Module 1- Making Appointments Assessment
This will go over important things to remember when making an appointment for an ADSM
- 1.What is the appointment standard for DRC 3 members for routine appointments?
- A.
9 calendar days
- B.
5 calendar days
- C.
7 calendar days
- D.
21 calendar days
- 2.What is the appointment standard for EE/TAMP eligible members for routine appointments?
- A.
7 calendar days
- B.
5 calendar days
- C.
21 calendar days
- D.
9 calendar days
- 3.When making an appointment with a non-participating provider what should you do on the appointment modification screen?
- A.
Select approved out of network yes underneath the provider information from the drop down box
- B.
Write in notes section why you are approving a non-participating provider
- C.
Both A and B
- D.
None of the above
- 4.When an ADSM calls in for a list of dentists what should we do?
- A.
Offer to send them a list of dentists via email
- B.
Offer the website to the ADSM
- C.
Give the name of Star designated providers that are in their area over the phone
- D.
All of the above should be offered
- 5.When a caller requests an Appointment Control Number, you should...
- A.
Fill out the form for the caller
- B.
Advise the caller they can request an ACN also through our website and IVR
- C.
Both A and B
- 6.How will you know if a provider that is listed on the appointment modification screen is a specialty provider?
- A.
The system will automatically check the specialist box next to the provider's name
- B.
The system will put a message below the provider's name stating the provider is a specialist
- C.
You will not be able to tell on the appointment modification screen
- 7.When an ACN is requested online, what information will the requestor have to fill out on the form?
- A.
Name of ADSM
- B.
Social Security Number of ADSM
- C.
Date of birth
- D.
Name of doctor ADSM is seeing
- E.
All of the above
- F.
A, B and C only
- 8.With the ADDP 14 enhancements with our website, an ADSM or their provider's office will be able to go online and get an instant ACN as long as the member is eligible for RADDP.
- A.
True
- B.
False
- 9.On the new DART search, you will be able to search for appeals.
- A.
True
- B.
False
- 10.On the enhanced DART search screen you can search for authorizations and referrals for a particular ADSM at the same time.
- A.
True
- B.
False
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