2014 - Qm - Page 1 Application

1. "Are you Male or Female?"If the ADP phrased the Gender question like this, QM would Major that line item because the ADP gave the answer while asking the question.

True

False

It is acceptable for the ADP/BA to ask “Are you male or female?”
QM does not Major if the ADP gives the answer, this would be a minor (for the majority of line items)

Explanation

It is acceptable for the ADP/BA to ask “Are you male or female?”
QM does not Major if the ADP gives the answer, this would be a minor (for the majority of line items)

2. If the customer gave their DOB as 8/20/49 and the application shows 8/20/1949, QM would score Major for information not matching.

True

False

If the customer gave their DOB as 8/20/49 and the application shows 8/20/1949, QM would not score Major for information not matching. This is because the year 1949 is the correct year of birth and matches the information provided by the customer. Therefore, the statement is false.

Explanation

If the customer gave their DOB as 8/20/49 and the application shows 8/20/1949, QM would not score Major for information not matching. This is because the year 1949 is the correct year of birth and matches the information provided by the customer. Therefore, the statement is false.

3. The customer said their date of birth is 5/31/36. The ADP asked the customer to restate the date of birth but give a four digit year.

The ADP knows they will lose points if they do not ask for the four digit year

The ADP will not lose points if they do not ask for the four digit year

The ADP is trying to get extra points on their QM form

The ADP will not lose points if they do not ask for the four digit year because the customer stated their date of birth as 5/31/36. The ADP is simply asking the customer to restate the date of birth with a four digit year, which is a standard requirement. The ADP is not trying to gain extra points on their QM form, but rather ensuring that the information provided is accurate and complete.

Explanation

The ADP will not lose points if they do not ask for the four digit year because the customer stated their date of birth as 5/31/36. The ADP is simply asking the customer to restate the date of birth with a four digit year, which is a standard requirement. The ADP is not trying to gain extra points on their QM form, but rather ensuring that the information provided is accurate and complete.

4. The ADP is completing an AARP Medicare Supplement from United Healthcare Plan F. The ADP stated "To continue with your enrollment, I will now need to verify the following information. Will you please say and spell your first and last name?" The Customer states their first and last name; however, they did not spell it. How should line item #28 be scored?

Yes

Minor

Major

N/A

Yes-The Customer is not required to spell their name.

Explanation

Yes-The Customer is not required to spell their name.

5. For the opening statement, the ADP stated "I need to verify your information." Line item #27 should be scored as a Major since the opening statement is "To continue with your enrollment, I will now need to verify the following information:"

True

False

False-This should be scored as a minor since it was not verbatim.

Explanation

False-This should be scored as a minor since it was not verbatim.

6. The customer stated their physical street address is 1234 Easy St NE. The application shows 1234 Easy Street. Score line item 33.

Yes, but coach the agent for leaving off the directional in the address

Minor, the agent did it but didn't do it correctly

Major, information heard on the recording doesn't match the application

N/A

The correct answer is "Yes, but coach the agent for leaving off the directional in the address." This answer is chosen because it acknowledges that the agent made a mistake by omitting the directional (NE) in the address. However, it also suggests that the mistake is minor and can be corrected through coaching.

Explanation

The correct answer is "Yes, but coach the agent for leaving off the directional in the address." This answer is chosen because it acknowledges that the agent made a mistake by omitting the directional (NE) in the address. However, it also suggests that the mistake is minor and can be corrected through coaching.

7. For Medicare Part A/B effective dates, if the customer states 'February of this year' and the application shows 2/1/14 how will QM score?

Yes

Minor, the ADP/BA did it but did it incorrectly

Major, the application doesn't match what the customer said

N/A

If the ADP/BA states "of this year" for the date, QM will not mark down for this; however, they should be coached

Explanation

If the ADP/BA states "of this year" for the date, QM will not mark down for this; however, they should be coached

8. When collecting the Customer's social security number on the application, the Customer stated "123456789A"; however, "123456789" is listed on the application. How should line item #31 be scored?

The ADP/BA asked for the Social Security number.

The ADP/BA provided the answer.

The ADP/BA skipped this question completely.

Information on the application does not match what was heard on the recording.

If the Customer states their social with a letter after it, QM will not mark down this line item as long as the numbers are correct (e.g., 123456789A).

Explanation

If the Customer states their social with a letter after it, QM will not mark down this line item as long as the numbers are correct (e.g., 123456789A).

