2018 Fl Smmc Healthtrack Choice Tools Quiz

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  • 1/20 Questions
    James is wanting to find a Pediatric doctor for his child. Which Search field would you look under to find a Pediatric doctor? - ProProfs

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

    • • Address
    • • Gender
    • • Panel Status
    • • Specialty
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About This Quiz

The 2018 FL SMMC HealthTrack Choice Tools Quiz assesses knowledge on selecting healthcare plans, finding healthcare providers, and understanding plan enrollment processes, focusing on Florida's Medicaid managed care. It's designed for learners navigating health insurance choices.

2018 Fl Smmc Healthtrack Choice Tools Quiz - Quiz

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  • 2. 
    Which option would you select to enroll into a medical plan? - ProProfs

    Which option would you select to enroll into a medical plan?

    • • LTC Enrollment

    • • Log Contact

    • • MMA Enrollment

    • • New Task

    Correct Answer
    A. • MMA Enrollment
    Explanation
    To enroll into a medical plan, the option to select would be "MMA Enrollment". This option is most likely related to medical plans as "MMA" is commonly used as an abbreviation for "Medicare Modernization Act" or "Medicare Managed Care". Therefore, choosing this option would be the correct choice for enrolling into a medical plan.

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  • 3. 

    Can an OB/GYN doctor be a PCP?

    • • No, Never

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

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

    • • Yes, they are a doctor.

    Correct Answer
    A. • Yes, as long as they are listed as a PCP.
    Explanation
    An OB/GYN doctor can be a PCP as long as they are listed as a PCP. This means that if the doctor is designated as a primary care physician by the healthcare provider or insurance company, they can serve as the primary care provider for patients. The key factor is the official designation or listing as a PCP, which allows the OB/GYN doctor to provide primary care services in addition to their specialty services in obstetrics and gynecology.

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  • 4. 

    To change the LTC Direct Service Provider, the enrollee should call:

    • • DOEA

    • • DCF

    • • Care Coordinator

    • • SSA

    Correct Answer
    A. • Care Coordinator
    Explanation
    The correct answer is "Care Coordinator" because they are responsible for coordinating and managing the enrollee's long-term care services. They have the knowledge and authority to make changes to the direct service provider based on the enrollee's needs and preferences. The enrollee should contact the Care Coordinator to discuss their desire to change the LTC Direct Service Provider and they will guide them through the process.

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  • 5. 

    Can you search for a PCP using a zip code?

    • • Yes, only in certain areas.

    • • No, you can only use an exact address.

    • • Yes, if you type in a zip code and choose a mile radius, it will populate the PCP's in that area.

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

    Correct Answer
    A. • Yes, if you type in a zip code and choose a mile radius, it will populate the PCP's in that area.
    Explanation
    The correct answer states that if you type in a zip code and choose a mile radius, it will populate the PCP's (Primary Care Physicians) in that area. This implies that the search function allows users to find PCPs based on a specific zip code and distance range, suggesting that it is possible to search for a PCP using a zip code.

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  • 6. 
    What plans can this enrollee enroll into? - ProProfs

    What plans can this enrollee enroll into?

    • •A. United Healthcare of Florida

    • •B. Amerigroup Community Care

    • •C. Sunshine Health

    • •D. A and C

    Correct Answer
    A. •D. A and C
    Explanation
    This enrollee can enroll into the plans offered by United Healthcare of Florida and Sunshine Health.

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  • 7. 
    Which of the following plans does Dr. James Joyner accept? - ProProfs

    Which of the following plans does Dr. James Joyner accept?

    • • Simply Healthcare

    • • Humana

    • • Sunshine Health

    • • Amerigroup

    Correct Answer
    A. • Sunshine Health
    Explanation
    Dr. James Joyner accepts Sunshine Health as one of the plans he accepts.

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  • 8. 

    Which search tool options can you use for MMA?

    • • PCP Search only

    • • Specialist Search only

    • • Hospital Search only

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

    Correct Answer
    A. • You can search with Hospital, Specialist, and/or PCP.
    Explanation
    The correct answer is that you can search with Hospital, Specialist, and/or PCP. This means that when using the search tool for MMA, you have the option to search for hospitals, specialists, and/or primary care physicians (PCPs). This suggests that the search tool is comprehensive and allows users to find healthcare providers based on their specific needs and preferences.

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  • 9. 

    If an enrollee is ready to enroll and requests a PCP, but you are unable to locate the doctor in Health Track, you should...

    • • Tell the enrollee to call the doctor to confirm the plans they accept. If they have already received confirmation from the PCP, advise the enrollee that they may enroll without selecting a PCP. Inform them that they will have to contact the plan once it becomes effective to add the PCP or the plan will select one for them.

    • • Tell the enrollee 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.

    • • Advise the enrollee 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.

    • • Advise the enrollee 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.

    Correct Answer
    A. • Tell the enrollee to call the doctor to confirm the plans they accept. If they have already received confirmation from the PCP, advise the enrollee that they may enroll without selecting a PCP. Inform them that they will have to contact the plan once it becomes effective to add the PCP or the plan will select one for them.
    Explanation
    If you are unable to locate the doctor in Health Track, the correct answer is to tell the enrollee to call the doctor to confirm the plans they accept. If they have already received confirmation from the PCP, advise the enrollee that they may enroll without selecting a PCP. Inform them that they will have to contact the plan once it becomes effective to add the PCP or the plan will select one for them. This ensures that the enrollee can proceed with enrollment and have the option to add their preferred PCP later on.

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  • 10. 

    "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 caller referring to?

