Membersupport : MLTC Quiz 1

10 Questions | Total Attempts: 59

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Membersupport : MLTC Quiz 1


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

      Letters & Attachments

    • B. 

      Member Contacts

    • C. 

      Member File

    • D. 

      Authorizations

  • 2. 
    Members granddaughter Janice called requesting additional hha hours for member; as members health condition has changed. Jane 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 granddaughter Jane Doe, called requesting additional hha hours for member; as members health condition has changed. Jane 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. What is the activity detail in CaseTrakker?
    • A. 

      Customer care - general inbound

    • B. 

      Sw inquiry

    • C. 

      Customer care - care manager services

    • D. 

      Customer care- sw inquiry

  • 4. 
    Prospect Calls to Reschedule UAS Assessment. Where in Casetrakker can an MSR confirm there is an already scheduled UAS assessment?
    • A. 

      JOURNAL & MEMBER FILE

    • B. 

      JOURNAL & AUTHORIZATIONS

    • C. 

      JOURNAL & MEMBER CONTACTS

    • D. 

      JOURNAL & LETTERS & ATTACHMENTS

    • E. 

      JOURNAL & ASSESSMENTS

  • 5. 
    Ms Lopez  calls to inform she is back from vacation and would like her aide to come back tommorow. MSR should send an email to [blank]
  • 6. 
    Provider calls because they received an authorization to provide Home Care services on 10/15/17 for 20 hours a week but the plan of care is 22 hours a week. MSR should contact :
    • A. 

      Cm

    • B. 

      Um

    • C. 

      Enrollment

    • D. 

      Field assessor

  • 7. 
    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

    • F. 

      CDPAP dept.

  • 8. 
    MBRS DAUGHTER CALLED TO ADVISE MBR WILL BE ENROLLED INTO CPHL IN 2 WEEKS BUT RECEIVED A LETTER ADVISING MBR WILL BE ASSIGNED TO CARING HOME CARE. MBR WISHES TO STAY WITH SAME AGENCY SHE HAS NOW, WHITE GLOVE. MSR SHOULD CONTACT THE CARE MANAGER
    • A. 

      True

    • B. 

      False

  • 9. 
    MBRS DAUGHTER IS REQUESTING A CM CHANGE. SHE IS REQUESTING A SPANISH SPEAKING CM FOR BETTER COMMUNICATION. WHO SHOULD AN MSR CONTACT
    • A. 

      MEMBER SERVICES SUPERVISOR

    • B. 

      CLINICAL TEAM MANAGER

    • C. 

      CARE MANAGER

    • D. 

      CARE COORDINATOR