9. The customer didn't provide their area code when giving their primary phone number but the area code is included on the application. How will QM score number 32?

Yes with a coaching note to please have the customer include the area code

Minor because the agent did it, but did it incorrectly

Major because the information heard on the recording does not match the application

Major because the agent skipped the area code portion of the question

The correct answer is Major because the information heard on the recording does not match the application. This is because the customer did not provide their area code when giving their primary phone number, but the area code is included on the application. This inconsistency between the customer's response and the information on the application is a significant error that could impact the accuracy and reliability of the recorded data.

Explanation

The correct answer is Major because the information heard on the recording does not match the application. This is because the customer did not provide their area code when giving their primary phone number, but the area code is included on the application. This inconsistency between the customer's response and the information on the application is a significant error that could impact the accuracy and reliability of the recorded data.

10. If the relationship on the POA section of the application is not asked, QM will:

Mark the form Yes, this is not relevant information for the carrier

Mark the form Minor, the ADP/BA did not read the statement/question verbatim

Mark the form Yes, and include a coaching note for the ADP/BA to ask for the relationship

Major, the ADP/BA skipped this question completely or any related questions or statements

If the relationship on the POA section of the application is not asked, QM will not mark down for this line item; however it should be coached

Explanation

If the relationship on the POA section of the application is not asked, QM will not mark down for this line item; however it should be coached

11. The ADP/BA did not ask the customer for the County for the alternate mailing address and the application shows the County is Baylor County. How will QM score this?

Yes with a coaching note

Minor for doing it but doing it incorrectly

Major for skipping a field

N/A

The ADP/BA did not ask the customer for the County for the alternate mailing address, which is a minor mistake. However, since the application shows the County as Baylor County, it indicates that the ADP/BA made an error in entering the information. Therefore, QM will score this as "Yes with a coaching note" to address the mistake and provide guidance for improvement.

Explanation

The ADP/BA did not ask the customer for the County for the alternate mailing address, which is a minor mistake. However, since the application shows the County as Baylor County, it indicates that the ADP/BA made an error in entering the information. Therefore, QM will score this as "Yes with a coaching note" to address the mistake and provide guidance for improvement.

12. The customer's name is William Johnson. On the application, he stated his first name as 'Will' and on the application it appears as 'William'. How will QM score this?

Yes because Will is short for William

Minor because it was done but not done correctly

Major because the application doesn't match what was heard on the recording

Check with a supervisor before scoring down

The correct answer is to check with a supervisor before scoring down because there is a discrepancy between the customer's stated first name and how it appears on the application. It is important to consult with a supervisor in such cases to ensure that the correct scoring decision is made.

Explanation

The correct answer is to check with a supervisor before scoring down because there is a discrepancy between the customer's stated first name and how it appears on the application. It is important to consult with a supervisor in such cases to ensure that the correct scoring decision is made.

13. If the Part A and B effective dates are the same and the Customer only states one date, ADP/BA should clarify if the same date applies to both. If they do not, QM will score Major for this line item.

True

False

If the Part A and B effective dates are the same and the Customer only states one date, ADP/BA should clarify if the same date applies to both. If they do not, then the ADP/BA should be coached

Explanation

If the Part A and B effective dates are the same and the Customer only states one date, ADP/BA should clarify if the same date applies to both. If they do not, then the ADP/BA should be coached

14. What questions on page 1 can an ADP/BA skip and not get marked down? Check all that apply.

Middle name

Primary phone number

Alternate phone number

Title

Alternate address

Alternate contact

Name on the Medicare card

Desired Effective Date

Email address

An ADP/BA can skip the questions on middle name, alternate phone number, alternate contact, name on the Medicare card, title, and email address without getting marked down. These questions are not essential for the purpose of the page and can be left blank without any negative consequences.

Explanation

An ADP/BA can skip the questions on middle name, alternate phone number, alternate contact, name on the Medicare card, title, and email address without getting marked down. These questions are not essential for the purpose of the page and can be left blank without any negative consequences.

Submit

15. The BA/ADP is able to answer which question(s) for the customer on page 1?Check all that apply.

Alternate mailing address

Gender

Desired Effective Date

Medicare Claim Number

Alternate Contact

POA question

The BA/ADP is able to answer the customer's questions regarding the Desired Effective Date and Alternate Contact on page 1.

Explanation

The BA/ADP is able to answer the customer's questions regarding the Desired Effective Date and Alternate Contact on page 1.

Submit