Smmc Refresher Quiz #13

Without explaining anything to the mother, refer to DCF/SSA and log the call as a quick call.

Ask the mother if she recently applied/reapplied for Medicaid. If she answers yes, contact express to determine if the enrollee can express enroll.

Continue with verification and advise the mother the child is not currently eligible and refer to DCF/SSA for eligibility.

Blind transfer the mother to express to process the express enrollment.

Inform the enrollee that their application is still pending and no enrollment can be processed at this time. Refer to DCF for eligibility assistance.

Advise the enrollee that only Mandatory enrollees are able to enroll, refer the enrollee to the AHCA Medicaid Helpline to complain.

Inform the enrollee that their application is still pending and they can either choose Medicaid Pending or Pending choice if they want to process an enrollment.

Tell the enrollee that their enrollment is currently pending and transfer the enrollee to express to complete the enrollment.

Check the hover information to see if the eligibility starts the first of the following month. Offer to process an enrollment for the enrollee due to their Pending eligibility.

Inform the enrollee they are not currently eligible and refer them to DCF/SSA for a timeframe on when they will be eligible.

Blind transfer the enrollee to express to process the express enrollment.

Check the hover information to see if the eligibility starts the first of the following month. If the eligibility starts the first of the following month, advise the enrollee to call back then to enroll.

Inform the mother that her son has Fee for Service. Refer the mother to the AHCA Medicaid Helpline for a list of providers that accept FFS.

Blind transfer the mother to express to process the express enrollment.

Inform the mother that her son's application is still pending and no enrollment can be processed at this time. Refer to DCF for eligibility assistance.

Inform the mother that her son has lost Medicaid eligibility and refer to DCF/SSA for eligibility assistance. Advise the mother that if the eligibility is reinstated, the child will be placed back on the previous plan.

Contact express to determine if the enrollee can Express Enroll.

Process enrollment through Medicaid Pending.

Process enrollment through the Discrepancy Log.

Enrollee is not eligible to enroll at this time.

Process plan change through the enrollment wizard and provide effective dates.

The enrollee is Medicaid Pending and cannot change plans. Advise the enrollee they can either disenroll or remain enrolled until Medicaid is approved.

Blind transfer the enrollee to express to process the express enrollment.

Process the plan change through the discrepancy log and advise the enrollee the plan change will be effective the first of the following month.

Always choose the case at the top of the list because it is the most recently updated.

If the cases are not linked, file a complaint so AHCA can combine the cases.

Review both cases and contact escalation to determine if either case is active and if so, which is primary. Continue with the primary case.

Always chose the case at the bottom of the list because it is the most recently updated.