MLTC New Hire Pop Quiz

6 Questions | Total Attempts: 385

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MLTC New Hire Pop Quiz


Questions and Answers
  • 1. 
    Marvin from Essen Medical calls to inquire on the reason for a denied claim. Which Tab in Casetrakker can you confirm if the Essen Medical was authorized to provide the denied service?
    • A. 

      Letters & Attachments

    • B. 

      Member Contacts

    • C. 

      Member File

    • D. 

      Authorizations

    • E. 

      Member File Tab

    • F. 

      Interruption of Care

    • G. 

      Appeals

  • 2. 
    Members granddaughter Janice called requesting additional hha hours for member; as members health condition has changed. Janice is requesting member receive 5 days/ 8 hours each day as member is in the hospital due to a stroke and will be returning home soon. MSR will call or send an email to the 
    • A. 

      Social Work dept.

    • B. 

      Field Assessor

    • C. 

      Care Coordinator

    • D. 

      Care Manager

  • 3. 
    Members Daughter Calls & Request Services for A Family Member to Take Care of Her Mom. Who should MSR send an email to :
    • A. 

      Care Manager

    • B. 

      Social Work dept.

    • C. 

      Intake UAS Nurse

    • D. 

      Intake CDPAP

    • E. 

      Intake Coordinator

  • 4. 
    Sarah Smith called stating her mother  will be enrolled into CPHL next month, but she received a letter advising her mom will be assigned to Caring Home Care. Sarah states her mom would like to keep her same aide who works at White Glove Home Care. How can an MSR assist Sarah with this request?
    • A. 

      Email the Intake Nurse and advise Sarah the nurse will call back

    • B. 

      Email Intake Representative and request someone follow up with Sarah

    • C. 

      Create an Activity Log, Assign the activity Log to the Intake Nurse and send an FYI email to the Intake Nurse advising of Sarah's request.

    • D. 

      Advise Sarah unfortunately she cannot make any changes. However , when her mom becomes a member she can call back and speak to the assigned Care manager.

    • E. 

      Send an email to the UM dept requesting the home care agency be changed from Caring Home Care to White Glove.

  • 5. 
    Ms Lopez  calls to inform she is back from vacation and wants to know if the aide will arrive tomorrow.  As per CaseTrakker there is an Interruption of Care (IOC) listed on the account. MSR should call or send an email to the
    • A. 

      Care Manager

    • B. 

      Field Assessor

    • C. 

      Intake Nurse

    • D. 

      Care Coordinator

    • E. 

      UM department

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