2014-qm Fun Quiz 1

10 Questions | Total Attempts: 46

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2014-qm Fun Quiz 1

This is the funnest quiz ever!


Questions and Answers
  • 1. 
    Call ID 7136839. Timestamp 00:12:00 - 00:13:10. What did the BA say that was incorrect?
  • 2. 
    The ADP read a non-required benefit incorrectly. How would you grade it?
    • A. 

      Mark as a minor on the QM form

    • B. 

      Since there is nowhere to grade it, coach it

    • C. 

      Mark as major on the QM form

    • D. 

      Red Flag

  • 3. 
    The customers are each enrolling into the same MAPD plan.  Select what must be done on a joint application. Check ALL that apply. 
    • A. 

      Read the opening script twice-once to each customer

    • B. 

      Authorize each other to assist with the application, number 10 in the Definitions

    • C. 

      Read the long term care facility tiers for drug coverage

    • D. 

      Get a response from each customer on number 9

  • 4. 
    Since the customers are HIPAA reps for each other, MR can answer for MRS on number 4 in the script
    • A. 

      True

    • B. 

      False

  • 5. 
    The ADP read all of the benefits verbatim, but did not read the headers for Doctor and Hospital Choice or Emergency Care. What grade would you give for those line items?
    • A. 

      Yes

    • B. 

      Minor

    • C. 

      Major

    • D. 

      Red Flag

    • E. 

      Coach

  • 6. 
    Call ID 7150253. Timestamp  00:03:27-00:04:20. Grade number 3  on the QM form.
    • A. 

      Prohibited Practice

    • B. 

      Coach

    • C. 

      Red Flag because the BA said 'typically'

  • 7. 
    Call ID 7191059. Grade Secure the Call for the BA. 
    • A. 

      Yes

    • B. 

      Major

    • C. 

      N/A

    • D. 

      Red Flag

  • 8. 
    Call ID 6990939. Timestamp 00:07:50 - 00:08:06 What prohibited practice would you use for this?
    • A. 

      Make any statement, claim or promise that conflicts with, alters or erroneously expands upon the information contained within CMS-approved materials, this includes misquoting plan benefits

    • B. 

      Claiming that a specific carrier is recommended or endorsed by CMS, Medicare or the Department of Health and Human Services

    • C. 

      Use absolute superlatives like asserting that a certain plan is “the best” plan

    • D. 

      Mislead, confuse or misrepresent to potential members about Medicare or competitive plans

  • 9. 
    The customer chose a Medigap Plan N and a Humana PDP. When the BA was transferring the call to an ADP, the line disconnected. The BA noticed that the Medigap plan for some reason, was not in the cart anymore, but the PDP was still there. The BA told the customer to hold on while she put the Medigap plan back in the cart. After she put the plan in the cart again, she transferred the call to an ADP. Since the BA only needed to put one of the plans back in the cart, the BA didn't have to read the MIR.  
    • A. 

      True

    • B. 

      False

  • 10. 
    The HIPAA called in for the customer and secured the call. 30 minutes later the customer came on the line. The BA secured the call with the customer. The customer could not recall the last four digits of their SSN and gave the incorrect phone number. How would you score Secure the Call?
    • A. 

      Yes

    • B. 

      Major

    • C. 

      N/A

    • D. 

      Red Flag

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