Aetna Quality Assurance Training: Quiz!

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| By Cchristian
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Cchristian
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Quizzes Created: 10 | Total Attempts: 1,846
Questions: 25 | Attempts: 214

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Aetna Quality Assurance Training: Quiz! - Quiz

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Questions and Answers
  • 1. 

    When criminal searches are requested:

    • A.

      Order a Statewide Repository search for each location.

    • B.

      Order a County Criminal search for each location.

    • C.

      Order both a Statewide and County search for each location.

    • D.

      Refer to the CIF to determine whether Statewide or County should be ordered for each location.

    Correct Answer
    D. Refer to the CIF to determine whether Statewide or County should be ordered for each location.
    Explanation
    The correct answer suggests that when criminal searches are requested, one should refer to the CIF (Criminal Information Form) to determine whether a Statewide or County search should be ordered for each location. The CIF likely contains information or guidelines that help determine the appropriate type of search based on the specific location or jurisdiction. This ensures that the most relevant and accurate information is obtained during the criminal search process.

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  • 2. 

    A Federal Criminal Search should always be ordered.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    A Federal Criminal Search should always be ordered because it provides a comprehensive background check on an individual's criminal history at the federal level. This search can uncover any federal offenses committed by the individual, such as fraud, drug trafficking, or white-collar crimes, which may not be revealed in a standard state or county criminal search. Ordering a Federal Criminal Search ensures that employers or organizations have access to all relevant information before making important decisions, such as hiring an employee or entering into a business partnership.

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  • 3. 

    When a Federal Criminal search is required, we should order:

    • A.

      The Federal District search for each provided & developed location.

    • B.

      The Federal District search for the current residence location only.

    • C.

      The National Federal search.

    • D.

      The GlobalWatch search.

    Correct Answer
    C. The National Federal search.
    Explanation
    When a Federal Criminal search is required, the best option is to order the National Federal search. This search will cover all federal criminal records across the country, providing a comprehensive overview of any potential criminal history. The other options, such as the Federal District search for each provided location or the current residence location only, may not capture records from other districts or jurisdictions, potentially missing crucial information. The GlobalWatch search, on the other hand, is not specifically focused on federal criminal records and may not provide the same level of detail and accuracy as the National Federal search.

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  • 4. 

    When an international location is provided:

    • A.

      Contact the account manager for permission to add an international criminal search.

    • B.

      Order the international search to cover the location.

    • C.

      Order a GlobalWatch search to cover the location.

    • D.

      Do not order any criminal searches for international locations.

    Correct Answer
    C. Order a GlobalWatch search to cover the location.
    Explanation
    When an international location is provided, the correct action to take is to order a GlobalWatch search to cover the location. This is because GlobalWatch is specifically designed to provide comprehensive background checks and due diligence on individuals and businesses across international jurisdictions. It includes criminal records, sanctions lists, and other relevant information from multiple countries. Therefore, ordering a GlobalWatch search would be the appropriate step to ensure a thorough investigation of the individual or business in the international location.

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  • 5. 

    Criminal search names and locations are developed regardless of the timeframe.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement suggests that criminal search names and locations are created without any consideration for the timeframe. This means that regardless of when the search is conducted, the names and locations of criminals are developed. In other words, the development of criminal search names and locations is not dependent on the timeframe in which the search is conducted. Therefore, the answer is true.

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  • 6. 

    Which of the following Criminal searches should be developed? 

    • A.

      All names and locations regardless of age.

    • B.

      All name and locations within the past 7 years.

    • C.

      All names regardless of age and locations within the past 7 years.

    • D.

      Primary name and address only.

    Correct Answer
    C. All names regardless of age and locations within the past 7 years.
    Explanation
    This answer is correct because it includes all names, regardless of age, which ensures that no potential criminals are overlooked. Additionally, it includes locations within the past 7 years, which is a reasonable timeframe for identifying recent criminal activity.

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  • 7. 

    Criminal search locations should be developed from:

    • A.

      Provided Current Residence

    • B.

      Provided Former Residences

    • C.

      Name and Address History / Trace Report

    • D.

      Provided Employment

    • E.

      Provided Education

    • F.

      Developed Employment

    • G.

      Developed Education

    • H.

      Driving History / MVR

    • I.

      Credit History

    Correct Answer(s)
    A. Provided Current Residence
    B. Provided Former Residences
    D. Provided Employment
    E. Provided Education
    F. Developed Employment
    G. Developed Education
    I. Credit History
    Explanation
    The correct answer includes all the relevant sources that should be used to develop criminal search locations. These sources include the provided current residence and former residences, as well as the provided employment and education information. Additionally, developed employment and education information should also be considered. Finally, credit history should be taken into account as it may provide valuable information about a person's background.

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  • 8. 

    Which of the following FELONY records should NOT be reported?

    • A.

      Felony convictions older than 7 years

    • B.

