Smmc: Healthtrack Choice Tools Quiz

20 Questions | Total Attempts: 739

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Health Quizzes & Trivia

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Questions and Answers
  • 1. 
    To change the LTC Direct Service Provider, the recipient should call the
    • A. 

      DOEA

    • B. 

      DCF

    • C. 

      Care Coordinator

    • D. 

      SSA

  • 2. 
    "My grandfather has Crohn's Disease and he has to be very careful about what he eats.  His stomach is very sensitive to a lot of foods.  I take care of him, but I'm not sure what type of food is right for him.  I don't want his condition to worsen because I'm not giving him the right foods."  Which covered service is the recipient referring to?
    • A. 

      Home Delivered Meals

    • B. 

      Hospice

    • C. 

      Personal Care

    • D. 

      Nutritional Assessment/Risk Reduction Services

  • 3. 
    James is wanting to find a Pediatric doctor for his child. Which Search field would you look under to find a Pediatric doctor? 
    • A. 

      Address

    • B. 

      Gender

    • C. 

      Panel Status

    • D. 

      Specialty

  • 4. 
    Which box would you check to enroll into a medical plan?
    • A. 

      LTC

    • B. 

      Better Health

    • C. 

      MMA

    • D. 

      Humana Medical Plan

  • 5. 
    Can an OB/GYN doctor be a PCP?
    • A. 

      No, Never

    • B. 

      Yes, as long as the member states they see them for Primary care needs as well.

    • C. 

      Yes, as long as they are listed as a PCP.

    • D. 

      Yes, they are a doctor.

  • 6. 
    You can search for a PCP using a zip code.
    • A. 

      Yes, only in certain areas.

    • B. 

      No, you can only use an exact address.

    • C. 

      Yes, if you type in a zip code it will populate the PCP's in that area.

    • D. 

      No, it would pull up to many PCP's in that area.

  • 7. 
    What plans can this member enroll into?
    • A. 

      Magellan Complete Care (Specialty)

    • B. 

      United Health Care of Florida

    • C. 

      Sunshine Health

    • D. 

      B and C

  • 8. 
    Which plans does Dr. Rufus Joseph accept?
    • A. 

      Simply Healthcare

    • B. 

      Humana

    • C. 

      Better Health

    • D. 

      Amerigroup

  • 9. 
    Which search tool options can you use for MMA?
    • A. 

      PCP Search only

    • B. 

      Specialist Search only

    • C. 

      Hospital Search only

    • D. 

      You can search with Hospital, Specialist, and/or PCP.

  • 10. 
    If a recipient is ready to enroll and requests a PCP, but you are unable to locate the doctor in Health Track, you should...
    • A. 

      Tell the recipient to call the doctor to confirm the plans they accept. Advise the recipient that they may enroll without selecting a PCP, but they will have to contact the plan once it becomes effective to add the PCP of their choice or the plan will select one for them.

    • B. 

      Tell the recipient that they can enroll without selecting a PCP and see any doctor that takes Medicaid. Because it really doesn't matter, you can select the first provider that populates under the plan that they requested in Health Track.

    • C. 

      Advise the recipient that you will hold on while they look on the providers website to verify if it provides a list of plans they accept, even if they previously informed you that they do not have access to the internet.

    • D. 

      Advise the recipient that the doctor must not accept Medicaid because they didn't pull up in the system at all and they must provide you with the name, address and/or telephone number of another doctor in order to enroll into a MMA plan.

  • 11. 
    Can you enroll this recipient with the PCP below?
    • A. 

      Yes, if that is who the caller is requesting.

    • B. 

      No, the recipient does not meet the age restrictions of the provider.

    • C. 

      Yes, if the recipient is in Broward County.

    • D. 

      No, because the provider is in Fort Lauderdale.

  • 12. 
    Scenario:  Ms. Jones has used Meals on Wheels in the past for LTC.  She would like to continue using Meals on Wheels.  How should you proceed?
    • A. 

      Search for Meals on Wheels and tell the caller which LTC plans they accept. Inform the caller that you cannot assign Meals on Wheels, but a Care Coordinator from the plan will help assign the providers once the plan is effective.

    • B. 

      Search for Meals on Wheels and tell the caller which LTC plans they accept. Assign Meals on Wheels to the plan enrollment. Tell the caller she will receive this service when the plan starts.

    • C. 

