Express Enrollments For Smmc Agents

1. Which applicant below will be directed to use the Express Enrollment website?

KidCare Applicants

DCF Applicants

SSA Applicants

WIC Applicants

DCF stands for Department of Children and Families. The DCF Applicants will be directed to use the Express Enrollment website. This suggests that the Express Enrollment website is specifically designed for individuals who are applying to the Department of Children and Families.

Explanation

DCF stands for Department of Children and Families. The DCF Applicants will be directed to use the Express Enrollment website. This suggests that the Express Enrollment website is specifically designed for individuals who are applying to the Department of Children and Families.

2. Express Enrollments will be effective

When Medicaid is approved. The effective date can be any day of the month.

When Medicaid is approved. The effective date is always on the first of the month.

As soon as the applicant applies for Medicaid, even if the status is "Processing".

The following month. The recipient will have FFS for the first month.

The correct answer is "when Medicaid is approved. The effective date can be any day of the month." This means that once an individual's Medicaid application is approved, their coverage will become effective on a date that can be any day of the month. This allows for flexibility in when the coverage starts, rather than being limited to only the first day of the month.

Explanation

The correct answer is "when Medicaid is approved. The effective date can be any day of the month." This means that once an individual's Medicaid application is approved, their coverage will become effective on a date that can be any day of the month. This allows for flexibility in when the coverage starts, rather than being limited to only the first day of the month.

3. If the recipient is not in HealthTrack and states they just applied for Medicaid, you should

Create a Supervisor Task for further research because HealthTrack is not updated.

Place the enrollment request on the discrepancy log.

Tell the caller they have to wait 24-48 hours for our system to update and call us back.

Transfer the call to an Express Enrollment Agent.

If the recipient is not in HealthTrack and states they just applied for Medicaid, the correct action to take is to transfer the call to an Express Enrollment Agent. This is because the recipient's enrollment status needs to be verified and processed by an agent who specializes in express enrollment. This will ensure that the recipient's application is handled promptly and accurately.

Explanation

If the recipient is not in HealthTrack and states they just applied for Medicaid, the correct action to take is to transfer the call to an Express Enrollment Agent. This is because the recipient's enrollment status needs to be verified and processed by an agent who specializes in express enrollment. This will ensure that the recipient's application is handled promptly and accurately.

4. Recipients will have __________ days to change the plan without a Good Cause Reason.

180

90

120

30

Recipients will have 120 days to change the plan without a Good Cause Reason. This means that within 120 days of receiving the plan, recipients can make changes without needing to provide a specific reason for doing so. After this time period, they may need to provide a valid reason for any changes they wish to make.

Explanation

Recipients will have 120 days to change the plan without a Good Cause Reason. This means that within 120 days of receiving the plan, recipients can make changes without needing to provide a specific reason for doing so. After this time period, they may need to provide a valid reason for any changes they wish to make.

5. Scenario: Sue calls to enroll because she just re-applied for Medicaid. HealthTrack shows Sue as "N-not Eligible". You see she lost Medicaid last month. How should you proceed?

Immediately transfer to an Express Enrollment Agent because she needs to enroll.

Tell Sue our system has not updated yet and she will need to call us back to enroll.

Tell Sue she can enroll on the SMMC website so her enrollment can be effective immediately.

Based on the scenario provided, Sue calls to enroll because she just re-applied for Medicaid, but HealthTrack shows her as "N-not Eligible" because she lost Medicaid last month. The correct answer suggests that the representative should explain to Sue that it has been less than six months since she lost eligibility and she will be enrolled back into her previous plan once her Medicaid is approved. The representative should also inform Sue that she will receive a letter in the mail to notify her. This explanation reassures Sue that she will be enrolled back into her previous plan once her Medicaid is approved and provides her with information about the notification process.

Explanation

Based on the scenario provided, Sue calls to enroll because she just re-applied for Medicaid, but HealthTrack shows her as "N-not Eligible" because she lost Medicaid last month. The correct answer suggests that the representative should explain to Sue that it has been less than six months since she lost eligibility and she will be enrolled back into her previous plan once her Medicaid is approved. The representative should also inform Sue that she will receive a letter in the mail to notify her. This explanation reassures Sue that she will be enrolled back into her previous plan once her Medicaid is approved and provides her with information about the notification process.

6. Families that are waiting to be approved for MediKids should be transferred to an Express Enrollment agent.

True

False

The statement suggests that families waiting to be approved for MediKids should be transferred to an Express Enrollment agent. However, there is no evidence or reasoning provided to support this claim. Therefore, the answer is false as there is no basis for transferring families to an Express Enrollment agent without further information or clarification.