      Felonies where the applicant was under 18 as of the conviction date

    • C.

      Felonies where the disposition is still pending

    • D.

      Felonies where the disposition is dismissed

    • E.

      Active diversions where the charge is a Felony

    Correct Answer
    D. Felonies where the disposition is dismissed
    Explanation
    Felonies where the disposition is dismissed should not be reported because a dismissed disposition means that the charges were dropped or the case was dismissed, indicating that the individual was not convicted of the felony. Therefore, it is not relevant or necessary to report these records.

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  • 9. 

    Which of the following MISDEMEANOR records should NOT be reported? 

    • A.

      Misdemeanor convictions older than 7 years

    • B.

      Misdemeanors where the applicant was under 18 as of the conviction date

    • C.

      Misdemeanors where the disposition is still pending

    • D.

      Misdemeanors where the disposition is dismissed

    • E.

      Active diversions where the charge is a Misdemeanor

    Correct Answer(s)
    A. Misdemeanor convictions older than 7 years
    D. Misdemeanors where the disposition is dismissed
    Explanation
    Misdemeanor convictions older than 7 years should not be reported because they are beyond the specified time frame for reporting. Similarly, misdemeanors where the disposition is dismissed should not be reported as there is no conviction or guilty plea involved.

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  • 10. 

    Any criminal record reported to the client must be graded as a Review.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    This statement suggests that any criminal record reported to the client should be evaluated or assessed further, indicating that it should be graded as a Review. This implies that the client should not dismiss or overlook any criminal record, regardless of its severity or nature. Therefore, the correct answer is True, as it aligns with the idea that all criminal records should be treated as potentially important information that requires further consideration.

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  • 11. 

    If a criminal search location is Statewide, the corresponding Civil search should also be Statewide.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement suggests that if a criminal search location is Statewide, then the corresponding Civil search should also be Statewide. However, this is not necessarily true. Criminal and Civil searches are separate processes with different databases and sources of information. The scope of a criminal search may vary depending on the jurisdiction and the type of search being conducted. Similarly, the scope of a civil search may vary based on the specific requirements and databases being accessed. Therefore, it cannot be assumed that the scope of a criminal search will dictate the scope of a corresponding civil search.

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  • 12. 

    Civil Records should be reported.

    • A.

      Only within the 7-year timeframe

    • B.

      Regardless of age

    • C.

      Only if the record is a child support or divorce settlement

    • D.

      Regardless of age except for child support or divorce settlements

    Correct Answer
    D. Regardless of age except for child support or divorce settlements
    Explanation
    Civil records should be reported regardless of age, except for child support or divorce settlements. This means that any civil records, such as lawsuits or judgments, should be reported regardless of how old they are, except for child support or divorce settlements. These exceptions imply that if the record is related to child support or a divorce settlement, it should only be reported within the 7-year timeframe.

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  • 13. 

    A civil record can be reported even if it has been dismissed.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    A civil record refers to any legal action or dispute involving individuals or organizations that is handled in a civil court. If a civil record has been dismissed, it means that the case has been resolved or dropped without any finding of guilt or liability. Therefore, a dismissed civil record does not typically need to be reported as it does not reflect any wrongdoing or negative outcome. Hence, the statement that a civil record can be reported even if it has been dismissed is false.

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  • 14. 

    When Education verification is requested, verify:

    • A.

      Only the most recent dates of graduation/attendance

    • B.

      Highest level completed beginning with High School

    • C.

      Highest level completed beginning with Associates

    • D.

      All provided Education

    Correct Answer
    C. Highest level completed beginning with Associates
    Explanation
    The answer suggests that when education verification is requested, the highest level completed beginning with an associate's degree should be verified. This means that if the individual has completed an associate's degree, it should be verified first before checking for any higher level of education. It implies that associate's degree holds significance in the verification process and should be given priority over other levels of education.

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  • 15. 

    All provided health/medical related education should be verified.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement suggests that all health/medical related education should be verified. However, this is not true. While it is important to verify the credibility and accuracy of health/medical information, it is not necessary to verify all provided education. It is advisable to rely on trusted sources and consult with healthcare professionals to ensure accurate and reliable information.

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  • 16. 

    All provided health/medical-related professional credentials should be verified.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    It is important to verify all health/medical-related professional credentials to ensure that the individuals providing healthcare services are qualified and competent. This verification process helps to protect patients' safety and well-being by confirming that the professionals have the necessary education, training, and experience to practice in their respective fields. Failing to verify credentials could lead to unqualified individuals providing healthcare services, potentially putting patients at risk. Therefore, it is crucial to verify all provided health/medical-related professional credentials.

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  • 17. 

    Re-verification must be conducted when 

    • A.

      Applicant indicates a degree was received and source does not confirm the degree

    • B.

      Education dates provided by the applicant differ from dates verified by source

    • C.