      Search for Meals on Wheels and tell the caller which LTC plans they accept. Tell the caller she will need to call Meals on Wheels directly for delivery and menu information.

    • D. 

      Tell the caller she will receive a list of providers from the plan once it becomes effective. She should call DOEA to find out if Meals on Wheels works with LTC plans.

  • 13. 
    If the caller does not have a PCP you should:
    • A. 

      Offer to search for a PCP in the area, ask for preferences such as male or female, a language preference, etc.

    • B. 

      Tell the caller to research the doctors in the area and call us back.

    • C. 

      Tell the caller the plan will send a list of doctors when the plan becomes effective.

    • D. 

      Provide the caller the plan website so they can get a full list of providers.

  • 14. 
    When will the member receive the health plan ID card and membership information from the plan?
    • A. 

      After the enrollment becomes effective.

    • B. 

      As soon as the member enrolls with the plan.

    • C. 

      During open enrollment.

    • D. 

      7-10 business days after the enrollment is completed.

  • 15. 
    The caller is currently enrolled into a plan. The caller states that they are happy with the plan, but need to change the PCP.  How do you proceed?
    • A. 

      Tell the caller the doctor can only be changed during the 120 days.

    • B. 

      Refer to the Medicaid Helpline to change the doctor.

    • C. 

      Tell the caller to call the health plan to change the doctor.

    • D. 

      Change the doctor through HealthTrack.

  • 16. 
    Daniel Bannerman calls to enroll into Simply HealthCare. He states that he just moved from another state and does not have a Primary Care Provider. How do you proceed?
    • A. 

      Inform Mr. Bannerman that in order to complete the enrollment, he is required to choose a Primary care Provider under the plan's network.

    • B. 

      Inform Mr. Bannerman that he really doesn't need a primary care provider and that he can choose one whenever he wants to.

    • C. 

      Inform Mr. Bannerman that you can help him find a PCP in the area and he is not required to choose a PCP at this time. If he does not choose one then the plan will assign a PCP.

    • D. 

      Inform Mr. Bannerman that the plan will choose a doctor that doesn't have a lot of patients for him.

  • 17. 
    Mrs. Osborne calls to enroll into Humana with Dr. Imani Akindo. You search for the provider, but she does not show up in Health Track. Mrs. Osborne states that she just talked to the provider and was told that they accept Humana.  How do you proceed?
    • A. 

      Inform Mrs. Osborne that this is the most up-to-date information that we have received from the plan and that she can call the plan to add Dr. Imani Akindo once the plan become effective.

    • B. 

      Advise Mrs. Osborne that Dr. Imani Akindo did not show under Humana and apparently no longer accepts Humana any more.

    • C. 

      Inform Mrs. Osborne that this is the most up-to-date information that we have received from the plan and that Dr. Imani Akindo is not on the list and another provider will need to be selected.

    • D. 

      Advise Mrs. Osborne that Dr. Imani Akindo accepts all of the plans available in her region, but she will have to call the plan to add her as the PCP.

  • 18. 
    Anita calls to enroll herself and her daughter in a plan. She wants to choose Prestige with her own PCP and states that her daughter's Pediatrician only accepts Staywell. Does Anita and her daughter have to enroll into the same plan because they are on the same case?
    • A. 

      Yes, because the babies have to enroll in the same plan that the mother has.

    • B. 

      Yes, because it's better for everyone to have the same plan and family doctor.

    • C. 

      Yes, because AHCA requires that one plan and PCP per family for billing purposes.

    • D. 

      No, she can choose a different plan and PCP for each member.

  • 19. 
    Affinity Home Care Inc. does not provide which service? 
    • A. 

      Medication Management

    • B. 

      Respiratory Therapy

    • C. 

      Home Accessibility Adaption Services

    • D. 

      Homemaker

  • 20. 
    Barbara needs to verify if Broward Health Imperial Point hospital located in Fort Lauderdale, accepts Better Health plan. Barbara was unable to provide you with her Recipient ID, Medicaid ID,SSN nor any other numbers to access her case. How do you proceed?
    • A. 

      Search for the provider using the Provider- MMA tool in Health Track menu bar.

    • B. 

      Search for the provider using the Provider- LTC tool in Health Track menu bar.

    • C. 

      Inform the caller that because you are unable to access the case and they must contact the plan to verify.

    • D. 

      Inform the caller that the hospitals are required to accept all plans available in their region.

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