Explanation

The statement suggests that families waiting to be approved for MediKids should be transferred to an Express Enrollment agent. However, there is no evidence or reasoning provided to support this claim. Therefore, the answer is false as there is no basis for transferring families to an Express Enrollment agent without further information or clarification.

7. Scenario: John calls to enroll because he just re-applied for Medicaid. HealthTrack shows John as "N-Not Eligible". You see he lost eligibility over a year ago. How should you proceed?

Place on the discrepancy log since the system is not updated.

Tell John to call DCF again because they didn't update the system with his eligibility.

Transfer the call to an Express Enrollment Agent to further determine if he can enroll.

Transfer the call to an Express Enrollment Agent to further determine if he can enroll. This is the appropriate action because the HealthTrack system shows John as "N-Not Eligible" despite him re-applying for Medicaid. By transferring the call to an Express Enrollment Agent, they can investigate the discrepancy and assess if John is indeed eligible for enrollment. This ensures that John's case is properly evaluated and any potential errors or updates in the system can be addressed.

Explanation

Transfer the call to an Express Enrollment Agent to further determine if he can enroll. This is the appropriate action because the HealthTrack system shows John as "N-Not Eligible" despite him re-applying for Medicaid. By transferring the call to an Express Enrollment Agent, they can investigate the discrepancy and assess if John is indeed eligible for enrollment. This ensures that John's case is properly evaluated and any potential errors or updates in the system can be addressed.

8. Scenario: Jane is calling to enroll her kids and herself. The kids are eligible to enroll but not Jane. Jane is not even on the case. She stated she also applied for herself. How should you proceed?

Refer Jane back to DCF and tell her she can enroll the kids online.

Transfer Jane to an Express Enrollment agent, they will also assist with enrolling the kids that are eligible.

Provide enrollment assistance for the kids, log the call, and transfer Jane to an Express Enrollment agent for further assistance.

In this scenario, Jane is not eligible to enroll herself, but her kids are eligible. Therefore, the best course of action is to provide enrollment assistance for the kids, log the call, and transfer Jane to an Express Enrollment agent for further assistance. This way, the kids can be enrolled while Jane can receive the necessary guidance and support from the Express Enrollment agent regarding her own enrollment.

Explanation

In this scenario, Jane is not eligible to enroll herself, but her kids are eligible. Therefore, the best course of action is to provide enrollment assistance for the kids, log the call, and transfer Jane to an Express Enrollment agent for further assistance. This way, the kids can be enrolled while Jane can receive the necessary guidance and support from the Express Enrollment agent regarding her own enrollment.

9. Which Call Action should be used if the caller is transferred to an Express Enrollment Agent?

Inquiry-General Information

Inquiry Referral

Express Enrollment-Transfer

Express Enrollment-Inquiry

The correct answer is Express Enrollment-Transfer because when the caller is transferred to an Express Enrollment Agent, it implies that the caller wants to proceed with the enrollment process. Using the Express Enrollment-Transfer call action will ensure that the caller is directed to the appropriate department or agent who can assist them with the enrollment process efficiently.

Explanation

The correct answer is Express Enrollment-Transfer because when the caller is transferred to an Express Enrollment Agent, it implies that the caller wants to proceed with the enrollment process. Using the Express Enrollment-Transfer call action will ensure that the caller is directed to the appropriate department or agent who can assist them with the enrollment process efficiently.

10. Scenario: Amy calls to enroll her grandmother into a LTC Plan. Her grandmother shows in HealthTrack as "N-Not Eligible". How should you proceed?

Transfer to an Express Enrollment Agent for further assistance.

Determine if the recipient has a Level of Care or Medicaid Application on file and refer to the correct agency.

Place on the discrepancy Log for further research.

Tell the caller they can enroll under Medicaid Pending while eligibility is being determined.

Based on the scenario provided, the correct course of action is to determine if the recipient has a Level of Care or Medicaid Application on file and refer to the correct agency. This is because Amy's grandmother is showing as "N-Not Eligible" in HealthTrack, indicating that there may be some issue or discrepancy with her eligibility for the LTC Plan. By checking if there is a Level of Care or Medicaid Application on file, the correct agency can be contacted to address the eligibility concern and provide further assistance.

Explanation

Based on the scenario provided, the correct course of action is to determine if the recipient has a Level of Care or Medicaid Application on file and refer to the correct agency. This is because Amy's grandmother is showing as "N-Not Eligible" in HealthTrack, indicating that there may be some issue or discrepancy with her eligibility for the LTC Plan. By checking if there is a Level of Care or Medicaid Application on file, the correct agency can be contacted to address the eligibility concern and provide further assistance.