Good Cause Refresher Quiz

15 Questions | Total Attempts: 161

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Good Cause Refresher Quiz - Quiz


Questions and Answers
  • 1. 
    Listen to the audio clip and then answer the following question.
  • 2. 
    Listen to the audio clip and then answer the following question.
  • 3. 
    Listen to the audio clip and then answer the following question.
  • 4. 
    Listen to the audio clip and then answer the following question.
  • 5. 
    Listen to the audio clip and then answer the following question.
  • 6. 
    Listen to the audio clip and then answer the following question.
  • 7. 
    Listen to the audio clip and then answer the following question.
  • 8. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "My Assisted Living Facility takes all of the plans available in my area, but my friend told me that her plan is the best one. She says that out of all of them, her plan offers more extra benefits and covers more services. Can I change to that plan?"
    • A. 

      GC4

    • B. 

      The enrollee does not qualify for a Good Cause plan change at this time

    • C. 

      GC1621

    • D. 

      GC19

  • 9. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "My daughter is 17 and she is pregnant. She’s still living with me and wants me to help her through this. The problem is that her doctor refuses to let me back with her whenever they do ultrasounds and wellness checks. This makes my daughter uncomfortable because she wants me there, not to mention that she is still a minor and I am her mother! We want to change to a different OBGYN because of all this, but this is the only provider that accepts her plan in our area. Can we change her plan?"
    • A. 

      GC13

    • B. 

      GC1623

    • C. 

      GC7

    • D. 

      The enrollee does not qualify for a Good Cause plan change at this time

  • 10. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "I don’t have a car, so I have to ride my bike anywhere I go. I’ve told my plan this and asked if I could have a PCP that is closer to my home, but the closest providers they offer are downtown. If I had a car, it wouldn’t be a problem, but it takes forever to bike there and back and it’s tiring, especially if I went because I wasn’t feeling well. Can I change my plan so that I can see providers closer to me?"
    • A. 

      The enrollee does not qualify for a Good Cause plan change at this time

    • B. 

      GC1623

    • C. 

      GC1619

    • D. 

      GC1621

  • 11. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "I have been paying out of pocket for a month to see my old eye doctor because my plan doesn’t accept him, but he’s the only one I trust to properly assess what treatment I need for my cataracts. He told me yesterday that he accepts a few of the other plans in my area and that I might be able to change my plan instead of continuing to pay. Can I change my plan?"
    • A. 

      GC1621

    • B. 

      The enrollee does not qualify for a Good Cause plan change at this time

    • C. 

      GC1623

    • D. 

      GC9

  • 12. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "I’m not sure why, but my plan won’t stop changing my Primary Care and every time to a different location. It’s happened 4 times and seems to happen every other month. I’ve been needing to see a doctor regularly because I have blood pressure problems. Don’t get me wrong, all of the doctors have been really nice, but the problem is that none of them are really able to get to know me or even try to understand what is going on with me before I am changed again. Can I change to a different plan?"
    • A. 

      GC4

    • B. 

      GC1620

    • C. 

      GC9

    • D. 

      The enrollee does not qualify for a Good Cause plan change at this time

  • 13. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "I need to have a surgery performed for kidney stones. My provider told me that I need to see a Urological Surgeon for the procedure, but the only one in the area does not accept the plan I have. I tried to ask my plan if they would work with him anyways, but they refused. Can I change my plan so I can have the surgery?"
    • A. 

      The enrollee does not qualify for a Good Cause plan change at this time

    • B. 

      GC9

    • C. 

      GC1619

    • D. 

      GC1623

  • 14. 
    Based off of the audio clip you listened to, choose which Good Cause matches the scenario: "I want to get my child circumcised, but when it was time for the appointment the Primary Care called me and told me that the plan is refusing to cover any circumcisions because they are morally against it. He told me I would need to change the plan to have my child circumcised. My child can’t continue to go without being circumcised or he will be too old to have the procedure performed, so I need to change the plan as soon as possible."
    • A. 

      GC4

    • B. 

      GC13

    • C. 

      The enrollee does not qualify for a Good Cause plan change at this time

    • D. 

      GC1621

  • 15. 
    The enrollee states that they have depression and anxiety and were advised to enroll into the specialty plan Staywell. Health track shows that they are locked in and the special condition (SMI) is not on file. Why doesn't the GC17- Move to Specialty Plan show as an option in the drop-down menu?
    • A. 

      The GC17 option will not show because anxiety and depression do not qualify you to have the SMI special condition

    • B. 

      The SMI special condition must be on file for GC17 to show as an option in the drop-down menu. Advise the enrollee to fax in documentation of the condition and provide the fax number for additional assistance

    • C. 

      There is a system error in which the SMI special condition does not always show in HealthTrack. Place the GC17 request on the discrepancy log and advise the enrollee the plan change will be effective the first of the following month

    • D. 

      The GC17 option will not show because SMI is no longer a special condition and there is no specialty plan for SMI

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