    • • Home Delivered Meals

    • • Hospice

    • • Personal Care

    • • Nutritional Assessment/Risk Reduction Services

    Correct Answer
    A. • Nutritional Assessment/Risk Reduction Services
    Explanation
    The caller is concerned about providing the right foods for their grandfather who has Crohn's Disease. They mention that his stomach is sensitive to a lot of foods and they want to avoid worsening his condition. This indicates that the caller is seeking guidance and assistance in determining the appropriate type of food for their grandfather. Therefore, the covered service that the caller is referring to is Nutritional Assessment/Risk Reduction Services, which can provide professional advice and assessment to help manage the grandfather's dietary needs.

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  • 11. 

    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?

    • • 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.

    • • 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.

    • • 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.

    • • 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.

    Correct Answer
    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.
    Explanation
    The correct answer is to search for Meals on Wheels and inform the caller about the LTC plans they accept. However, the agent cannot assign Meals on Wheels directly. Instead, a Care Coordinator from the plan will assist in assigning the providers once the plan becomes effective. This ensures that the caller can continue using Meals on Wheels while also receiving assistance from the plan in assigning providers.

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  • 12. 

    If the caller does not have a PCP you should:

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

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

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

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

    Correct Answer
    A. • Offer to search for a PCP in the area, ask for preferences such as male or female, a language preference, etc.
    Explanation
    The correct answer is to offer to search for a PCP in the area and ask for preferences such as male or female, a language preference, etc. This option demonstrates proactive customer service by assisting the caller in finding a suitable PCP based on their preferences. It shows that the company is willing to go the extra mile to help the caller navigate the process of finding a healthcare provider.

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  • 13. 

    When will the enrollee receive the health plan ID card and membership information from the plan?

    • • As soon as the enrollee enrolls with the plan.

    • • After the enrollment becomes effective.

    • • During open enrollment.

    • • 7-10 business days after the enrollment is completed.

    Correct Answer
    A. • After the enrollment becomes effective.
    Explanation
    The enrollee will receive the health plan ID card and membership information from the plan after the enrollment becomes effective. This means that the enrollee will receive the card and information once their enrollment is processed and they are officially enrolled in the health plan. The timing of when the enrollment becomes effective may vary, but it typically occurs shortly after the enrollment is completed.

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  • 14. 

    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?

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

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

    • • 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.

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

    Correct Answer
    A. • 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.
    Explanation
    The correct answer is to 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. This is the appropriate response because Mr. Bannerman does not have a Primary Care Provider and needs assistance in finding one. The plan allows for the option of assigning a PCP if he does not choose one himself.

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  • 15. 

    The caller is currently enrolled into a plan. The caller states that they are happy with the plan and do not want to process a plan change, but they need to change the PCP.  How do you proceed?

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

    • • Refer to the Medicaid Helpline to change the doctor.

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

    • • Change the doctor through HealthTrack.

    Correct Answer
    A. • Tell the caller to call the health plan to change the doctor.
    Explanation
    The correct answer is to tell the caller to call the health plan to change the doctor. This is the appropriate course of action because the caller is currently enrolled in a plan and wants to change their primary care physician (PCP). The best way to do this is by contacting the health plan directly, as they will have the necessary information and processes in place to facilitate the PCP change.

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  • 16. 

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

    • • 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.

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

    • • 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.

    • • 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.

    Correct Answer
    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.
    Explanation
    The correct answer is to 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 becomes effective. This response acknowledges that the provider may accept Humana in the future but is not currently listed in HealthTrack. It also provides a solution for Mrs. Osborne to contact the plan and make the necessary arrangements once her plan becomes effective.

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  • 17. 

    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. Anita wants to know if she must choose the same plan for both of them because they are on the same case. What should you inform Anita?

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

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

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

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

    Correct Answer
    A. • No, she can choose a different plan and PCP for each enrollee.
    Explanation
    You should inform Anita that she does not have to choose the same plan and PCP for both herself and her daughter. They can choose different plans and PCPs for each enrollee.

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  • 18. 

    "My aunt is on a lot of medications for her liver disease.  She has a new medication that makes her throw up every time she takes it.  She usually gets blood drawn every month to check her levels, but that has not happened in over 6 months. I don't think her medicine is right." Which covered service is the caller referring to?

    • • Medical Equipment and Supplies

    • • Medication Administration

    • • Caregiver Training

    • • Medication Management

    Correct Answer
    A. • Medication Management
    Explanation
    The caller is referring to the service of Medication Management. This is indicated by the statement that the aunt has a new medication that makes her throw up every time she takes it, and the fact that her blood levels have not been checked in over 6 months. This suggests that the medication may not be right for her, and highlights the need for proper management and monitoring of her medications.

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  • 19. 
    What do the numbers in the boxes indicate? - ProProfs

    What do the numbers in the boxes indicate?

    • • How many of each kind of provider are available through the plan.

    • • The number of enrollees that type of provider will accept.

    • • The provider rating for the plan.

    • • The saved provider selection based off the search results.

    Correct Answer
    A. • The saved provider selection based off the search results.
    Explanation
    The numbers in the boxes indicate the saved provider selection based off the search results. This means that the numbers represent the providers that have been selected or saved by the user after conducting a search.

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  • 20. 
    Which of the following services does this direct service provider cover? - ProProfs

    Which of the following services does this direct service provider cover?

    • • Adult Daycare

    • •B. Medication Administration

    • •C. Attendant Care

    • •D. Both B and C

    Correct Answer
    A. •D. Both B and C
    Explanation
    This direct service provider covers both medication administration and attendant care.

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Quiz Review Timeline (Updated): Dec 20, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Dec 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 21, 2017
    Quiz Created by
    AHSFLTrainer

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