Express Enrollments For Smmc Agents

10 Questions | Total Attempts: 161

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Express Enrollments For Smmc Agents

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Questions and Answers
  • 1. 
    Which applicant below will be directed to use the Express Enrollment website?
    • A. 

      KidCare Applicants

    • B. 

      DCF Applicants

    • C. 

      SSA Applicants

    • D. 

      WIC Applicants

  • 2. 
    Express Enrollments will be effective
    • A. 

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

    • B. 

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

    • C. 

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

    • D. 

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

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

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

    • B. 

      Place the enrollment request on the discrepancy log.

    • C. 

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

    • D. 

      Transfer the call to an Express Enrollment Agent.

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

      180

    • B. 

      90

    • C. 

      120

    • D. 

      30

  • 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?
    • A. 

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

    • B. 

      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. She will receive a letter in the mail to notify her.

    • C. 

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

    • D. 

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

  • 6. 
    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?
    • A. 

      Tell John he will need to wait for our system to update and call us back in a couple of days.

    • B. 

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

    • C. 

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

    • D. 

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

  • 7. 
    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?
    • A. 

      Tell Jane to call us back because the system has not updated yet, we can enroll all the kids at that time.

    • B. 

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

    • C. 

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

    • D. 

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

  • 8. 
    Scenario:  Amy calls to enroll her grandmother into a LTC Plan.  Her grandmother shows in HealthTrack as "N-Not Eligible".  How should you proceed?
    • A. 

      Transfer to an Express Enrollment Agent for further assistance.

    • B. 

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

    • C. 

      Place on the discrepancy Log for further research.

    • D. 

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

  • 9. 
    Families that are waiting to be approved for MediKids should be transferred to an Express Enrollment agent.
    • A. 

      True

    • B. 

      False

  • 10. 
    Which Call Action should be used if the caller is transferred to an Express Enrollment Agent?
    • A. 

      Inquiry-General Information

    • B. 

      Inquiry Referral

    • C. 

      Express Enrollment-Transfer

    • D. 

      Express Enrollment-Inquiry

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