  If so, what is it called?
    • A. 

      No such form exists.

    • B. 

      Yes, it is called the PHI Authorization form.

    • C. 

      Yes, it is called the HIPAA Authorization form.

    • D. 

      There is no form, they just need to call and have it permantly documented.

  • 7. 
    If a provider calls with specific questions about a member, what system or website do you use to confirm that it's a valid provider you're speaking with?
    • A. 

      Facets

    • B. 

      Google

    • C. 

      NPPES

    • D. 

      All of the above

    • E. 

      None of the above

  • 8. 
    How can a member obtain a HIPAA Authorization form?
    • A. 

      Call Member Services

    • B. 

      Call the Grievance Line

    • C. 

      Look in their EOC

    • D. 

      All of the above

    • E. 

      None of the above

  • 9. 
    A member's diagnosis or condition is considered PHI.
    • A. 

      True

    • B. 

      False

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