      Education major provided by the applicant differs from major verified by source

    • D.

      Applicant’s provided name does not match verified Name Attended Under

    Correct Answer(s)
    A. Applicant indicates a degree was received and source does not confirm the degree
    C. Education major provided by the applicant differs from major verified by source
    Explanation
    When the applicant indicates that they have received a degree, but the source does not confirm this information, re-verification must be conducted. Similarly, if the education major provided by the applicant differs from the major verified by the source, re-verification is necessary. These situations indicate a discrepancy between the applicant's claims and the information provided by the source, which could potentially affect the accuracy and validity of the applicant's qualifications. Therefore, conducting re-verification ensures that the correct information is obtained and verified.

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  • 18. 

    When the application is not attached to the case, the QA Analyst should:

    • A.

      Find the application in Fax Manager and attach it to the case

    • B.

      Reject the case indicating that the application is not attached

    • C.

      Enter a Cherwell ticket to have the application attached

    • D.

      Email a supervisor or manager for advice

    Correct Answer
    B. Reject the case indicating that the application is not attached
    Explanation
    If the application is not attached to the case, the QA Analyst should reject the case indicating that the application is not attached. This is the appropriate action because without the application being attached, the case cannot proceed further. Rejecting the case will prompt the necessary action to attach the application before proceeding with the case.

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  • 19. 

    Verifications should remove employment from the report if the applicant indicates they never worked there.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    If an applicant indicates that they never worked at a certain place, it is important for verifications to remove that employment from the report. This is because the applicant has explicitly stated that they have never been employed there, and including it in the report would be inaccurate and misleading. Verifications are meant to provide accurate and reliable information, so it is necessary to remove any employment that the applicant denies.

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  • 20. 

    Which of the following examples should be graded as a gap in employment? 

    • A.

      8/1/2009 to 9/1/2010 and 10/1/2010 to Present

    • B.

      2/1/2002 to 8/1/2009 and 10/1/2010 to Present

    • C.

      2/1/2002 to 8/1/2009 and 6/1/2010 to Present

    • D.

      All of the above

    • E.

      None of the above

    Correct Answer
    B. 2/1/2002 to 8/1/2009 and 10/1/2010 to Present
    Explanation
    The correct answer is 2/1/2002 to 8/1/2009 and 10/1/2010 to Present. This is because there is a gap in employment between 8/1/2009 and 10/1/2010, indicating that the person was not employed during that period. The other options either do not have any gaps in employment or have overlapping dates, suggesting continuous employment.

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  • 21. 

    The MVR should not be graded for a Speeding charge if it was admitted on the application.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    If the MVR (Motor Vehicle Record) was admitted on the application, it means that the applicant has already disclosed their speeding charge. Therefore, there is no need to grade the MVR again for the same offense. This is why the statement "The MVR should not be graded for a Speeding charge if it was admitted on the application" is true.

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  • 22. 

    In order to satisfactorily verify provided employment from 2005 to 2008, the applicant must:

    • A.

      Provide W-2 forms to cover 2007 and 2008

    • B.

      Provide W-2 forms to cover 2005, 2006, 2007, 2008, and 2009

    • C.

      Provide a reference who will vouch for their period of employment

    • D.

      Swear in court that the provided employment dates are correct

    Correct Answer
    A. Provide W-2 forms to cover 2007 and 2008
    Explanation
    The correct answer is to provide W-2 forms to cover 2007 and 2008. This is because W-2 forms are official documents issued by employers that provide information about an individual's income and taxes withheld for a specific year. By providing W-2 forms for 2007 and 2008, the applicant can provide concrete evidence of their employment during that period.

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  • 23. 

    Grading does not apply for a gap in employment if education is verified that covers the gap period.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    If education is verified to cover the gap period in employment, it means that the individual was engaged in educational activities during the gap and not unemployed. Therefore, grading does not apply in this case because the individual was not expected to be working during that period. Hence, the statement is true.

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  • 24. 

    If education has been provided that would resolve a gap in employment, the education should be verified even if it is not the highest level completed.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The explanation for the given answer "False" is that the statement is incorrect. It states that if education has been provided to fill an employment gap, it should be verified even if it is not the highest level completed. However, this is not true. The verification of education should typically focus on the highest level completed, as it is the most relevant and significant qualification. Lower levels of education may not be as important or impactful in terms of employment opportunities. Therefore, it is not necessary to verify education that is not the highest level completed.

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  • 25. 

    If current employment can be verified through a fee-based system, it is not necessary to wait until Day 4 to verify the employment.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that if there is a fee-based system in place to verify current employment, it means that the verification process can be expedited and does not need to wait until Day 4. This suggests that the verification can be done earlier, potentially saving time and allowing for a more efficient process. Therefore, the statement is true.

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  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Apr 10, 2014
    Quiz Created by
    Cchristian
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